Waiting and watching with ‘Stage 0’ breast cancer put to nationwide test

Barbara Nickles and Ligia Toro de Stefani are both women in their early 60s who were diagnosed with abnormal cells in a breast, or Stage 0 breast cancer, as it’s sometimes labeled. Nickles decided to have a double mastectomy. Toro de Stefani opted for “active surveillance” and a twice-yearly battery of tests.

“I wish I had breasts, but I am also happy they are gone so that I don’t have to worry so much about breast cancer,” says Nickles, whose grandmother had the disease.

“Quality of life is the most important thing to me,” says Toro de Stefani, an avid traveler and scuba diver.

The two illustrate the vexing questions facing the 60,000 women a year diagnosed in this country with ductal carcinoma in situ (DCIS), a condition in which cancerous-looking cells are found in the breast duct. What exactly is it — a pre-cancer, cancer or more a risk factor? How much treatment is too much? Too little? Which women can safely skip surgery? What about those who want more treatment than their doctors recommend?

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