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The DCIS (ductal carcinoma in situ) breast cancer controversy and PCORI

Medical News Today announced yesterday, Monday, February 24, 2014, in its article, "Patient-Centered Outcomes Research Institute sets prioritized research agenda for managing two diverse conditions" that PCORI (Patient-Centered Outcomes Research Institute) based standards of research for DCIS would be soon published in the Annals of Internal Medicine. The controversy is based upon these questions: Is DCIS (Stage 0) breast cancer or is it non-cancerous or over time, will it become breast cancer? These and other questions have been rigorously posed by patients, caregivers, advocates and some physicians for some time. A quote from the article … DCIS presents “challenges to physicians and patients because the diagnosis is often not clear-cut and typical treatments come with a trade-off of benefits and serious side effects.” Their voices have been given an ear and a platform made for resolution through PCORI. The title and summary of one of two abstracts cited in today’s Annals of Internal Medicine, gets to the point of what the controversy is and what needs to be done to resolve it: “Setting a Research Agenda for Ductal Carcinoma in Situ That Meets the Current Need for Change; This issue includes a report of the Patient-Centered Outcomes Research Institute's effort to identify research priorities related to ductal carcinoma in situ. The editorialists comment on the identified priorities and look forward to evidence that will help us manage risk in women diagnosed with ductal carcinoma in situ lesions rather than treating them all as if they have cancer.” The second abstract, Prioritization of Research Addressing Management Strategies for Ductal Carcinoma in Situ provides background, great detail and a good summary, “As long as mammography continues to be the primary tool available to reduce breast cancer mortality rates, many women will be given a DCIS diagnosis during their lifetime. Thus, improvement of the ability of women given a DCIS diagnosis to make informed decisions about management options will be a critical need for the foreseeable future. A workgroup of 9 stakeholders representing diverse perspectives identified 10 research areas as the highest priority for future research for patient-centered management strategies for DCIS that, if studied, have the potential to resolve some of the uncertainty surrounding a DCIS diagnosis." For more info about PCORI’s Mission and Vision and Priorities, see website: