The buzz has been over an EDITORIAL. Repeat, an editorial... in other words, an opinion. It was the opinion of the author(s). Based upon a brainstorming meeting facilitated by the NCI, published in the Journal of the American Medical Association, it appears the working group included ten doctors plus the three authors who chaired the panel.
Do we lose the word cancer in favor of less scary words? How do we handle overtreatment? Specific to the breast cancer community, it's all about DCIS. I'm not going to throw my two cents into this discussion. It's been quite ably addressed in a number of publications and on several blogs. Those diagnosed with DCIS are faced with agonizing decisions. The odds aren't good enough to ignore the diagnosis.
Bottom line, there could have, there might have been a patient included on that NCI assembled working group. We don't bite. We are respectful. We know we bring a specific point of view and we aren't trying to be doctors. We learn by listening but it must be a two way street. We may have brought some value, some perspective to the table.
"Physicians, patients, and the general public must recognize that overdiagnosis is common and occurs more frequently with screening."
Yes. We are well aware. The patient voice..... Where was it? We, as advocates, carry the message into our communities.
And, for what it's worth, the NIH provided partial funding for this study which was published in March. The study looked at next generation sequencing as A Powerful Tool for the Discovery of Molecular Markers in Breast DCIS. It's Medscape, you need a login, but here's the bottom line, direct from the publication:
"Despite intensive research, robust biomarkers that would predict the risk of progression or recurrence in DCIS have not been discovered.......there is an unmet need to identify important markers in DCIS and that the study of biomarkers for DCIS is still in its infancy."
Until DCIS can be identified with a better certainty, nothing changes. It's all about having a conversation. The risk/reward conversation.
And that is the message I bring to the breast cancer community.
Talk to your doctor.
Ask for an explanation of the words in the pathology report.
In fact, it might not be a bad idea to have the slides looked at under the microscope of a second pathologist.