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Small Tumors as Risk Factors not Disease
Published online by Cambridge University Press: 01 January 2022
Abstract
I argue that ductal carcinoma in situ (DCIS), the tumor most commonly diagnosed by breast mammography, cannot be confidently classified as cancer, that is, as pathological. This is because there may not be dysfunction present in DCIS—as I argue based on its high prevalence and the small amount of risk it conveys—and thus DCIS may not count as a disease by dysfunction-requiring approaches, such as Boorse’s biostatistical theory and Wakefield’s harmful dysfunction account. Patients should decide about treatment for DCIS based on the risks it poses and the risks and benefits of treatment, not on its disease status.
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- Copyright © The Philosophy of Science Association
Footnotes
Thanks to Chris Boorse, Dan Hausman, Eric Meslin, and Greg Sachs for discussion. Thanks to Anya Plutynski for inviting me to participate in this panel and Miriam Solomon for her commentary. My research was supported in part by a career development award from the American Cancer Society (CCCDA-10-085-01) and by the Indiana Clinical and Translational Sciences Institute (National Institutes of Health [NIH]/National Center for Research Resources [NCRR]: 1 UL TR001108-01).
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