This was the heading of the cover of the prestigious Time magazine for its October 12, 2015 issue and it was addressing “Breast cancer’s new frontier.” I would say that I was intrigued and concerned of such a title that made me shuffle the pages to get to this article which I read rapidly. My surprise turned into disappointment.

I found that this title was misleading since this was referring only to Ductal Carcinoma In Situ (DCIS). An early cancer of the breast confined to the ducts or, as I explain to my patients, “a crab without legs” unable to invade or go to other places. This type of tumor represent only 20 to 25% of the women with cancer of the breast.

The genesis of DCIS has two theories behind it. An old one that believes that this is a different tumor and it will be always DCIS. Therefore the risk is the same regardless how early or advanced it is; or the current one that most of us believe is an intraductal tumor that will eventually evolve in an invasive one, given the opportunity. Therefore, it should be taken care sooner rather than later.

The treatment of DCIS is also surrounded by controversy and confusion that includes the patient’s panic in trying to get rid of the disease as soon as possible and prevent any chance of similar event. That calls for double mastectomy, a procedure that definitely is overused with the excuse of “patient’s choice”.

While the majority of patients are treated with more conservative and more realistic procedures as lumpectomy, wide excision and partial mastectomy commonly followed by radiotherapy and anti-estrogen hormonotherapy. All of them carrying certain degree of toxicity from burning of the tissues in the area of radiation to the systemic side effects of hormonotherapy specially inducing menopausal symptoms in young women.

Now, “active surveillance” that must be reserved for certain post menopausal patients when specific favorable factors are present as patients age and comorbidities, size and tumor characteristics, type of DCIS, location, extension, presence of Estrogen receptors and others.

The majority of early cancer of the breast patients are referred to surgeons who properly advise the patients in most of the cases. When a patient has a concern that requires a second opinion, I usually recommend to be given by a medical oncologist keeping in mind the type of surgical indication already given.

Recent Posts



Your feedback is important. If this

is an urgent matter, please contact your clinic as responses may take up to 48 - 72 hours. For all other inquiries, please...


  • Facebook Social Icon
  • Twitter Social Icon
  • Instagram Social Icon
  • LinkedIn Social Icon
  • YouTube Social  Icon

The Oncology Consultants Overcoming Cancer

logo is a registered trademark.

Texas Medical Center
2130 W. Holcombe Blvd., 10th Fl.
Houston, TX 77030
Memorial City
925 Gessner Rd., Ste. 600
Houston, TX 77024
23960 Katy Freeway, Ste. 325
Katy, TX 77494
Sugar Land
17520 W Grand Pkwy S., Suite 460
Sugar Land, TX 77479
Greater Heights 
1631 North Loop West, Ste. 410
Houston, TX 77008
13215  Dotson Rd., Ste. 340
Houston, TX 77070
11920 Astoria Boulevard, Ste. 150
Houston, TX 77089
7789 Southwest Fwy, Ste. 460
Houston, TX 77074
1920 Country Pl. Pwy, Ste. 370
Pearland, TX 77584
27700 Northwest Freeway, Ste. 400
Cypress, TX 77433
League City
2555 Gulf Freeway S., Ste. 700
League City, TX 77573
Precision Cancer Center
10405 Katy Freeway, Ste. 150E
Houston, TX 77024
3333 Bayshore Blvd., Ste. 250
Pasadena, TX 77504