Plus my 4-step, natural approach to preventing DCIS in the first place
I’ve often reported that some conditions considered “pre-cancerous” typically never lead to cancer. For years, doctors and researchers have pointed out that these frequently innocuous health issues get treated as cancer precursors—even though they don’t behave like cancer at all.
This practice has led to an epidemic of overdiagnosis and overtreatment of “cancer.” And this overdiagnosis epidemic has created unnecessary costs, confusion, and worry. Not to mention very real, very negative side effects from unnecessary treatments.
This is particularly true for certain conditions related to the skin, thyroid, prostate, and breasts.
One of the biggest culprits is something called ductal carcinoma in situ (DCIS). Basically, DCIS is defined as “abnormal” cells discovered by a mammogram within a woman’s breast ducts.
The American Cancer Society reports that about 60,000 women were diagnosed with DCIS in 2015, accounting for almost 20% of all new breast “cancer” cases.
Mainstream oncology calls DCIS the earliest sign of breast cancer, and typically treats it as a medical emergency. Oncologists will order a lumpectomy within two weeks after diagnosis, followed by radiation.
Cancer organizations say this aggressive treatment of DCIS saves thousands of lives. But a new study on more than 100,000 women found that DCIS was associated with only a 3.3% rate of breast cancer deaths after 20 years.
That’s similar to what the American Cancer Society cites as the risk of an average woman dying of breast cancer.1 In other words, you’re no more likely to die of breast cancer if you’re diagnosed with DCIS than someone without this diagnosis.
And, considering a five-year survival rate is the typical benchmark for success in treating cancer, DCIS hardly qualifies as the medical emergency so many clinicians treat it as.
In fact, surgery and radiation does not appear to be necessary at all for the vast majority of women with DCIS. It is only warranted in a small number of cases.
Assessing your own DCIS risk profile
Researchers analyzed 108,000 cases of DCIS diagnosed from 1988 to 2011. As I mentioned above, they found that 20 years after a DCIS diagnosis, the average death rate from breast cancer was only 3.3%— which was somewhat lower than previous findings.
However, depending upon other risk factors, some women who are diagnosed with DCIS have a much higher chance of eventually dying from breast cancer.
For example, the researchers found that women under age 35 who were diagnosed with DCIS had a breast cancer death rate of 7.8%. That’s likely because women that young typically have much more aggressive forms of cancer growth than do older women.
Looking at the characteristics of the breast tissue cells in DCIS is also important. Risk factors to watch include the cells’ response to estrogen (estrogen receptor status), size, appearance (grade), and whether there’s surrounding tissue death. Women with higher-grade DCIS cells were 1.9 times more likely to die compared to women with lower-grade cells.
Finally, the researchers noted that African-American women with DCIS also had a higher mortality rate—7%.
Overall, 20% of women with DCIS had one or more of these other characteristics that placed them at higher risk of eventually succumbing to breast cancer. These are the women whom researchers said probably should have lumpectomies and radiation if they’re diagnosed with DCIS.
For the other 80% of women with DCIS, the researchers discovered something quite surprising.
Aggressive treatment doesn’t improve chances of survival
The 80% of women in this category who had a lumpectomy plus radiation, or even a mastectomy, were no less likely to die from breast cancer than women who didn’t have those surgeries and treatments.
The main goal behind aggressive DCIS treatment has always been to prevent the “cancer” from spreading within the same breast. Of course, if breast cancer becomes invasive, it dramatically increases the risk of death. For example, the researchers noted that the risk of dying was 18 times higher in women whose cancer had spread within the same breast.
The researchers found that, as expected, women with DCIS who had a lumpectomy plus radiation reduced their risk of abnormal cell recurrence after 10 years—from 4.9% for women who didn’t have treatment to 2.5% for women who did have treatment.
But the researchers were surprised to discover lumpectomy and radiation didn’t lower the women’s chances of dying from breast cancer.
Even the more radical surgery of mastectomy didn’t reduce breast cancer mortality.
In fact, the death rate among mastectomy patients was higher (1.3%) compared to lumpectomy patients (0.8%). The researchers believe that’s because women who have mastectomies tended to have higher-grade cancers in the first place
These findings all run counter to the dogma that DCIS is a precursor to cancer. And that more invasive cancer therapy leads to better outcomes.
To recap, the researchers found that 80% of DCIS diagnoses are low risk, and could be best treated by “prevention strategies.”
You read that right. Mainstream medicine is finally talking about prevention rather than “early diagnosis” (i.e. overdiagnosis) and “aggressive treatment” (i.e. overtreatment). Of course, that’s something I’ve been talking about for 30 years. But better late than never.
My own personal experiences have shown me that an ounce of prevention is indeed worth a pound of “cure”—especially when it comes to cancer.
In 1977, my 82-year-old grandmother, a life-long resident of France, was diagnosed with DCIS.
