Understanding Stage Zero Breast Cancer
- Actress Maura Tierney, who battled early-stage breast cancer in 2009 at 44 years old, is receiving warm wishes from fans on her 60th birthday. Her milestone birthday is a reminder of crucial screenings for breast cancer.
- Tierney, who previously underwent a mastectomy followed by chemotherapy, has since been declared to have no evidence of disease.
- Stage zero breast cancer refers to DCIS otherwise known as Ductal Carcinoma In Situ. DCIS are abnormal cells that line the duct in a breast. A normal breast comprises lots of ducts (these ducts carry milk to the nipple in a woman who is lactating).
- The U.S. Preventive Services Task Force recommends women begin screening for breast cancer at age 40. Women should talk with their doctor to learn about their cancer risk and assess when a good time is to start annual mammograms.
- Remember, when something doesn’t feel right, talk to your doctor and always get a second opinion if you’re not getting answers; you need to be your biggest advocate regarding your health.
Tierney, who was diagnosed with early-stage breast cancer at age 44 in 2009 and beat the disease after surgery and chemotherapy, is clearly loved by many after playing such an iconic role in the mystery drama “The Affair” and for playing nurse Abby Lockhart on NBC’s “ER.” She also acted in the NBC workplace sitcom “NewsRadio.”
Read MoreHAPPY BIRTHDAY to our favorite actress! ?
You are so loved and supported by all your fans around the world, always. It’s been another great Maura-year and we can’t wait to see what the next one brings. May you have ALL the joy your heart can hold. Happy birthday, Maura! ? pic.twitter.com/a7G0TT06fq
— Maura Tierney News (@MauraTierneyFan) February 3, 2025
A third fan commented, “Happy birthday Maura/Abby that is when I discovered one of the most beautiful woman on the tv.and like a bottle of fine wine you get better with age Happy Birthday.”
“Happy Maura Monday to you and everyone, and Happy Blessed Birthday to you, Maura!!! You are a beauty and a blessing to all of us who love you and admire you and Everything!!! Here’s to many more years to celebrate, and I hope that you have the best birthday ever,” a fourth fan wrote.
“You deserve all of the happiness and love you got from your family and friends and us, your fans!!! Here’s to many more years to celebrate!!! Always!!! I will watch you in your shows and videos and movies to celebrate you!!! I really do that anyway!!! Keep celebrating and doing you!!!”
A fifth fan kindly added, “Happy birthday to my favorite actress and someone who I had a had a crush on for the last 34 years and she still one of the greatest actresses I ever seen and I hope she continues her career and keeps putting herself out there.”
Maura Tierney’s Breast Cancer Journey
Maura Tierney’s breast cancer journey began after she found a lump in her breast. The actress went to get a mammogram to get it checked out by her doctor, and that’s when she was diagnosed with cancer at the age of 44.
After finding out she had a tumor in her breast which needed surgery, she said in an earlier statement, “I will not know either my exact diagnosis or course of treatment until that surgery is performed.
“My doctors have all assured me this is a very treatable condition. I’m very optimistic as to the outcome and want to thank everyone who has sent positive thoughts and support. I look forward to going back to work soon.”
Part of Tierney’s shock after her diagnosis stemmed from the likelihood of breast cancer risk growing as you age. Most people diagnosed with breast cancer are 50 or older, according to the CDC.
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In the aftermath of her diagnosis, Tierney underwent a skin-sparing mastectomy, which is the removal of the entire breast during surgery. As per research published in Gland Surgery, skin-sparing mastectomies “optimize the cosmetic outcomes of smaller incisions and preserve breast anatomy.”
“It’s scary to think you have to have a mastectomy, but I had a great plastic surgeon and a great reconstruction,” Tierney said in an earlier interview with the nonprofit organization My Faulty Gene.
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There are several factors to weigh when considering a mastectomy, chief among them being whether breast-conserving surgery (or lumpectomy) is possible. Your doctor will look at the size and features of your tumor and your family history to make a recommendation.
Following her surgery, Tierney received chemotherapy treatments.
She continued, “Looking back at my experience, one of the main challenges I faced was that I just didn’t know what to expect from the chemotherapy my doctors told me I needed.
“I was very, very afraid anticipating the chemotherapy. I had a tremendous amount of anxiety. I worried that I would be so sick that I wouldn’t be able to get up or even leave the house. Fortunately, this turned out to be untrue for me.”
Helping Patients Cope with Early-Stage Breast Cancer
- Introduction to Early-Stage Breast Cancer
- Hope For Some Early-Stage Breast Cancer Patients: Verzenio
- Updated Guidelines on Biomarkers for Early-Stage Breast Cancer
- Early Stage Breast Cancer: What to Know About Testing
- Why Active Surveillance is Being Studied for Stage Zero Breast Cancer
- I Have Stage Zero Breast Cancer: What Should I Do?
- How Does Molecular Testing Help Determine the Best Breast Cancer Treatment Option?
- Surgery or Chemo First? How is Breast Cancer Treatment Order Determined
Stage Zero Breast Cancer
Stage zero breast cancer refers to Ductal Carcinoma In Situ (DCIS). DCIS are abnormal cells that line the duct in a breast. A normal breast is made up of lots of ducts (these ducts carry milk to the nipple in a woman who is lactating).
Learning About Stage Zero Breast Cancer (DCIS)
DCIS is not an invasive cancer, meaning it hasn’t spread outside the milk duct and it cannot invade other parts of the breast. In some instances, if left untreated, doctors believe that DCIS can evolve into a more invasive breast cancer. This is why historically, the standard treatment for DCIS is to remove it surgically and in some instances offer radiation as well.
