Breast Surgeon - Interview 37
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A doctor explains why women diagnosed with DCIS are given different treatments.
A doctor explains why women diagnosed with DCIS are given different treatments.
And a lot of women also wondered why the different, in different hospitals women seemed to get treated in different ways for DCIS.
I suppose part of that is how people present, and every patient is different. And sometimes ladies will say, “I didn’t quite have that treatment, but this lady had a different treatment,” and that’s how it should be because I know there are a number of ways of treating somebody, many of which would be effective for different reasons. And the treatment the patient gets should be specific for them; it should be for the problem that they’ve come with. Much like we said earlier, some patients would have a small piece of the breast removed, others would have a mastectomy with a reconstruction because it was over a wider area.
So every lady’s treatment will differ, be it DCIS or be it invasive cancer. Now it is true that people then look on things differently from a clinician point of view and, as we said earlier, when you have a situation where the evidence isn’t cast iron that an extra treatment of radiotherapy or tamoxifen is always of use. And people have different beliefs as regards to the benefits that patients get, so there will be some variation.
And have you come across many women who didn’t want to have any treatment at all?
Very few actually, in essence, and we often say to patients that, for example when a lady goes to a breast screening unit for her mammogram, most will go in the belief that they’re going to be told that everything’s alright. They don’t go really thinking that this process may well find something that’s severe. They’ll think about it when the question’s asked, but the normal way of things to go is to be told they’re alright, it’s not part of the plan to be told that maybe things aren’t alright. And therefore patients when they come usually feel that something’s been found and it needs to be dealt with. Now they have the information, the diagnosis, it’s very difficult then not to do something about it. If they didn’t know, they would be alright. But once they know, they find it very difficult to ignore.
A doctor explains what DCIS is.
A doctor explains what DCIS is.
A doctor explains why DCIS is treated by either wide local excision or mastectomy.
A doctor explains why DCIS is treated by either wide local excision or mastectomy.
And a lot of women also wondered why the different, in different hospitals women seemed to get treated in different ways for DCIS.
I suppose part of that is how people present, and every patient is different. And sometimes ladies will say, “I didn’t quite have that treatment, but this lady had a different treatment,” and that’s how it should be because I know there are a number of ways of treating somebody, many of which would be effective for different reasons. And the treatment the patient gets should be specific for them; it should be for the problem that they’ve come with. Much like we said earlier, some patients would have a small piece of the breast removed, others would have a mastectomy with a reconstruction because it was over a wider area.
So every lady’s treatment will differ, be it DCIS or be it invasive cancer. Now it is true that people then look on things differently from a clinician point of view and, as we said earlier, when you have a situation where the evidence isn’t cast iron that an extra treatment of radiotherapy or tamoxifen is always of use. And people have different beliefs as regards to the benefits that patients get, so there will be some variation.
And have you come across many women who didn’t want to have any treatment at all?
Very few actually, in essence, and we often say to patients that, for example when a lady goes to a breast screening unit for her mammogram, most will go in the belief that they’re going to be told that everything’s alright. They don’t go really thinking that this process may well find something that’s severe. They’ll think about it when the question’s asked, but the normal way of things to go is to be told they’re alright, it’s not part of the plan to be told that maybe things aren’t alright. And therefore patients when they come usually feel that something’s been found and it needs to be dealt with. Now they have the information, the diagnosis, it’s very difficult then not to do something about it. If they didn’t know, they would be alright. But once they know, they find it very difficult to ignore.
A doctor explains more about the different grades of DCIS.
A doctor explains more about the different grades of DCIS.
A doctor talks about DCIS and recurrence.
A doctor talks about DCIS and recurrence.
A doctor explains why most women have no need to worry about general anaesthetic.
A doctor explains why most women have no need to worry about general anaesthetic.
A doctor explains why a mastectomy is recommended for some women with DCIS.
A doctor explains why a mastectomy is recommended for some women with DCIS.
A doctor explains why lymph nodes are sometimes removed when a woman has DCIS.
A doctor explains why lymph nodes are sometimes removed when a woman has DCIS.