Psycho‐Oncology - Labels, Language and Other Strategies to Improve Communication About Lowest Grade Ductal Carcinoma in Situ

Sep 23, 2026

Uploaded by Jake

Women diagnosed with ductal carcinoma in situ (DCIS) and clinicians report persistent communication barriers that increase confusion and anxiety. This qualitative study examined how to improve DCIS communication through alternative labels, language choices, and practical strategies. Interviews with women (July 2024–January 2025) and clinicians across Canada were analyzed using Communication Accommodation Theory. Results show divergent preferences about labels, converging recommendations on lay language, clear distinction from invasive cancer, and supportive tools.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Objective

Methods

Results

Conclusions

Background

DCIS characteristics and prognosis

Evolving low-grade management

Need for patient-centered communication

Label terminology and patient anxiety

Psycho‐Oncology Labels, Language and Other Strategies to Improve Communication About Lowest Grade Ductal Carcinoma in Situ: Qualitative Interviews With Women and Physicians Suzanna Apostolovski1 | Nicole J. Look Hong2 | Frances C. Wright2 | Anna R. Gagliardi3 1University of Toronto, Toronto, Ontario, Canada | 2Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, Ontario, Canada | 3Toronto General Hospital Research Institute, University Health Network and Department of Surgery, University of Toronto, Toronto, Ontario, Canada Correspondence: Suzanna Apostolovski ([suzanna.apostolovski@gmail.com](suzanna.apostolovski@gmail.com)) Received: 5 August 2025 | Revised: 9 March 2026 | Accepted: 25 March 2026 Keywords: cancer | ductal carcinoma in situ | health communication | interviews as topic | oncology | patient‐centered care | patient preferences | terminology ABSTRACT Objective: Women diagnosed with ductal carcinoma in situ (DCIS) and clinicians have reported challenges in communication about DCIS, contributing to women's confusion and anxiety. This study explored how to improve communication about DCIS including alternative labels, language and other strategies. Methods: We interviewed women from July 2024‐January 2025 who had DCIS and clinicians from across Canada, and analyzed themes using Communication Accommodation Theory. Results: Participants included 12 women (67% aged 45 to 65, 58% non‐White) and 16 clinicians of diverse specialties (87% women, 63% mid career) . Women and clinicians held divergent views about an alternative label for DCIS. Women preferred“abnormal cells” over “DCIS” to avoid the word cancer. Clinicians preferred precursor labels (e.g., stage 0 cancer, pre‐cancer) over abnormal cells and felt confident explaining DCIS using precursor labels, which triggered women's concern. Women and clinicians held convergent views on how to improve communication about DCIS including language (use lay language rather than technical jargon, explicitly distinguishing DCIS from invasive breast cancer, address the risk of spread beyond the breast ducts and mortality) and other strategies (take time to educate women, using visual aids, providing take‐home information, tailoring pathology reports to patients) . Conclusions: This study adds to prior research that identified challenges to communication about DCIS but did not fully examine how to improve communication. Several implications emerged for policy (consider formal label change) and practice (share communication aids or other tools with clinicians and patients). Future research should develop and evaluate the impact of these approaches. 1 | Background Ductal carcinoma in situ (DCIS) makes up approximately 25% of breast lesions detected by mammogram but differs from invasive breast cancer because lesions are contained within the milk ducts [1–3] . Although about 20% of women diagnosed with DCIS will develop invasive breast cancer, the 20‐year breast cancer specific mortality of DCIS is 3.3%[1–3] . This favorable prognosis is, in part, due to the fact that DCIS includes a spectrum of cells that vary by nuclear grade, and lesions of low or intermediate grade are less likely than higher‐grade lesions to evolve to invasive breast cancer [3, 4] . Trials have shown that active surveillance may be an acceptable way to manage “lower risk” forms of DCIS [5]; however, the majority of women This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2026 The Author(s) . Psycho‐Oncology published by John Wiley & Sons Ltd. Psycho‐Oncology, 2026; 35:e70442 1 of 10 [https://doi.org/10.1002/pon.70442](https://doi.org/10.1002/pon.70442) diagnosed with DCIS are currently treated with lumpectomy or mastectomy, and possibly radiotherapy and/or h

FAQs

What communication challenges does the study focus on for DCIS?

Women and clinicians report difficulties in communicating about DCIS, which contributes to women’s confusion and anxiety. The study evaluates ways to improve these communication pathways through labels, language, and strategies.

How were participants and data analyzed in this study?

The researchers interviewed women diagnosed with DCIS and clinicians across Canada from July 2024 to January 2025, then analyzed emerging themes using Communication Accommodation Theory.

What differences emerged between women and clinicians regarding alternative labels for DCIS?

Women preferred wording such as “abnormal cells” to avoid “cancer,” while clinicians preferred precursor labels (e.g., “stage 0 cancer” or “pre-cancer”). Each group felt differently about how these labels affect understanding and concern.

Sep 23, 2026

Uploaded by Jake