The art of being yourself | Caroline McHugh | TEDxMiltonKeynesWomen


Serena Williams Takes On Body-Shaming Haters In Powerful Speech ~ Juliet Spies-Gans


Speaking at the Sports Illustrated “Sportsperson of the Year” ceremony held in her honor on Tuesday night, Serena Williams addressed the body-shaming that she has had to face and overcome throughout her career, emphasizing just how important internal acceptance is when seeking external success.

“I’ve had people look down on me, put me down because I didn’t look like them — I look stronger,” she said in her acceptance speech. “I’ve had people look past me because the color of my skin, I’ve had people overlook me because I was a woman, I’ve had critics say I [would] never win another Grand Slam when I was only at number seven — and here I stand today with 21 Grand Slam titles, and I’m still going.”

Williams continued, spending much of her time onstage addressing the difficult ride she’s had and the self-confidence that has been necessary to ignore the naysayers and achieve greatness.

The trek to get to this stage and this moment of her career was not easy. “I’ve lived through tragedies and controversies and horses,” she said, the latter being a not-so-subtle reference to the recent debate as to whether she or the Triple Crown winner American Pharoah was more deserving of the “Sportsperson of the Year” title. But now, looking back, Williams explained that each and every one of these emotional and physical hurdles, these internal and external struggles, led her to that podium in New York City on Tuesday night, making history as the first individual woman in more than three decades to earn the crown of “Sportsperson of the Year.”

“For all the ladies out there, yes we can do it,” she said. “My hope by winning this award [is that I] can inspire many, many, many more women … to stand right here on this podium and accept another ‘Sportsperson of the Year,’ so yes ladies it can be done.

“In 1984 in Compton is where I began my journey of becoming a tennis player on beaten down courts,” she said. “Now 30 years later, I still have goals and still have dreams of winning, and this award actually makes me want to work harder to reach more goals.”


I Spent A Week Trying To Be A More Assertive Woman In The Workplace ~ Farrah Penn

Hi, I’m Farrah, and I’m consistently guilty of using “woman in a meeting” language in both the workplace and my personal life. I suffer from the chronic need to please people.

Charlotte Gomez for BuzzFeed

At it’s core, “woman in a meeting” language is intentionally using overenthusiastic sentences and softer words in order to prevent coming off as abrasive. Many women (including myself) constantly apologize, use exclamation points, or preface points they’d like to make with “I think,” or “I just.”

After reading this and recognizing that many strong women throughout history were unapologetically themselves without fear of being called “abrasive” or a “bitch,” I decided I would spend a week trying to eliminate this type of language from the way I speak.

When I started looking for my overuse of soft language… sadly, it wasn’t too hard to find:

When I started looking for my overuse of soft language... sadly, it wasn't too hard to find:

Charlotte Gomez for BuzzFeed

Charlotte Gomez for BuzzFeed

For five days, I followed these rules, which eliminated common phrases from my “soft language” vocabulary.

Charlotte Gomez for BuzzFeed

There were tons of challenges that came up during this entire process. My main concern was coming off as a jerk. In some instances, it took me A LOT longer to compose a very direct email than it would have if I was using my bubbly! excited! tone!. And I overanalyzed EVERYTHING.

Scenario 1: Replying to a co-worker in NYC about a project.

Scenario 1: Replying to a co-worker in NYC about a project.

Charlotte Gomez for BuzzFeed

I haven’t been to BuzzFeed’s NYC office, so I don’t know any of the staff except those I’ve interacted with over email and Slack — the instant messaging system we use. I was nervous about coming off cold in my email, which is why it took me maybe ten minutes to write on top of reading over it dozens of times. I cringed when I sent it. I didn’t want him to think I wasn’t excited about the post anymore.

Despite my worrying, Lincoln really didn’t seem phased by my lack of enthusiastic exclamations. Also, I realized that although I wanted to add in an apology, it wasn’t needed. Why was I apologizing on behalf of my draft? That’s what drafts are FOR.
But the tone in his response showed the same enthusiasm for our project, which meant I was stressing over this one email for NOTHING.

