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Is it or isn’t it?

That’s the debate in some circles when it comes to stage 0 breast cancer: is it a cancer and should it be treated immediately? Or, is it something where patients should take the watchful waiting approach?

For 52-year-old Nancy Zimini, the decision to get surgery was an easy one, “I just knew I needed to do it.”

Zimini, a high-powered aviation executive with a national organization, discovered her cancer like most women – during a routine screening. She says her radiologist saw what looked like a cloudy area on the mammogram and called her back in for further tests. The diagnosis eventually came back as DCIS or Ductal Carcinoma in Situ, commonly called, Stage 0 breast cancer.

The non-invasive cancer is where abnormal cells are found in the lining of the milk duct. In Stage 0 breast cancer, atypical cells have not spread outside of the ducts or lobules into the surrounding breast tissue. But, it’s not known if the cancer will grow and spread, and that’s where the confusion lies.

“They know what they want, what they need and what they can live with,” says Sentara Cancer Network Radiologist Dr. Tammy Lamb, speaking about her patients.

Dr. Lamb says DCIS represents about a quarter of her breast cancer diagnoses. She says she’s as straight forward as possible, “Carcinoma in situ may never progress into invasive cancer, the problem is imaging cannot tell the difference, surgery cannot distinguish, but more importantly the pathology is not yet there.”

It’s the lack of predictability of what the cancer will do in the future which fuels this debate.

For Nancy Zimini, she wasn’t taking any chances, “I took care of it very quickly. As far as I’m concerned, I can’t go on thinking there’s something that could turn into cancer, or is cancer, and not do anything about it. That’s just who I am.”

That’s why Zimini turned to the Sentara Cancer Network for a plan of attack. With Sentara’s highly-skilled physicians and specialists using advanced technology and treatment, Zimini said she had the collaborative care to move forward.

She eventually decided to have a single mastectomy. Now, three-years later, she’s healthy, happy and thriving, “I just did what I had to do,” says Zimini smiling. And, as difficult as that decision may have been, she says she’s glad she had the Sentara multidisciplinary healthcare team by her side: “They were key. They made my journey simple.”

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