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What's in a name: Describing ductal carcinoma in situ (DCIS).
J Clin Oncol 32, 2014 (suppl; abstr e12020)
Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).
Background: Despite aggressive management of DCIS invasive breast cancer incidence continues to rise. Data suggest that many women, especially those with screen detected low and intermediate grade DCIS, may be over treated. In the absence of definitive data about its natural history and consequently true risks of ever becoming invasive cancer, is it even appropriate to describe DCIS as cancer at all? A new trial in the UK, LORIS (Low Risk DCIS), compares surgery with active monitoring. Recruitment is likely to be challenging as the word carcinoma in DCIS may lead women to think that they have breast cancer, so clinicians must describe the condition in a balanced manner. We conducted a survey amongst the multidisciplinary British Breast Group (BBG), to determine which descriptions of low grade DCIS should be used when discussing the LORIS trial with patients. Methods: Attendees at the February 2013 BBG meeting participated in a questionnaire survey comprising 5 short descriptions adapted from UK cancer charities’ websites and one designed by the LORIS Trial Management Group (TMG). Respondents indicated if they would feel comfortable using each description with patients, then to state their most preferred and most disliked descriptions. Results: 54/73 (74%) attendees completed the survey: surgeons (41%), oncologists (24%), radiologists (13%), scientists (12.9%), pathologists (5.5%), other (3.6%). A majority (34/54; 63%) said they would be comfortable using the description which explained DCIS as abnormal cells in the milk ducts that had not spread into other breast tissue and which did not need urgent treatment as if it was breast cancer. This one, devised by the LORIS TMG was also the most preferred description (24/54; 44%). Portrayal of DCIS as the earliest possible form of breast cancer was the least preferred description (17/54; 31%). Conclusions: Little consensus exists regarding how best to explain low grade DCIS to patients. Cancer charity websites and clinicians use different terms. There is an urgent need when discussing DCIS trials, especially those with an active monitoring arm, to use consistent, accurate but non-alarming terminology avoiding the use of the words ‘early breast cancer’.
Abstracts by Lesley Fallowfield:
Denosumab or zoledronic acid (ZA) therapy on pain interference and cancer-specific quality of life (CSQoL) in patients with castrate-resistant prostate cancer (CRPC) and bone metastases (BM).Category: Genitourinary Cancer - Prostate Cancer
Impact of skeletal-related events on pain and analgesic use in patients with solid tumors and bone metastases.
Presentations by Lesley Fallowfield:
Effects of denosumab versus zoledronic acid (ZA) on health-related quality of life (HRQL) in metastatic breast cancer: Results from a randomized phase III trial.Session: Breast Cancer - Metastatic (Poster Discussion Session)