They can't always find it even with biopsy yet they spend millions trying to find it with imaging.

We need a breakthrough because we seem to be going around in circles.

We're treating people to death in this country. Radiation and chemo can kill you so it is time to stop overreacting to faint signs of possible cancer. Of course, doctors often overeact because they don't like being sued and do like the revenue from the possibly unneccessary treatment and surgery. Lets lump the lawyers in there too for some blame since they jump on any lack of action as a reason to for a lawsuit. Our medical system is broke. No wonder we spend so much needless money on health care in this country with no gain in life expectancy.

I have always had a lingering doubt as to whether my DCIS was a correct diagnosis. This was 13 years ago, is there any way this can be checked?

3 out of 4 of my mothers sisters have been diagnosed with breast cancer 2 of which have already had their breast removed and have undergone kemotherapy. The 3rd just started kemo 2 days ago, she's only 36 years old. It would be really sad if this was all unnecessary. All the pain and heartache they and the family have been through. This really needs to change.

Do some early stage cancers just go away? What did people do before they had access to so many tests? Was there the same amount of cancer then?

As can be seen by many of these comments, people are confusing DCIS with Invasive Ductal Cancer. And I doubt anyone can EVER "over-react" to cancer. What a ridiculous statement. I have just finished my last radiation treatment, and I went through Chemotherapy earlier this year. If I am alive 5 years from now it is BECAUSE of these "over-reactions." I'm guessing that those who posted above have no CLUE that there are over 30 different TYPES of breast cancer?! If you knew that, your reading of the article would have produced far different commentary.

Nanato3: Yes, if you had surgery to remove the DCIS, it would have been checked when the tissue that was surgically removed was sent to pathology. It's challenging to diagnose DCIS from a fine needle biopsy but it's easier from a large surgical specimen. Just check the pathology report from after the surgery.

We used to hear that we should get screened, get preventive care, catch it early and live longer - whatever "It" is. And, as soon as the Healthcare bill passed, we hear how we are being tested too much, too soon, and how inaccurate it is. I can't help but wonder whether it is a coincidence. Could it be that we can't trust what we read anymore? Could it be that this is just the government's way of trying to create a different mindset for the masses so we go to doctors less often because our government is already concerned about controlling the costs? Could this be just one tactic to control healthcare and begin rationing?

I've had DCIS and I went through everything Ms. Long went through. I started with a mammogram with suspicious showings. Then an ultrasound that was not conclusive. Next a needle biopsy that had me on my stomach with my breast between a board for hours. Finally, I had an open breast biopsy that showed DCIS or so I was told. I had radiation and currently on Tamoxifen for another year. After reading this article I am curious just how many other women have gone through this unnecessarily and with irreversible consequences (taking out breast tissue), only to be misdiagnosed and probably never know it. I'm afraid to ask for a retest to see if I was misdiagnosed. It’s been 4 years and nothing is reversible so I don’t want to know. It's too late to get my breast tissue back. I feel for Ms. Long, because I would be livid with the pathologist if my results were wrong. Instead of a law suit I might be inclined to take something away from the doctor like balls he could not get back.

I hope she wins a great deal of money.

So you arbitrarily select 12 people from history and feel that it supports your argument that our life expectancy isn't increasing?  That doesn't even register a blip in statistical analysis.

If, as stated in the article, up to 30% of DCIS can progress to invasive (malignant) breast cancer, how much treatment would you be willing to go through to eliminate that risk? None?

The article really does not do justice to the extreme difficulty of diagnosing some forms of DCIS. Even among experts there is disagreement in a surprisingly large number of cases. The problem is that we are trying to diagnose very early forms of a potentially deadly disease in order to provide the earliest possible chance at therapy and cure. Walking that thin line in any area of medicine is going to create a situation where some cases are overdiagnosed in the interest of allowing early treatment for the majority. Sometimes that is due to lack of skill in the pathologist, but much more often it is a well considered opinion that the pathologist agonizes over, patient always in mind, and finally decides he or she believes the slide contains DCIS based on the presence of some criteria. Many pathologists in community hospitals send the very difficult cases to tertiary centers with known experts in the field. In most cases, there is little but the ego of the pathologist to prevent this from happening since the hospital covers the cost in order to provide better care for the patient. However, if the hospital has an agreement with another facility, such as seems to be the case in Dr. Vi's consult, probably as a cost-saving measure, then the pathologist can not easily send the case to someone whose opinion they trust more. Regardless, it is quite rare for a case to be reviewed by three different pathologists and all of them to agree on a misdiagnosis so peer review at other community hospitals is often effective. In this case, the disagreement about the variant of the disease could have been a clue that the case may need further review.

