Posted: September 9, 2015

Recall the last news posting here about a month ago, in which Dr. Stark lambasted a new study purporting to show that Ductal Carcinoma in Situ of the breast is being overtreated.  Now comes a front-page story from the New York Times in which a prominent breast surgeon from San Francisco is profiled.  The essence of the article is that other surgeons recommend aggressive surgery for DCIS, but when women come to her she disabuses them of that idea and agrees to just follow them.   The article makes her into a cult figure protecting women’s right to decide their own fate instead of going along like sheep.  Dr. Stark weighs in, “This article, prominently featured in the world’s most important newspaper, does a disservice in my opinion to the world of breast cancer.   There are really no controlled data to support watchful waiting.  Studies in the past have shown that when a breast biopsy is misinterpreted as atypia (benign) when it is really DCIS patients get inadequate treatment and some of them go on to die of breast cancer.  With that information in the background it is hard to recommend watchful waiting in the absence of a new randomized trial showing that waiting gives identical outcomes.  We haven’t heard the last of this.”