Stage 0 breast cancer and unnecessary treatment
8 Min Read
If you, or a loved one, has been diagnosed with breast cancer, it can be an incredibly difficult time. Understanding the terminology – and what this could mean for you – may help you to come to terms with the situation.
Breast cancer is diagnosed in different stages, depending on the severity of the cancer. This article will explain what stage 0 breast cancer is, the treatment options should be considered and whether they are necessary. In some cases, stage 0 cancer is associated with unnecessary surgery that can cause the patient to experience unneeded nasty side effects.
Here, we explore stage 0 breast cancer and our client’s medical negligence story.
Breast cancer stages
- Stage 0 – refers to non-invasive breast cancer. This is where there is zero evidence of cancerous or abnormal cells moving from the part of the breast where they first formed – or affecting other tissue.[1]
- Stage 1 – during stage one, the cancer is small and is only found within the breast tissue – or in lymph nodes.
- Stage 2 – is another early stage, where the cancer could be in the breast, lymph nodes, or both.
- Stage 3 – the cancer has spread from the breast to surrounding areas – like the lymph nodes, the breast skin, or the chest wall.
- Stage 4 – if the cancer is at stage four, it has spread to other areas of the body.[2]
What is stage 0 breast cancer?
Stage 0 breast cancer, or ‘pre-cancer’, is also known as ductal carcinoma in situ (DCIS). Around 7,000 people in the UK are diagnosed with DCIS every year.[3]
Treatment will often involve surgery such as mastectomy – removing the breast – and radiotherapy. But new research funded by Cancer Research and the Dutch Cancer Society has shown that many cases of DCIS will never become cancer at all.[4] The worry is that some women with DCIS will have nasty side-effects from treatment they could have avoided.
In DCIS, some of the cells in the lining of the milk ducts of the breast tissue have started to turn into cancer cells. The cancer cells are inside the ducts – they haven’t started to spread to the rest of the breast tissue. A specialist may diagnose DCIS after finding a lump in the breast, breast pain or discharge. Sometimes DCIS can show up in a routine mammogram.[5]
LCIS vs DCIS
Lobular Carcinoma in Situ (LCIS) is another type of in-situ carcinoma. A carcinoma is a cancer that starts in the epithelial cells (lining) or organs. If the cancer does not break out of the duct or lobule it started in, it’s classed as in-situ.
DCIS is considered to be a form of pre-cancer, but it is not certain as to whether LCIS is a pre-cancer or a higher risk factor for breast cancer developing.[6]
Does stage 0 breast cancer always turn into breast cancer?
At the moment, doctors don’t know which cases of DCIS will become breast cancer and which won’t. So, they often advise that women have treatment as it’s better to be safe than sorry.
In a big study being carried out in the Netherlands called the ‘Grand Challenge’ scientists are trying to find out how to tell which cases of DCIS will turn into cancer. The aim is for women to avoid unnecessary treatment that may be more harmful than the DCIS itself.
Recent findings suggest that the risk of DCIS recurrence may be overestimated. In fact, one in five cases thought to be reoccurrences from a DCIS are new primary tumours. These findings can help patients to accurately understand the risk that DCIS may cause them, in order to make an informed choice of what treatment is right for them.[7]
In the meantime, it can be important that patients with DCIS are given enough information. They need to know about the disease, the treatment options, and the risks. Then they can make an informed choice.
The treatments for stage 0 breast cancer
Unfortunately, treatment is often needed for stage 0 breast cancer – but it’ll usually be less invasive than with later breast cancer stages. The treatment options for your stage 0 breast cancer may be as follows:
- Total mastectomy of the breast
- Lumpectomy (also known as breast-conserving surgery) – removes the cancer from the breast with a small amount of the surrounding healthy tissue
- Lumpectomy with radiation – radiation may be used to kill any cancer cells that were not removed through the surgery.
- Hormone therapy may be advised – if the cancer is hormone-receptor positive.[8]
As stage 0 breast cancer has not spread from the part of the breast where it first formed, in most cases lymph nodes will not need treatment.
The link between stage 0 breast cancer and medical negligence
Sadly, sometimes medical professionals can get things wrong. When dealing with complex decisions, sometimes the wrong decision can be made – no matter how good the intentions are.
In some circumstances, medical professionals weigh up the costs and benefits of major surgery in a way that may be considered negligent. Surgical negligence may cause a decreased quality of life for the patient.