Scenario 2: My boss let me know we were getting lunch today.

Scenario 2: My boss let me know we were getting lunch today.

Charlotte Gomez for BuzzFeed

My response was a faster-than-normal reply for me, especially since the rules cut off the time I would spend looking for an emoji to send. I saved some time by not worrying about making myself seem happy and upbeat.

BUT her response made me overanalyze my lack of enthusiasm. I always want to come off as a positive team player, and forgoing my excessive use of exclamation marks made my tone seem sarcastic and ungrateful. Was she mad? Did she think I was being ungrateful? Did she think I was being rude or sarcastic? OR A JERK?

She didn’t seem to think so, because the rest of the day carried on as normal. Looking back, it’s a funny how anxious I became over — literally — one exclamation mark.

Scenario 3: Receiving feedback from my editors about a post I was working on.

Scenario 3: Receiving feedback from my editors about a post I was working on.

Charlotte Gomez for BuzzFeed

The way I acknowledge feedback has always been super important to me. In the past, I’ve made sure to be EXTREMELY enthusiastic, using tons! of! exclamation! marks! to prove that I’m not aggressively put off by any changes. I never want my editor to think, is she mad because I’m giving her this feedback? Does she even care?

There were some instances throughout these 5 days where it took me about ten minutes to gather the courage to send people messages.

When I look back at what I wanted to say — and have said on numerous occasions as replies to edits — I’m kind of annoyed with myself. Why do I need to use that many exclamation marks? And smiley faces? Tone is really important when communicating through instant messaging, but what I wanted to say feels like overdoing it. Which means I HAVE overdone it before.

Scenario 4: Asking a co-worker to collab for the first time.

Scenario 4: Asking a co-worker to collab for the first time.

Charlotte Gomez for BuzzFeed

I haven’t collabed with Crystal on a project before, and I DEFINITELY would have added “if you’re not too busy!” to the end of this message on a normal day. But that would have meant I was providing her with an excuse, and my goal was to be more assertive. 

It took her a while to reply, which made me think: omg she definitely thinks I’m not excited for this. I should have given her an excuse in case she wanted to let me down easy! But her reply was genuinely enthusiastic. Even if she had been too busy, I shouldn’t have felt the need to provide an excuse.

Scenario 5: Replying to a co-worker’s question.

Scenario 5: Replying to a co-worker's question.

Charlotte Gomez for BuzzFeed

My conscious attempt to NOT use the exclamation marks made me realize (again) how much I use them on an everyday basis. But I felt like my use of exclamations would have expressed a tone that resembled: oh don’t worry about it, it’s no trouble to get this quick link for you.

Nina was only looking for a link, but I was the one worrying how my tone was coming across through our exchange. In the end, I realized that responding in a direct manner to a forthright question did not automatically make me a jerk.

Scenario 6: Collaborating on a project with my co-workers.

Scenario 6: Collaborating on a project with my co-workers.

Charlotte Gomez for BuzzFeed

At first I was very self-conscious of not being able to express my enthusiasm in this Slack brainstorm with my co-workers, but it actually ended up getting easier and easier. This interaction happened on the fourth day, and I discovered I was gaining more confidence being assertive. 

Forgoing phrases like “I feel like” and “maybe” during brainstorms like this one was a challenge. I wasn’t sure why I needed to soften my tone when I was interjecting an idea. It was a wake up call that made me realize I REALLY needed to cut back on that type of language.

Charlotte Gomez for BuzzFeed
  • There are times when being direct comes in handy, and it’s possible for me to be direct without sounding like a jerk.
  • Not EVERY reply needs to have an exclamation mark, because that’s annoying, but I like having my voice.
  • Look, I like using emojis. Sometimes when words fail, emojis speak. There are some instances were it’s better to forgo them, but I’m not going to completely stop using them. 
  • I don’t have to be afraid of being assertive about my opinions, especially during edits. Softening my feedback with “maybe” and “I feel like” and “I’m wondering” can come across as if I’m unsure of myself, and I’m not!
  • Looking back, all my unnecessary hahas and lols were pretty irritating. I’m going to try and stop that habit. Because, really, nothing is that funny all the time. 
  • This experiment actually showed me that, overall, I saved a lot of time typing direct responses — time that I probably would have normally spent of second-guessing my ~soft~ sentences and searching for emojis.
  • I WILL stop unnecessarily apologizing for things I don’t need to apologize for. 

I wish I could say I’m now an assertive badass after my 5-day experiment, but I’m not. I like having my own voice, and when I’m excited about something I want to be able to express that. But this experiment did teach me that I don’t have to be afraid of coming across as rude when, in reality, I’m being direct.

How to Talk to Your Daughter About Her Body ~ Sarah Koppelkam

How to talk to your daughter about her body, step one: Don’t talk to your daughter about her body, except to teach her how it works.

Don’t say anything if she’s lost weight. Don’t say anything if she’s gained weight.

If you think your daughter’s body looks amazing, don’t say that. Here are some things you can say instead:

“You look so healthy!” is a great one.

Or how about, “You’re looking so strong.”

“I can see how happy you are — you’re glowing.”

Better yet, compliment her on something that has nothing to do with her body.

Don’t comment on other women’s bodies either. Nope. Not a single comment, not a nice one or a mean one.

Teach her about kindness towards others, but also kindness towards yourself.

Don’t you dare talk about how much you hate your body in front of your daughter, or talk about your new diet. In fact, don’t go on a diet in front of your daughter. Buy healthy food. Cook healthy meals. But don’t say, “I’m not eating carbs right now.” Your daughter should never think that carbs are evil, because shame over what you eat only leads to shame about yourself.

Encourage your daughter to run because it makes her feel less stressed. Encourage your daughter to climb mountains because there is nowhere better to explore your spirituality than the peak of the universe. Encourage your daughter to surf, or rock climb, or mountain bike because it scares her and that’s a good thing sometimes.

Help your daughter love soccer or rowing or hockey because sports make her a better leader and a more confident woman. Explain that no matter how old you get, you’ll never stop needing good teamwork. Never make her play a sport she isn’t absolutely in love with.

Prove to your daughter that women don’t need men to move their furniture.

Teach your daughter how to cook kale.

Teach your daughter how to bake chocolate cake made with six sticks of butter.

Pass on your own mom’s recipe for Christmas morning coffee cake. Pass on your love of being outside.

Maybe you and your daughter both have thick thighs or wide ribcages. It’s easy to hate these non-size zero body parts. Don’t. Tell your daughter that with her legs she can run a marathon if she wants to, and her ribcage is nothing but a carrying case for strong lungs. She can scream and she can sing and she can lift up the world, if she wants.

Remind your daughter that the best thing she can do with her body is to use it to mobilize her beautiful soul.

A Complicated Normal: Riding the Wave of Mental Illness ~ Vanessa Hazzard

I thought I was well. It’s been over a year since I stopped cutting and almost two years since I’ve been released from the hospital after being treated for borderline personality disorder, bipolar disorder and PTSD. Since then, I’ve held a steady job and re-enrolled in a Bachelors degree program. My life had been successfully recalibrated after years of trauma. That life was so far in the rear view mirror, so small, that it seemed just a blip on the radar compared to all the good things that lay before me.

I felt normal for the first time in my life. Not bland normal, just sane normal; a stable, healthy, functional normal. I should’ve known that my kind of normal is a bit more complicated when a seemingly innocent hug from behind triggered a rush of memories long forgotten. It wasn’t even so much the memories themselves that bothered me. It was the feelings of being dirty, used-up, and insignificant that accompanied them. I’m not lazy when it comes to my mental health. I do the work, as tiresome as it may be, and yet this occurrence sent me into a tailspin. How can some people shake off their woes, while others, like myself, are just left shaken? 

That night, I tried to sleep it off, but to no avail. Through all the tossing and turning and tears, I couldn’t escape myself. I remembered that I had an expired bottle of Valium with a few pills left inside. Hoping they still had some potency; I washed down a pill with a sip of cheap wine and waited for my mind to settle but it wasn’t long before the psychosis began. This trance-like reality was a familiar place for me, just a few years prior when the symptoms of PTSD were at its peak. I was slow and heavy, yet deliberate when I grabbed the razor in my drawer and did as I’ve done many times before. I cranked up the classical music station I was listening to and began slicing my inner thighs. The razor slid across my skin like a bow on violin strings. I always want to be a violin when I’m in this state. It’s so beautiful, fine and delicate, attributes I always fell short of embodying.

At first, my slicing was a bit haphazard, a few cuts here and there. I just wanted to see my blood escape from the inside of my body. Then, as the music grew louder, I became increasingly more intentional with the cutting, as my need to be a violin intensified. I was focused and on a mission. By this point, my mind was completely fragmented yet a small part of me knew I was obsessed with an impossibility. But the orchestral violins, like a pied piper, led my other parts further and further away from the stable, healthy, functional normal that I worked so hard to achieve. I began cutting a musical staff in my leg. Then I sliced another. Then one more. I kept going until the violins released their hold and I was re-minded. I’m not sure how much time went by, but when I looked down, I had cuts that spanned the length of both my inner thighs. The drops of blood dripped out like notes in a messed up lullaby, as it was successful at putting me to sleep. 

The days and nights that followed were more of the same. I’d put on a happy, pleasant face at work. I’d help my son with his homework, make dinner, and then head upstairs to cut while he was playing with his uncles. I was good at faking normalcy when all the while I was slipping deeper and deeper into depression. Truth is, I was battling a depressive episode for a few weeks, but was able to keep it at bay. Between medication, meditation, and working out, I knew I was able to work through it as I have done in the past. This trigger though…it snuck up on me and pulled me under. For days, I was a melancholy mass of flesh and shame drudging through what felt like molasses towards the mights at the end of the tunnel. I might be healthy one day. I might be successful. I might never have to take medication again. The thought of my son was like dangling a carrot in front of me to keep me running towards those mights, instead of succumbing to my current reality…my inner thighs were full of fresh, self-inflicted scars… the results of a poor and dangerous coping mechanism. One that I sadly and shamefully enjoyed.

When bedtime came, my son came upstairs crying for his dad. His dad and I have been divorced and living in separate households for a few years now. Even when I think that my son has processed our separation and accepted that he’ll see his dad only on weekends, by mid-week he usually begins to cry for him. I do as I always do. I put him on my lap and rock and embrace him. The weight of his, lanky, seven-year-old body stings my scars and I am immediately filled with hypocrisy. How can I console him when I can’t healthily attend to my own depression?

After his tears subside, he asks me to read him a book, Something Beautiful by Sharon Dennis Wyeth. The little girl in the book is in search of something beautiful in her neighborhood and questions her neighbors on what they think is beautiful. In the end, the girl’s mother says that she is her something beautiful. I looked at my son and said, “…and you’re my something beautiful”. Without hesitation, he replied, “…and you are mine, mommy”. I couldn’t help but burst into tears while my son drifted off to sleep. This tainted, scarred body and complicated mind was his mommy…and he thought her beautiful. That was his normal and I hope that one day it becomes my own.

Woman Says She Endured 8 Days In Psych Ward Because Cops Didn’t Believe BMW Was Hers ~ Christopher Mathias



NEW YORK — Kamilah Brock says the New York City police sent her to a mental hospital for a hellish eight days, where she was forcefully injected with powerful drugs, essentially because they couldn’t believe a black woman owned a BMW. 

In her first on-camera interview about her ordeal, which aired Thursday, the 32-year-old told PIX11 that it was all a “nightmare.”

It’s a nightmare, Brock’s lawyer told The Huffington Post, that never would have happened if she weren’t African-American.  

Brock sued the city earlier this year in the U.S. District Court for the Southern District of New York. She contends that her constitutional rights under the Fourth and 14th Amendments were violated and that she suffered “unwanted and unwarranted intrusion of her personal integrity, loss of liberty [and] mental anguish.” 