In the case of lawsuits, such as described in the article, there will of course be experts agreeing that a case was misdiagnosed. They are hired by the plaintiff to do just that. I expect there are also experts that reviewed the case for the defense who agree that it was a reasonable diagnosis. That doesn't necessarily mean that the experts are being dishonest. It is a reflection that this really is a gray area and trying to interpret and predict the likely biologic behaviour of these lesions based on subtle and overlapping microscopic cytoarchitectural features is easily one of the most challenging areas of medicine. The vast majority of lawsuits in this area are unsuccessful but costly.

I do applaud the CAP for trying to create a "certification", but an arbitrary number of cases per year is a terrible benchmark. There are some very skilled pathologists in community hospitals who might see 50-100 cases per year and there are some terrible pathologists in large medical centers or private laboratories who see several hundred per year. I have personally seen some terribly inept diagnoses coming out of very well regarded medical centers and have seen community pathologists catch significant misdiagnoses prior to patients recieving chemotherapy at their hospitals. Of course, the opposite is also true. A proficiency test system such as that already in place for Pap smears would be more effective, educational and meaningful.

I agree with Shelley Dee-1489259. I wish "journalists" would report the facts and not their suppositions. I see this in every area of "journalism."

I was recently diagnosed with Invasive Ductile Carcinoma, Stage 2. I had two biopsies by different pathology groups and both agreed. I had two lumpectomies since some of the cancerous tissue was missed during the 1st surgery (it happens and they tell you that up front). Both post-surgical pathology reports showed the cancer present in the removed tissue. I asked for copies of the reports each time the procedures were done. I did nothing until I had the report in hand. We need to learn to understand these reports and it is not that hard. Chemo was not necessary for my type of cancer and I had radiation therapy. I chose to take Femara for the next 5 years - that was a choice available, not an absolute necessity.

All this said to support previous postings that we need to educate ourselves about the many types of cancer so that we are not knocked over by the "journalistic" winds that blow with information that is complete enough for us to be truly informed. This is true of all medical procedures/treatments. Educate yourself and then augment your education again and again.

Wow, interesting reading.  I too was diagnosied with DCIS.  That was nine years and one mastectomy ago.  I have no idea whether the diagnosis was correct, although I prefer to believe that it was.  Yes, diagnosis and treatment were difficult and frightening, for both myself and my family.  I am personally grateful for the level of care I received, the choices I was allowed and encouraged to make for myself and the compassion of my medical staff.  We all have some differences and similarities in our experiences and stories.  The biggest similarity and the one I am most grateful for is that we are all alive to tell our story. 

I also was diagnosed with DCIS. Went for my yearly mammogram,then went for a biopsy in 2 areas of my right breast. Got the news that I had DCIS, and went off to see a surgen to perfom a lumpecomy. When I went for the day of surgery they had put a needle sticking out of my breast so the surgen could find where my marker was. The needle was no where near where my biopsy was. Then before I knocked out on the OR table the stopped surgery. The doctor told my family that the marker had moved. But then I was called in to have another mammogram and they said that I have 4 more areas that probably could be more DCIS. So then I had to go through a mastecomy. I only then ended up having just the one area of DCIS. I believe there was many mistakes in my situation with DCIS.

@ Unit Price Flying in Seattle "I would be livid with the pathologist if my results were wrong. Instead of a law suit I might be inclined to take something away from the doctor like balls he could not get back."
"I hope she wins a great deal of money."

@ Unit Price Flying in Seattle "I would be livid with the pathologist if my results were wrong. Instead of a law suit I might be inclined to take something away from the doctor like balls he could not get back."

You say all of this like as if anyone did it on purpose! How outlandish!

"I hope she wins a great deal of money."

And this is exactly one of the major reasons healthcare costs us so much, because everyone believes that every time any error happens they are entitled to "a great deal of money" and they sue, which causes medical practice insurance to be excessively costly for doctors, which in turn is passed on to us, the patients.

Where is it said that medicine is perfect? That people in medicine are perfect? That no errors are ever made?

These people don't even know, yet, if you did suffer an error, and if you won't follow through, they won't ever know, which means nothing will be done to prevent it happening from that group to other people in the future, because they are not aware of the error.