Surgical negligence can be difficult to define. Enable Law can help you understand the meaning of clinical negligence, and whether you could be eligible for a claim.
If you, or a loved one, has suffered as a direct result of an incorrect surgical decision, contact us today.
Medical negligence for stage 0 breast cancer: Ms D’s story
Enable Law’s Guy Eskell and Caroline Frean acted for 44-year-old Ms D. She was diagnosed with DCIS in her left breast after she noticed discharge from her left nipple.
Surgical decisions: Lumpectomy vs mastectomy
Ms D was offered a lumpectomy, (an operation to remove just the area of DCIS and some of the healthy tissue surrounding, or a mastectomy (an operation to remove the entire breast).
Due to Ms D’s fear that she had been diagnosed with stage 0 breast cancer, she decided to have both of her breasts removed to eliminate any risk that the DCIS would develop into an invasive cancer.
As Ms D wished, her surgeon removed both breasts during her mastectomy. Ms D also asked for them to be replaced with breast implants.
Severe pain and infections following the treatments
Unfortunately, Ms D had a very bad experience following this surgery. Both breasts became badly infected and would not respond to treatment. She became very ill, and her body rejected the breast implants. She was in pain and was unhappy with the look of her breasts.
Because of her pain and infections, Ms D had to give up her job. She then found it very hard to find another job after being out of work for a few years.
Taking legal action for unnecessary surgery
Ms D’s surgeon should have advised her that she didn’t need major surgery – especially in her right breast as there hadn’t been any evidence of DCIS there. A lumpectomy would have done the job just as well.
These issues made it more likely that she would develop infection, including from implants, the legal case found. Unfortunately, Ms D’s surgeon didn’t give her very much information at all about her options or the risks involved.
Medical negligence claim
Enable Law was able to settle Ms D’s claim for a sum which recognised her pain and suffering, the extra care her husband had to provide, and Ms D’s lost earnings.
If you have been unhappy with your treatment for DCIS, please contact a member of the Enable Law team and we will be happy to talk it through with you, or call us on 0800 044 8488.
Stage 0 breast cancer and negligence: Key questions.
Is surgery necessary for stage 0 cancer?
It’s very difficult to decide if surgery is needed for stage 0 breast cancer and it’s never a simple decision. The decision to undergo surgery should be carefully considered as well as any other factors that could have an effect on the treatment.
In some cases, stage 0 cancer can be treated with radiation or hormone therapy, but other times surgery may be necessary. But sometimes, medical professionals perform surgeries that were not appropriate or necessary for the patient.[9]
Is stage 0 breast cancer considered cancer?
Stage 0 breast cancer is considered a pre-invasive breast cancer. The cancer cells are found in breast milk ducts, but they have not invaded the surrounding tissue.[10] There is some debate as to whether stage 0 cancer is cancer, or a ‘pre-cancer’, but as the cancer is in the earliest stages, it is still a form of cancer.[11]
Can I sue with a misdiagnosis of cancer?
Sometimes, it is possible to sue for cancer misdiagnosis – if your surgeon failed to diagnose you in time or made the wrong decision with your treatment. If the medical negligence exacerbated your condition or symptoms, you could be eligible for compensation.
If you need advice on whether you have suffered from a cancer misdiagnosis, contact us today for expert advice on whether you can make a claim.
[1] https://www.breastcancer.org/pathology-report/breast-cancer-stages#section-stage-0
[2] https://www.cancerresearchuk.org/about-cancer/breast-cancer/stages-types-grades/number-stages
[3] https://breastcancernow.org/about-us/media/facts-statistics
[4] https://www.cancerresearchuk.org/funding-for-researchers/how-we-deliver-research/our-research-partnerships/grand-challenge-working-in-partnership-with-the-dutch-cancer-society
[5] https://www.webmd.com/breast-cancer/breast-cancer-early-stage-dcis
[6] https://www.cancer.org/treatment/understanding-your-diagnosis/tests/understanding-your-pathology-report/breast-pathology/lobular-carcinoma-in-situ.html
[7] https://cancergrandchallenges.org/news/step-closer-avoiding-overtreatment-people-dcis
[8] https://www.breastcancer.org/treatment/hormonal-therapy
[9] https://www.nationalbreastcancer.org/breast-cancer-stage-0-and-stage-1
[10] https://www.cancerresearchuk.org/about-cancer/breast-cancer/stages-types-grades/about-breast-cancer-staging-grades
[11] https://www.webmd.com/breast-cancer/breast-cancer-early-stage-dcis
