Medical trial could settle breast cancer treatment debate

Posted at 6:31 PM, Jul 05, 2017
and last updated 2017-07-05 21:46:02-04

SAN DIEGO (KGTV) - “Early on in my career I somehow just gravitated toward this and thought I have a lot to give,” said Dr. Christina Casteel, medical director of the Breast Health Center at Sharp Memorial Hospital.

More than twenty years later, Dr. Christina Casteel is still leading the fight against breast cancer.

"I take it home with me,” she said.

Now, Dr. Casteel and others across the country are embarking on a clinical trial aimed at making the hard and emotionally challenging decisions a little easier.

"I think for the longest time there was a trend of what more can we do, and now it's like what can we back away from and maybe not be so aggressive if it's not necessary and there's no benefit in the long run,” Casteel told 10News.

The trial, called COMET, is focused on Ductal Carcinoma in Situ or DCIS.

It’s estimated around 60 thousand people are diagnosed with DCIS each year.

Doctors believe about 20 to 30 percent of the diagnosis will go on to become invasive cancer.

According to Dr. Casteel the current national guideline is to treat it.

"We treat it aggressively, we treat it very similarly to the way we treat invasive cancer,” she said.

According to a write-up on, the purpose of the trial "looks at the risks and benefits of active surveillance (AS) compared to guideline concordant care (GCC) in the setting of a pragmatic prospective randomized trial for low risk DCIS. Our overarching hypothesis is that management of low-risk Ductal Carcinoma in Situ (DCIS) using an AS approach does not yield inferior cancer or quality of life outcomes compared to GCC."

Right now many women face the decision of surgery.

"Are we harming women by doing surgery that in the long run maybe isn't necessary and that's the answer that we're after here," she said.

The results of the study could be a game-changer for how DICS is treated, giving women the most information for the best outcome.

"Look at how far we've gone with all sorts of things and concerns to breast cancer, and it's all based upon these clinical trials,” she said. “It's where we need to get those answers so we can change what we're doing.”

To learn more about the trial visit: