Health behavior change following a diagnosis of ductal carcinoma in situ: An opportunity to improve health outcomes

Amy M Berkman; Amy Trentham-Dietz; Kim Dittus; Vicki Hart; Christine M Vatovec; John G King; Ted A James; Susan G Lakoski; Brian L Sprague

doi:10.1016/j.ypmed.2015.03.020

Health behavior change following a diagnosis of ductal carcinoma in situ: An opportunity to improve health outcomes

Prev Med. 2015 Nov:80:53-9. doi: 10.1016/j.ypmed.2015.03.020. Epub 2015 Apr 6.

Authors

Amy M Berkman¹, Amy Trentham-Dietz², Kim Dittus³, Vicki Hart¹, Christine M Vatovec⁴, John G King⁵, Ted A James⁶, Susan G Lakoski³, Brian L Sprague⁷

Affiliations

¹ Office of Health Promotion Research, University of Vermont, Burlington, VT, USA.
² Department of Population Health Sciences and Carbone Cancer Center, University of Wisconsin, Madison, WI, USA; Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA.
³ Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Medicine, University of Vermont, Burlington, VT, USA; University of Vermont Cancer Center, Burlington, VT, USA.
⁴ University of Vermont Cancer Center, Burlington, VT, USA; Rubenstein School of Natural Resources, University of Vermont, Burlington, VT, USA.
⁵ Department of Family Medicine, University of Vermont, Burlington, VT, USA.
⁶ University of Vermont Cancer Center, Burlington, VT, USA; Department of Surgery, University of Vermont, Burlington, VT, USA.
⁷ Office of Health Promotion Research, University of Vermont, Burlington, VT, USA; Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; University of Vermont Cancer Center, Burlington, VT, USA; Department of Surgery, University of Vermont, Burlington, VT, USA. Electronic address: bsprague@uvm.edu.

Abstract

Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer that comprises approximately 20% of new breast cancer diagnoses. DCIS is predominantly detected by screening mammography prior to the development of any clinical symptoms. Prognosis following a DCIS diagnosis is excellent, due to both the availability of effective treatments and the frequently benign nature of the disease. However, a DCIS diagnosis and its treatment have psychological and physical impacts that often lead to adverse changes in health-related behaviors, including changes in physical activity, body weight, alcohol intake, and smoking, which may represent a greater threat to the woman's overall health than the DCIS itself. Depending on age at diagnosis, women diagnosed with DCIS are 3-13 times more likely to die from non-breast cancer related causes, such as cardiovascular disease, than from breast cancer. Thus, the maintenance and improvement of healthy behaviors that influence a variety of outcomes after diagnosis may warrant increased attention during DCIS management. This may also represent an important opportunity to promote the adoption of healthy behaviors, given that DCIS carries the psychological impact of a cancer diagnosis but also a favorable prognosis. Particular focus is needed to address these issues in vulnerable patient subgroups with pre-existing higher rates of unhealthy behaviors and demonstrated health disparities.

Keywords: DCIS; Health behavior; Prevention.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Breast Neoplasms* / diagnostic imaging
Breast Neoplasms* / psychology
Carcinoma, Intraductal, Noninfiltrating* / diagnostic imaging
Carcinoma, Intraductal, Noninfiltrating* / psychology
Early Detection of Cancer
Female
Health Behavior*
Humans
Mammography
Risk Factors
Treatment Outcome

Abstract

Publication types

MeSH terms

Grants and funding