KOMEN SAYS WHAT???

cinnamonsmiles

Radiation therapy

Radiation therapy is not given to women who are treated with mastectomy for DCIS.

In contrast, lumpectomy for DCIS is usually followed by radiation therapy to lower the risk of invasive breast cancer and DCIS recurrence [66,78-82]. Select women with smaller, lower grade DCIS and clean surgical margins, may be candidates for lumpectomy without radiation therapy [66,83].

Overall survival appears to be similar for women with DCIS who have lumpectomy with or without radiation therapy [79-80].

 http://ww5.komen.org/BreastCancer/RecommendedTreatmentsforDuctalCarcinomaInSitu.html

I was looking for information on standard of care for DCIS for a lady on here whose insurance denied her mastectomy.I was TOTALLY FLOORED when I read this.

Radiation is not given to women who had a MX??? I think that is totally wrong for people who had dirty margins after the mastectomy!!! Way to go to give insurance companies more ammunition to deny treatments!! 

And now they want to pave the way so insurance companies deny rads with lumpectomies???

UNREAL!!!

Anyone else disgusted by this info? 

Beesie

I'm a bit frustrated by this, but not disgusted.  Treatment standards are ever-changing and until very recently it was quite true that rads was never (or virtually never) given after a MX for DCIS.  So Komen are just a little out of date.  And in this case the change in treatment standards is actually moving towards giving rads, rather than moving away from it. 

In fact the NCCN guidelines - which is the gold standard for treatment guidelines - just changed their statement on this very recently (just in their latest edition, I believe). Previously they said that rads was not required after a mastectomy for DCIS. What the NCCN guidelines currently say in their DCIS section is that "Radiotherapy is not needed following a mastectomy unless cancer cells are found in the tissue margin." So the only condition on which they are saying rads might be necessary is if the margins are positive.  http://www.nccn.com/files/cancer-guidelines/breast/index.html#/62/ 

Komen does refer readers to the NCCN site.  And at least Komen call DCIS breast cancer, which is better than some other websites.  Dr. Love's website calls DCIS a pre-cancer and in discussing treatment options, rads is only mentioned as part of the discussion about breast conservation surgery (i.e. lumpectomy). Even there it's stated that "There is currently a controversy about whether radiation is necessary following breast conservation surgery." So if we are talking about messages that are potentially misleading and subject to misinterpretion (or that might lead someone newly diagnosed down a dangerous path), I worry much more about what's written on Dr. Love's site.   http://www.dslrf.org/mwh/content.asp?L2=3&L3=2&SID=164