In Reply We could not agree more with the wise letter from Dr Foucar. All of the specialties, the surgeons, radiologists, and pathologists have been unwitting participants in a specialty-wide error in applying malignant terminology to low-grade intraductal lesions. The good news is that the data today are clear and the time to correct that error is now. Dr Foucar is correct, that entrenched practices can be difficult to uproot. We need strong leadership across the specialties to lead the charge to change terminology. The best way to make the change is to establish large national or regional registry studies where we can accumulate the data to help inform women about how to optimize their choices. Studies of 28 patients should indeed become a relic of the past.
Esserman L, Yau C. Treatment and Long-Term Risks for Patients With a Diagnosis of Ductal Carcinoma In Situ—Reply. JAMA Oncol. 2016;2(3):395–396. doi:10.1001/jamaoncol.2015.4840
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