New 'stage' of cancer causing debate

Published On: Oct 29 2013 10:17:32 PM CDT
Updated On: Oct 29 2013 11:07:20 PM CDT

Oct. 29, 2013: Stage zero breast cancer is a term many women have never heard before and it's causing fierce debate among doctors in Houston. Rachel McNeill reports.

HOUSTON -

Stage zero breast cancer is a term many women have never heard before and it's causing fierce debate among doctors in Houston.

Priscilla Stegman has a long family history of breast cancer.

“My mother died at 57 of breast cancer, my sister died of cancer at 60, my first cousin died at 47 of cancer," Stegman explained.

And now she's one of the millions of American women facing her own diagnosis.  Stegman's disease is defined with as 'stage zero' breast cancer.

"Zero was still cancer and it's a scary word," Stegman said.

According to oncologist, Dr. Archana Maini, stage zero breast cancer is an earlier indicator of a potentially serious disease.

"It's pre-malignant so if left on its own it would have developed into an invasive cancer," Dr. Maini explained.

A stage zero diagnosis is most often made following a mammogram that detects a lesion on the breast. There are also slight abnormalities in the breast cells that could eventually become cancerous.

Richard Theriault, D.O, with MD Anderson Cancer Center says the term stage zero is being hotly debated in the medical community right now. 

"It's very controversial at the present time because screening has detected so many of these and we don't understand the biologic behavior of them, so the question is, are we over-diagnosing and therefore over-treating people whose disease would never come to the fore," Theriault said.

Dr. Maini says some doctors are choosing to use the terms 'breast lesion' or 'abnormal cells' to define the earliest of stages.

"What they are thinking is cancer is a word that should only be used for something that has metastasized and have adverse effects on the human body and ultimately be capable of killing the body. We should not use this word for anything less than that," she explained.

But, a study of 400 women found that when the word 'cancer' was removed from the diagnosis, the patients chose less aggressive treatments. That concerns Dr. Maini who says even stage zero cancer cannot be ignored.

"It does require a full fledge of treatment those women," Dr. Maini said.

"Right now, it's what we have to work with.  But as we get more knowledge about the genetics of the tumor, the biomarkers of the tumor, we'll be able to classify, this one is a real potential cancer and this one we should just leave alone,” Theriault added.

Priscilla Stegman went through surgery to remove what her doctor called 'a speck of dust' followed by radiation treatments and she's taking the cancer drug Tamoxifen for the next five years.

"I'm doing everything I can to prevent it again," Stegman said.

To do everything you can to prevent breast cancer, don't smoke, avoid alcohol and if you've reached menopause, be cautious about hormone replacement therapy.  Yearly mammograms starting at age 40 for average risk women can also help detect cancer at its earliest stages.

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