This scares the crap out of me...

Came across this article and other than not being A black women and under 35, I win the prize of all the rest of the risk factors. I was nervous before but this doesn't help!

A number of factors were identified that predict whether invasive breast cancer and death are more likely to occur. The death rate was higher in black women and in women who were diagnosed before age 35, making both of these key risk factors. Additional risk factors include:

• a DCIS that is larger than 1 cm. (1/2 inch).

• a DCIS that is insensitive to hormones (no estrogen or progesterone receptors).

• a DCIS that is of higher grade (more cancer-like).

• a DCIS showing increased cell death (comedonecrosis).

While these factors have been suspect for some time, having them confirmed in such a large study makes us more comfortable in sorting out which DCIS patients are more or less likely to die from an invasive breast cancer.

For DCIS types associated with high risk factors, it may be more beneficial to consider systemic therapies, like chemotherapy or hormonal therapy.

The second paper published in JAMA, "Rethinking the Standard for Ductal Carcinoma in Situ Treatment," reviews treatment options in light of these new findings.

So, what should you do if you are diagnosed with DCIS?

As always, the best advice is to get a second opinion, and the best place to get it is at a well-known and respected breast cancer center. Their experts will evaluate your risks and discuss with you all the treatment options available. With the identification of factors more likely to be associated with death, there is now the real possibility of tailoring treatment depending on a woman's individual risk.

Remember the good news is that all DCIS tumors are not the same – some are associated with higher risk for breast cancer death; others are not.

In addition, 97 percent of the time, DCIS does not result in a death from breast cancer. And if you have few or none of the high-risk conditions, your prognosis is even better that 97 percent.

Mary E. Costanza, MD, is a professor of medicine at University of Massachusetts Medical School.