However, many doctors aren’t sure if even that is necessary for DCIS, because it may or may not turn into cancer.
And in an effort to reduce the fear around the earliest stage breast cancer we want you to understand the definition and the debate around treatment.
Two important facts about DCIS breast cancer are:
- It doesn’t spread to other parts of the body.
- The risk of death is essentially zero.
RELATED: Why Active Surveillance is Being Studied for Stage Zero Breast Cancer
As for the debate, some doctors don’t consider it cancer, but rather a collection of abnormal cells or a pre-cancer, which is why some women opt for a watch-and-wait approach.
Others may recommend the surgery route which usually involves a lumpectomy and potentially radiation as well. This somewhat more aggressive treatment (which is the standard protocol at major cancer centers) does have side effects, and potentially, long-term effects.
Dr. Elizabeth Comen Explains The Main Aspects Of Early-stage Breast Cancer
Less commonly, doctors and their patients will decide on more aggressive approaches depending on the amount of DCIS in the breast and a woman’s specific risk factors for future breast cancer. One reason some doctors may want to remove DCIS is if a biopsy reveals any evidence that a more invasive breast cancer could be present.
Meanwhile, Dr. Ann Partridge, an oncologist at Dana-Farber Cancer Institute and the founder and Director of the Program for Young Women with Breast Cancer, previously told SurvivorNet that DCIS is “a pre-cancer, technically.”
Dr. Partridge explained to SurvivorNet that stage zero breast cancer is, “Something that may turn into invasive breast cancer. Invasive breast cancer is the kind of breast cancer that has the potential to not only grow in your breast but to spread to other places in the body and ultimately hurt someone more than just needing a breast surgery.”
The current standard of care is treatment with either lumpectomy or mastectomy, radiation, and hormonal therapy.
Additionally, Dr. Chirag Shah, Director of Breast Radiation Oncology at the Cleveland Clinic Cancer Center, says recent studies show that the risk of dying from stage zero breast cancer is very low, prompting some doctors to opt for less aggressive treatment and, even in some cases, active surveillance.
“Protocols, such as the comet trial, are studying the use of surveillance regimens, but this is not standard of care and is experimental at this time, and active surveillance is not something that we would recommend for patients outside of a clinical study,” Dr. Shah said.
Deciding the Right Course of Breast Cancer Treatment
Doctors treating breast cancer seek out markers on your particular cancer to help decide what course of treatment is best for you. This is due to the cancer cells possibly having what are known as receptors that help identify the unique features of the cancer.
The three main receptors are the estrogen receptor, the progesterone receptor, and the HER2 receptor. The estrogen and progesterone receptors go together because they are fueled by hormones. Think of the cancer cell as having little hands on the outside of the cell which grabs hold of proteins that help it grow. These proteins are sometimes called “ligands.”
An example of a type of ligand that can stimulate a cancer cell is the hormone estrogen. An estrogen receptor-positive breast cancer will be stimulated by estrogen to grow. In this instance, your doctor may offer you treatment to specifically target the estrogen receptor.
The Unique Features of Breast Cancer
Another important receptor to test for is the HER2 receptor. For HER2 positive breast cancers, therapies that uniquely target the HER2 receptor are essential to treating the disease.
Dr. Alana Welm, of the Huntsman Cancer Institute, also told SurvivorNet that doctors need to find a balance between screening and finding cancers that actually require treatment.
Finding a Balance Between Screening and Treating
Screenings lead to more people being diagnosed with cancer, and some of those cancers may have never caused an issue. Dr. Welm says treating these cancers exposes patients to unnecessary toxicities. Stage zero breast cancer, for example, can get picked up during screening but not all doctors see eye-to-eye on whether it requires treatment or just monitoring.
Internationally recognized breast surgeon and breast oncology specialist Dr. Laura Esserman, who conducted the COMET study to look at the benefit of active surveillance versus standard treatment for stage zero breast cancer, also previously offered SurvivorNet some additional insight on this matter.
Dr. Esserman told SurvivorNet last year, “Surgery is standard of care for DCIS. Chemotherapy is never recommended for treatment of DCIS. The COMET study, for which we eagerly await the results, is a landmark effort to transform our approach and test the idea of active surveillance.
“We have just launched an exciting new study to test new approaches to risk reduction in DCIS. The RECAST DCIS (Re-evaluating Conditions for Active Surveillance suitable as Therapy for DCIS) will start with a non-operative approach.”
She continued, “Everyone can start with six months of surveillance and we used MRI imaging features to determine who is a good candidate to continue surveillance and avoid surgery. DCIS is a window of opportunity to rethink prevention.”
The Importance of Breast Cancer Screenings
Mammograms are used to screen for breast cancer. Women who haven’t gone through menopause are encouraged to get a mammogram annually between the ages of 45 and 54. If you have experienced menopause, you can get a mammogram every two years.
The U.S. Preventive Services Task Force recommends women begin screening for breast cancer at age 40. Women should talk with their doctor to learn about their cancer risk and assess when a good time is to start annual mammograms.
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“We all agree regular screening mammography saves lives,” Dr. Connie Lehman, a professor at Harvard Medical School, told SurvivorNet.
Suppose you fit into the high-risk category for breast cancer, meaning a close family relative has been diagnosed. People at higher risk may have the BRCA1 or BRCA2 gene mutation or had radiation to the chest area when they were young. In cases like this, people in the high-risk category should begin annual mammograms at 30 years old.
Contributing: SurvivorNet Staff
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