The suit details how Brock pulled up to a traffic light in Harlem on Sept. 12, 2014, the music on her car stereo playing loudly. An NYPD officer approached her and asked why she was driving without her hands on the steering wheel, according to the suit. 

“I said I was dancing, I am at a light,” Brock told PIX11. “He asked me to get out of the car.”

For unclear reason, Brock contends, she was taken into custody and transported to the NYPD’s 30th Precinct, where she was held for a few hours before being released without being charged with any crime. She said she was told to come back the next day to pick up her car, a 2003 BMW 325Ci.

When she showed up at a police substation to get the car the next day, Brock said, “I just felt like from the moment I said I owned a BMW, I was looked at as a liar. They put me in handcuffs and said they just need to put me in handcuffs to take me to my car. And I said OK, whatever it’s gonna take to get to my car.”

“Then EMS approached me,” she continued. “And they said we’re gonna take you to your car. And I’m like, in an ambulance? I’m going to my car in an ambulance? I’m going to my car in an ambulance? I was just so confused.”

Brock was taken instead to Harlem Hospital, where medical records obtained by her attorney, Michael Lamonsoff, show she was injected with powerful sedatives and forced to take doses of lithium.

“He held onto me and then the doctor stuck me in the arm and I was on a stretcher and I woke up to them taking my clothes off, specifically my underwear,” Brock tearfully recalled for PIX11’s Nicole Johnson. “Then I went back out again. When I woke up the next day, I felt like I was in a nightmare. I didn’t understand why that was happening to me.” 

Medical records also show that over the course of her eight-day stay, personnel at the hospital repeatedly tried to get Brock to deny three things before she could be released: that she owned the BMW, that she was a professional banker, and that President Barack Obama followed her on Twitter. 

The lawsuit says it was these three assertions that were the basis for the city determining that Brock was delusional and to diagnose her with bipolar disorder. 

But according to Lamonsoff, Brock had no history of mental illness. She did own the BMW. At the time, she was employed as a banker and had worked at Citibank, Chase and Astoria Bank. And Obama does follow Brock on Twitter, just as he follows 640,000 other people. 

When Brock was finally released from the hospital, the lawsuit states, she was slapped with a $13,000 medical bill.

A white woman would not have been treated like that, Lamonsoff argues.


“If a white woman was trying to reclaim her BMW impounded by police, would she have been made a victim?” he said to HuffPost. “Would she have been questioned? Would she have been subject to sarcastic comments? Would she be made to justify who she was in order to ask for help? I don’t think so. I do think race played a part in this.”

Institutional bias against African-Americans is well-documented and contributes to the racial disparities in how laws are enforced. Just this week, James Blake, formerly the fourth-ranked men’s tennis player in the world, was tackled and handcuffed at a midtown Manhattan hotel by police officers who confused him for a suspect in a crime. Blake, who is black, suffered cuts and bruises and was detained for about 15 minutes, until officers realized who he was. 

“In my mind, there’s probably a race factor involved, but no matter what, there’s no reason for anybody to do that to anybody,” Blake said after the incident.

Responding to Brock’s lawsuit earlier this summer, the city claimed in court filings that she had been “acting irrational, she spoke incoherently and inconsistently, and she ran into the middle of traffic on Eighth Ave” during her encounter with police.

Lamonsoff told HuffPost that “those allegations are without merit” and that “the true facts of what happened that day will be brought out” through the litigation. The lawsuit, which names the city of New York, unidentified police officers and Harlem Hospital as defendants, seeks unspecified damages.

Neither the NYPD nor the City Law Department, which handles lawsuits filed against the city, responded to a request for comment on Friday. Previously the police department has only confirmed that Brock was taken into custody.

This Amazing 10-Year-Old Wants To Help Make Girls More Confident by Taryn Finley


Olivia Allen, 10, has already taken her first steps to becoming a philanthropist.

Allen, who lives in Louisville, Kentucky, hosted a free conference for her peers on Aug. 22 titled, “I Can Be: Girls Confidence Conference.”

