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Making Decisions

Risk and Risk Factors

Risk information is complex and can be presented in various ways. Women diagnosed with DCIS will often hear about risk and risk factors. Many feel confused and scared when they hear numbers about risk. Studies have shown that women often overestimate breast cancer risk. For example, the chance of DCIS returning and dying from breast cancer. Having a clear understanding of DCIS risk can help women to make informed treatment decisions.

Past Uncertainty and Differing Information

DCIS has only recently become a more common diagnosis. This is due to increased mammography screening. Risk from DCIS is often uncertain and unclear. Studies have found gaps in knowledge about DCIS. Women often receive different advice about treatment options. Experts disagree about what the risks are and how they can be reduced. Medical experts cannot accurately predict which DCIS will lead to invasive breast cancer. The best choice of treatment may be based on personal values.

Understanding Relative Risk versus Actual Risk

Researchers study health conditions that populations have in common. If enough people have common experiences, these become risk factors. It can be hard to estimate risk for an individual person. Risk information may use different rates of developing a disease. This makes comparison difficult.

Results of studies can be misleading and confusing. The numbers may be presented in terms of relative risk. This is instead of being presented in terms of absolute risk. Understanding the difference is essential.

Trade-offs among DCIS Management Strategies

There are trade-offs among management strategies for DCIS. A trade-off means giving up one thing in return for another. For example, lumpectomy reduces the risk of invasive breast cancer. Yet the trade-offs may include both short and long-term side effects. These may include loss of feeling, disfigurement and pain. There can be surgical complications and a possibility of more surgery. This may be needed to assure all DCIS is removed. Active surveillance involves no immediate treatment. There is a slightly greater risk of changes to your DCIS over time.

The importance women attach to DCIS outcomes may differ. For example, patients may weigh quality of life factors differently. Women should feel comfortable and supported in taking the time they need to make decisions. If uncertain about treatment options, women should seek a second opinion. This is not only appropriate but recommended for DCIS treatment.


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