She had never once in her life had surgery of any kind, and refused to have surgery then. Instead, doctors treated her with radiation to the chest. The cancer never spread and was “cured,” but the radiation severely damaged her lung tissue. She developed respiratory failure and died in 1983.
I remember traveling to France after my grandmother’s radiation treatments to try to find appropriate long-term care for her. She was living in Provence, but I had to meet with a government physician in Paris to start the process. (Since the time of Napoleon I, 200 years ago, the French government has been highly centralized in Paris).
I remember the female government physician arrived for our appointment late, wearing a fur coat. (Admittedly, the French government offices were not well heated.)
And I wondered just what I was going to have to do to get her attention.
Shortly thereafter, I began professional research on risk factors for breast cancer, and eventually completed my Ph.D. dissertation on the topic. Even then, the evidence pointed to nutrition, growth, and development during childhood, and reproductive factors during early adulthood, as the keys to whether a woman was likely to develop breast cancer. All of the attention at the National Cancer Institute on adult weight and dietary factors, such as fat intake, was completely misplaced.
My dissertation results were published in the medical and scientific literature 30 years ago. But aside from a few colleagues such as Walt Willett at Harvard, nobody paid attention. Certainly not my bureaucratic government bosses who were busy wasting money pursuing every naive theory about breast cancer (and other cancers).
Ironically, last summer, after 30 years and hundreds of millions of dollars in research funding, I read how a career cancer expert had just “discovered” we need to look at factors during childhood to control the breast cancer epidemic!
Noninvasive, effective steps you can take to lower your risk of breast cancer
It’s clear that mainstream medicine has been way off in its approach to breast cancer—from useless mammography screenings, to mistaken assumptions about the dangers of DCIS, to largely ignoring childhood experiences, and the real dietary factors, and refusing to confront the reality of all the reproductive factors.
So what can you do to lower your risk of breast cancer? Here’s my 4-step, evidence-based approach.
1. Load up on fruits and vegetables. A new study of 1,042 women found that carotenoids— alpha-carotene, beta-carotene, lycopene, lutein, and zeaxanthin— may help prevent breast cancer. Not only are carotenoids powerful antioxidants that can protect against DNA damage, but the researchers noted that they may even help keep normal cells from mutating into cancerous cells.
Alpha-carotene is found in orange foods like pumpkin and carrots. Beta-carotene is also found in carrots, along with leafy greens and peppers. Lycopene is what makes foods like tomatoes, watermelon, and grapefruit red. And you can find high doses of lutein and zeaxanthin in leafy greens.
2. Take your daily vitamins. Of course, all of the fruits and vegetables I mentioned above are also high in B and C vitamins. But I also recommend taking a high-quality B-complex vitamin every day, along with 250 mg of C twice a day.
A variety of studies have shown that vitamin E can also help prevent breast cancer. I recommend 50 mg per day.
And it’s no surprise that the wonder vitamin, D, has been shown in numerous studies to be protective against breast cancer. Or if you are diagnosed with breast cancer, a long-term study involving 4,443 women shows that taking higher levels of vitamin D improves quality of life and doubles your chances of survival. I recommend 10,000 IU of D3 every day.
3. Eat calcium-rich foods. Research shows that calcium and vitamin D together are protective against breast cancer. It’s essential you get calcium from your diet, as calcium supplements are ineffective and dangerous. So make sure to eat plenty of seafood and healthy meat and dairy.
4. Supplement with selenium. Research shows this mineral can help suppress a protein involved in tumor development, growth, and metastasis. In fact, an analysis of nine studies involving more than 150,000 people found that selenium supplementation cut the risk of all types of cancer by 24%.
I recommend 50-200 mcg of selenium each day.
Bottom line: If you have a breast biopsy that shows DCIS, be sure to consult with your doctor about all your options—not just invasive surgery and radiation. The new research shows that when it comes to treating breast cancer, for the vast majority of women, less is more.
Your 3-step DCIS risk-assessment checklist
To assess your own DCIS risk, answer the following questions:
1. Are you age 35 or younger?
2. Are you African American?
3. If you’ve been diagnosed with DCIS, are your DCIS cells higher-grade? (If you aren’t sure, ask your oncologist)
If you answered “YES” to any of these questions, more aggressive treatment may be warranted if you’re diagnosed with DCIS. If not, chances are there’s no harm in “watchful waiting.”
“Rethinking the Standard for Ductal Carcinoma In Situ Treatment.” JAMA Oncol. 2015;1(7):881-883.
“Specific serum carotenoids are inversely associated with breast cancer risk among Chinese women: a case–control study.” Br J Nutr. 2015 Oct 20:1-9.
“Meta-analysis of vitamin D sufficiency for improving survival of patients with breast cancer.” Anticancer Res. 2014 Mar;34(3):1163-6.
“Effects of selenium supplements on cancer prevention: meta-analysis of randomized controlled trials.” Nutr Cancer. 2011 Nov;63(8):1185-95.