“It’s important to give back,” Allen told The Huffington Post. “There are a lot of people in our community and if I help someone, they’ll help someone else… and it will be a cycle.”

About 50 girls ages 8 to 12, and their parents, attended the conference as Allen led her peers in a morning filled with workshops that touched on the physical, social and psychological challenges young girls face, mainly by tackling wavering self-esteem.

Allen said, this conference was necessary because she noticed a decline in morale among young girls in her community.

“I realize some girls’ confidence goes down when they start puberty,” Allen said, admitting that she even noticed a difference in her own at times. Because of this, she said, she wanted to do something to uplift others. 


Allen spent this summer planning the conference mainly on her own and had financial assistance from her mother, Anitra Allen. She contacted speakers to help lead three separate workshops that focused on envisioning success, turning a passion into a business and personal health care. The conference also featured two keynote speakers (Barbara Sexton Smith and Ashley D. Miller) who addressed confidence and pursuing your dreams. Greg Fischer, mayor of Louisville, opened the conference and commended Allen for her work in the community.

According to her mom, Allen has always had a caring spirit. She said, her daughter once told her after seeing a panhandler one day after school, “Mommy, every time I see a homeless person, I just want to raise money to buy them a house.” She suggested her daughter do something more feasible to help out her community and Allen took her advice, she said, by holding a toy drive in March where she collected more than 100 toys for Kosair Charities. One month following the toy drive, Allen organized a food drive where she fed underprivileged children in her community. 

The confidence conference was Allen’s most recent community outreach event, but she told HuffPost it wouldn’t be her last. She plans on continuing her work in the community and holding another conference for girls soon, she said. 

“The importance of having a conference like this is to show girls what they can be,” her mom told HuffPost. “I never want to tell her she can’t do anything.” 

Allen attributes much of her confidence to both her parents and her spiritual upbringing. Her career aspirations currently include everything from becoming a fashion designer, mathematician, news anchor, actress, singer and more.

“It was important to me because it was important to her,” her mom said. “Confidence is one of those things that can dictate what you decide to do and that will influence who you think you are.”

How Menstrual Cups Are Changing Lives in East Africa by Sabrina Rubli

Women around the world consistently face unique, gender-specific barriers when it comes to staying safe and healthy. Women are at higher risk for contracting HIV/AIDS, malaria, pneumonia, as well as sexual assault and related complications. Many of these issues are beyond our control, and linked to deep-rooted cultural practices that would take decades to alter. 

However, there are some issues that can be addressed, and have surprisingly simple solutions with remarkably impactful outcomes. Menstruation is a huge barrier faced by women around the world, and improper management and hygiene practices often lead to serious health concerns, as well as harmful social practices

In Kenya, the average cost of a package of sanitary pads is 75KSH — approximately $1 CAD. While this may seem like a minimal amount of money, the average daily income for unskilled labourers is around $1.50 CAD, meaning that purchasing sanitary supplies each month is not financially possible for thousands of women. 

Without access to proper sanitary supplies, women and girls will resort to using alternative methods of menstrual management — such as leaves, newspaper, rags, cotton, bits of mattress stuffing, even mud. Not only do these methods not work, but they can lead to serious infections and discomfort. Not to mention how uncomfortable they are to wear during the day.

Providing access to healthy and sustainable menstrual management materials allows women to stay safe, and healthy, and does not sacrifice her ability to participate in work, school or daily activities. 

Menstrual cups are made out of surgical grade silicone and are inserted into the vagina to collect, rather than absorb menstrual fluid, and are overall a much healthier option for a woman’s body. Unlike tampons and pads that contain harmful bleaches and chemicals, menstrual cups have no negative side effects on a woman’s body and there is no threat of Toxic Shock Syndrome. 


When inserted correctly, the cup sits about half an inch inside the vagina, and creates a vacuum seal to prevent leakage. The cups provide 12 hours of comfortable, leak-free protection, and can be reused for up to 10 years — making it an economically wise and sustainable solution. For women in North America, it makes your period simple and hassle-free. For women in developing countries, it can be a life-changing solution.