South Carolina has an all-encompassing group, SC DHEC, which can investigate, heavily fine, walk in to factories, hospitals, nursing homes, doctor offices, and say "As of this moment, you are CLOSED!" and they have that authority.

I am quite certain that most states have a similar branch. We are not talking board licensure, but monitoring, etc.

Reporting to DHEC won't get you "a great deal of money" but if they are wrong it will guarantee that they never do it again, and isn't that more important?

I found a lump in my breast last year that turned out to be HER2+ cancer, the most aggressive form of breast cancer (and here (I was thinking breast cancer was breast cancer).....I underwent chemo and Herceptin (the latter for one year), fortunately it had not spread and turns out that the lump had been on my mammogram for two years and the second cancer above the breast bone itself had been there a year earlier, yet not one doctor did a thing, so you can't win other than get a second opinion, have a repeat test if necessary and get copies of EVERYTHING....at the end of the day my cancer had not spread, I am in remission and no-one, including my oncologist (who is wonderful) believes it will come back.....women, wake up, take control of your life and do not believe the first guy as it may be wrong....everyone is human and therefore prone to error and with a diagnosis such as cancer or any other form of life threatening condition, get a second or even third diagnosis.

Next time, just read your own damn biopsy...you sound like you are so sure you can do better. The doc in this story did his best, he even sent the tissue for 2 second opinions that concurred. Still some sleazy ass trial lawyer makes it seem like the pathologist should NEVER make a mistake. If you want perfection, read the biopsy yourself...or maybe send it to the lawyer and let him take a shot at reading it.

One title: "IMDS" (Imaging Diagnostic Systems)

-One of the most advanced, accurate, and non-invasive breast cancer detection devices ever created. No surgery, no cutting, no compression, no pain. The device is now making breakthroughs all over the world-Europe, Asia, and the Middle East, but is still awaiting PMA approval in the US-this even though the FDA has already deemed it "Low-risk."

@Dani: You've got your terminology wrong. "Intraductal carcinoma" is DCIS. The tumor is contained within the duct.

I was diagnosed with DCIS almost eight years ago. Considering my tumor was large, I believe my diagnosis from a type of needle biopsy would have been correct. Further pathology after lumpectomy confirmed that. Luckily after lumpectomy, radiation, and five years of tamoxifen, I am none the worse for wear.

I was diagnosed with DCIS nearly 6 years ago after finding a lump - a fibroadenoma which turned out to have cancerous cells within it. My doctor recommended an open biopsy, then a second lumpectomy to try and achieve clear margins. I requested and received path reports from both and was able to review and discuss these with my surgeon. In one case the pathologist did not include information I wanted on the report, and my surgeon requested the pathologist re-review the slides and revise his report. I felt that my surgeon and I were armed with as much information as possible, after the second lumpectomy came back still without clear margins, to opt for a mastectomy instead of another lumpectomy (which would effectively have been a quadrantectomy, like the woman in this story had).

After my mastectomy, when I reviewed the pathology report and saw that the great majority of the slides showed DCIS spread throughout the ducts of the breast, I felt that my decision to have the mastectomy was the correct one.

All this to say that the time to do your research, ask questions, seek other opinions, etc., is before the decision to have the surgery that can't be undone. Cancer is very seldom an emergency. An educated, involved patient is THE most important component in healthcare decision-making.

I had five different friends misdiagnosed back in 2004-06; two after undergoing partial breast removal, the other three got second opinions and there were others I know of who went through painful biopsies on "suspicious lumps" that turned out to be nothing. I have opted out of breast cancer screening; I'll take my chances.

Barbara, I can see why you might feel that way in light of what happened to some of your friends... for myself, I think I'd prefer to have the biopsy that turned out negative (or, in my case, that found the early-stage cancer) than to forego all screening until it was too late. 

I'm reminded of a woman who was diagnosed within a week of my diagnosis in September 2004.  She, too, had chosen to opt out of breast cancer screening.  Unfortunately, by the time she found a palpable lump, her breast cancer had become invasive, traveled to lymph nodes and then to distant points of metastasis (a process that would have taken several years to develop).  She died seven months later. 

This is truly amazing...I meet with my breast surgeon, radiologist and oncologist tomorrow to discuss my recent diagnosis for DCIS. After reading all the comment I am more prepared to ask questions than before. When I think that I am the only female in my family to be diagnosed with this I am more and more convinced that I need a second opinion.

If she was in Russia she had gave too much money to fireman for her error.