Menstrual cups create economic freedom and relieve the financial burden of menstruation. Without having to budget for sanitary pads each month, women are better able to provide for themselves and their families. 

Having 12 hours of protection allows women to go about her life without having to worry about locating latrines — a major challenge in many communities. It also allows her to control her body — emptying the cup when she has the time for a shower. 

For schoolgirls, having a menstrual cup allows them to attend school — every day of the month. Girls in Kenya will miss an average of 4.9 days of school each month because of her periods, adding up to around 20 per cent of the school year. Giving a schoolgirl a menstrual cup means she no longer needs to leave school to find a latrine during the day. She is no longer afraid of leaking, and being mocked by her classmates. She can sit comfortably in class and participate in school activities. She no longer needs to skip breakfast to buy pads. 


Keeping girls in the classroom allows them to excel academically, and increases their odds of continuing on to post-secondary school, and becoming influential and respected members of society. 

Femme International’s Feminine Health Management Program distributes menstrual cups, along with the essential education and hygiene materials to schoolgirls in East Africa, helping them stay safe, health and in school — every day of the month. To donate a menstrual cup, or a Femme Kit, to a girl in need, please visit Femme’s Holiday Giving Campaign


This Type Of Breast Cancer Is More Deadly For Black Women by Lindsey Tanner

For young women and black women, the death rates were twice as high.

CHICAGO (AP) — New research shows that chances of dying from very early breast cancer are small but the disease is riskier for young women and blacks, the same disparities seen for more advanced cancer.

Death rates in the 20 years after diagnosis totaled about 3 percent for women whose breast cancer was confined to a milk duct. The death rates were twice as high for those younger than 35 at diagnosis and in blacks – but still lower than those with more common invasive breast cancer.

The findings will likely add to the debate over how to treat these early kinds of tumors that some have said should not even be considered a true cancer because they rarely spread.

The study authors analyzed U.S. government data on more than 100,000 women diagnosed from 1988 to 2011 with DCIS – ductal carcinoma in situ. Women were aged 54 on average at diagnosis.

Though low, the risk of dying from breast cancer was almost twice as high as the breast cancer rate in the general population of U.S. women, said Dr. Steven Narod, the lead author and a senior scientist at Women’s College Research Institute in Toronto.

More than 900 women died of breast cancer during the study years. Some had developed invasive disease in either breast, but more than 500 deaths were in women never diagnosed with a second tumor or recurrence, meaning their DCIS had likely spread before they received treatment, Narod said.

The study was published Thursday in JAMA Oncology.

DCIS will be found in about 60,000 U.S. women this year, versus more than 230,000 women expected to be diagnosed with invasive breast cancer, the cancer society estimates. More women have been diagnosed with DCIS in recent years because of increased screening and better imaging techniques.

Standard DCIS treatment is lumpectomy followed by radiation, although some women choose to have the entire breast or even both breasts removed. The study found that radiation reduced chances for disease recurrence but didn’t lower 20-year survival chances. That may lead some women to skip radiation, Narod said.

By contrast, the results may lead some young women and blacks to seek more aggressive treatment including chemotherapy, although that isn’t usually recommended when the death rate is less than 10 percent, he said.

“These are tough choices,” said Dr. Len Lichtenfeld, the American Cancer Society’s deputy chief medical officer.

Women diagnosed with DCIS shouldn’t panic, he said, because chances for being cured are good. Still, the study shows the disease can behave like invasive cancer and doctors should discuss rates for recurrence and death, and inform patients of all options, he said.

Dr. Richard Bleicher, a breast cancer expert at Fox Chase Cancer Center in Philadelphia, noted that the study lacked information that may have influenced women’s outcomes, including whether younger women who died had genetic mutations that may have put them at risk.

A JAMA Oncology editorial says more research is needed to better understand the riskiest DCIS cases and to test treatment approaches that may reduce deaths.


JAMA Oncology:

American Cancer Society: