What Is Ductal Carcinoma In Situ
Ductal carcinoma in situ is a very early form of breast cancer thats confined to the milk ducts, which is why its called ductal. Carcinoma is the name for any cancer that begins in cells that line the inner or outer surfaces of tissues, such as the breast ducts. In situ is a Latin term meaning in its original place. DCIS is the most common form of noninvasive breast cancer.
DCIS is classified as low, intermediate, or high grade. Grades are based on what the cells look like under a microscope. The lower the grade, the more closely DCIS resembles normal breast cells. The higher the grade, the more different it is from normal cells. DCIS can sometimes involve the nipple, causing it to look red and scaly. This is a rare form of cancer known as Pagets disease of the breast .
In some women, DCIS may not progress to invasive cancer in their lifetime. This has fueled debate about DCIS about whether women with low-risk disease need any treatment, or if they could be safely checked with annual mammograms and breast exams to see if the cancer is progressing. Currently, the standard treatment for DCIS includes surgery, often a lumpectomy.
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What Should A Person With Stage 4 Breast Cancer Expect From Treatment
Treatment options vary widely depending on where you live, your access to specialists and sub-specialists, and your willingness to try therapies that are still in the experimental phase.
Seek out oncology specialists who specialize in Stage 4 breast cancer. Discuss with your treatment team what clinical trials may be available for your clinical situation.
During this time, be sure to surround yourself with a support system of friends and family.
What Are The Risk Factors For Breast Cancer
Like many conditions, risk factors for breast cancer fall into the categories of things you can control and things that you cannot control. Risk factors affect your chances of getting a disease, but having a risk factor does not mean that you are guaranteed to get a certain disease.
Controllable risk factors for breast cancer
- Alcohol consumption. The risk of breast cancer increases with the amount of alcohol consumed. For instance, women who consume two or three alcoholic beverages daily have an approximately 20% higher risk of getting breast cancer than women who do not drink at all.
- Body weight. Being obese is a risk factor for breast cancer. It is important to eat a healthy diet and exercise regularly.
- Breast implants. Having silicone breast implants and resulting scar tissue make it harder to distinguish problems on regular mammograms. It is best to have a few more images to improve the examination. There is also a rare cancer called anaplastic large cell lymphoma that is associated with the implants.
- Choosing not to breastfeed. Not breastfeeding can raise the risk.
- Using hormone-based prescriptions. This includes using hormone replacement therapy during menopause for more than five years and taking certain types of birth control pills.
Non-controllable risk factors for breast cancer
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T Categories For Breast Cancer
T followed by a number from 0 to 4 describes the main tumor’s size and if it has spread to the skin or to the chest wall under the breast. Higher T numbers mean a larger tumor and/or wider spread to tissues near the breast.
TX: Primary tumor cannot be assessed.
T0: No evidence of primary tumor.
Tis: Carcinoma in situ
T1 : Tumor is 2 cm or less across.
T2: Tumor is more than 2 cm but not more than 5 cm across.
T3: Tumor is more than 5 cm across.
T4 : Tumor of any size growing into the chest wall or skin. This includes inflammatory breast cancer.
Male Breast Ultrasound: Gynecomastia Versus Breast Cancer
Male breast cancer is very rare, but one condition, gynecomastia, which is the development of abnormally large breasts in men, is quite common. Gynecomastia is usually caused by excessive growth of fibroglandular breast tissue in men in their 60s or as the result of hormonal imbalances.
However, in rare cases, breast cancer can be the cause of gynecomastia so, a full mammographic investigation is always necessary.
In the mammogram below, one can see the increase in the density of the fibroglandular tissues behind the nipple. It appears to be developing in a concentric pattern. The contour of the dense area is concave-outward and interspersed with fat.
There are no well-formed masses and no suspicious microcalcifications. It certainly would appear to be gynecomastia from natural or hormonal causes and not breast cancer.
In the sonogram of the same breast, one notes that the density appears hypoechoic with ill-defined margins. The amount of tissue appears to be thicker than average in a male but the only way to know if anything abnormal is going on in the sonogram would be to compare it with an ultrasound of the other breast to see if the densities are about the same.
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What Are The Warning Signs Of Breast Cancer
- A lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle.
- A mass or lump, which may feel as small as a pea.
- A change in the size, shape, or contour of the breast.
- A blood-stained or clear fluid discharge from the nipple.
- A change in the look or feel of the skin on the breast or nipple .
- Redness of the skin on the breast or nipple.
- An area that is distinctly different from any other area on either breast.
- A marble-like hardened area under the skin.
These changes may be found when performing monthly breast self-exams. By performing breast self-exams, you can become familiar with the normal monthly changes in your breasts.
Breast self-examination should be performed at the same time each month, three to five days after your menstrual period ends. If you have stopped menstruating, perform the exam on the same day of each month.
A Change In The Breast Or Nipple Appearance
- Any unexplained change in the size or shape of the breast
- Dimpling anywhere on the breast
- Unexplained swelling of the breast
- Unexplained shrinkage of the breast
- Recent asymmetry of the breasts. Although it is common for women to have one breast that is slightly larger than the other, if the onset of asymmetry is recent, it should be checked.
- Nipple that is turned slightly inward or inverted
- Skin of the breast, areola, or nipple that becomes scaly, red, or swollen or may have ridges or pitting resembling the skin of an orange
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Men And Breast Cancer Warning Signs
Breast cancer isnt typically associated with people who were assigned male at birth. But male breast cancer can occur in rare instances at any age, although its more common in older men.
Many people dont realize that people assigned male at birth have breast tissue too, and those cells can undergo cancerous changes. Because male breast cells are much less developed than female breast cells, breast cancer isnt as common in this part of the population.
The most common symptom of breast cancer in people assigned male at birth is a lump in the breast tissue.
Other than a lump, symptoms of male breast cancer include:
- thickening of the breast tissue
- nipple discharge
- redness or scaling of the nipple
- a nipple that retracts or turns inward
- unexplained redness, swelling, skin irritation, itchiness, or rash on the breast
Most men dont regularly check their breast tissue for signs of lumps, so male breast cancer is often diagnosed much later.
Although a lump in the breast is typically associated with breast cancer, these lumps usually arent cancer. Most are benign, or noncancerous.
Common causes of benign breast lumps include:
With fat necrosis, the mass cant be distinguished from a cancerous lump without a biopsy.
Even though the majority of breast lumps are caused by less severe conditions, new, painless lumps are still the most common symptom of breast cancer.
How Is Breast Cancer Diagnosed
Magnetic resonance imaging may be used to diagnose breast cancer.
Doctors often use additional tests to find or diagnose breast cancer. They may refer women to a breast specialist or a surgeon. This does not mean that she has cancer or that she needs surgery. These doctors are experts in diagnosing breast problems.
- Breast ultrasound. A machine that uses sound waves to make pictures, called sonograms, of areas inside the breast.
- Diagnostic mammogram. If you have a problem in your breast, such as lumps, or if an area of the breast looks abnormal on a screening mammogram, doctors may have you get a diagnostic mammogram. This is a more detailed X-ray of the breast.
- Breast magnetic resonance imaging . A kind of body scan that uses a magnet linked to a computer. The MRI scan will make detailed pictures of areas inside the breast.
- Biopsy. This is a test that removes tissue or fluid from the breast to be looked at under a microscope and do more testing. There are different kinds of biopsies .
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What Are The Stages Of Breast Cancer
There are two different staging systems for breast cancer. One is called anatomic staging while the other is prognostic staging. The anatomic staging is defined by the areas of the body where the breast cancer is found and helps to define appropriate treatment. The prognostic staging helps medical professionals communicate how likely a patient is to be cured of the cancer assuming that all appropriate treatment is given.
The anatomic staging system is as follows:
Stage 0 breast disease is when the disease is localized to the milk ducts .
Stage I breast cancer is smaller than 2 cm across and hasn’t spread anywhere including no involvement in the lymph nodes.
Stage II breast cancer is one of the following:
- The tumor is less than 2 cm across but has spread to the underarm lymph nodes .
- The tumor is between 2 and 5 cm .
- The tumor is larger than 5 cm and has not spread to the lymph nodes under the arm .
Stage III breast cancer is also called “locally advanced breast cancer.” The tumor is any size with cancerous lymph nodes that adhere to one another or to surrounding tissue . Stage IIIB breast cancer is a tumor of any size that has spread to the skin, chest wall, or internal mammary lymph nodes .
Stage IV breast cancer is defined as a tumor, regardless of size, that has spread to areas away from the breast, such as bones, lungs, liver or brain.
How Long Does A Breast Ultrasound Take
The examination takes between 1530 minutes.
Sometimes you will be asked to wait and have the images checked by a radiologist . Sometimes it will be necessary for the radiologist to attend the examination, because it may be important to see the images on the screen rather than as still photographs. The radiologist may also want to examine your breast if you have a symptom and might also ask you some questions about these symptoms. This extra information may help the radiologist to better understand your ultrasound images, so they can give an accurate diagnosis.
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Chronic Abscess Of The Breast
Patients may present with fever, pain, tenderness to touch and increased white cell count. Abscesses are most commonly located in the central or subareolar area. An abscess may show an ill-defined or a well-defined outline. It may be anechoic or may reveal low-level internal echoes and posterior enhancement .
Do You Need Tests For Later
Imaging tests. If your cancer is stage IIIB or IV, you should get an imaging test to look for cancer in other parts of your body. Treatment can depend on how much and where the cancer has spread.
Tumor marker tests. If you have later-stage breast cancer, your doctor may also use blood tests to look at tumor markers. These tests should be done only when it is known that you have advanced cancer.
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
09/2012
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What To Know About Breast Cancer Symptoms
The symptoms of breast cancer can vary widely and some types of breast cancer may not have any noticeable symptoms.
Sometimes a lump may be too small to be felt or to cause any changes to your breast or surrounding area. In these cases, cancerous cells are often first detected through screening techniques like a mammogram.
When there are symptoms, they can include:
- a lump or thickening of breast tissue that you can feel with your fingers
- breast swelling or changes to your breast size or shape
- changes to the skin on your breast, such as dimpling, redness, or skin irritation
- the nipple turning inward or nipple pain
- a lump in your underarm area
- nipple discharge other than breast milk
Its important to be familiar with how your breasts usually look and feel. This will help you notice any changes and to follow up with your healthcare professional promptly if anything looks or feels different.
Noninvasive breast cancer develops in the cells of a duct or lobule and remains in that location. Its also referred to as in situ which means in the original place.
There are two types of noninvasive breast cancer:
- ductal carcinoma in situ
- lobular carcinoma in situ
Lets take a closer look at each type.
Who Interprets The Results And How Do I Get Them
A radiologist, a doctor trained to supervise and interpret radiology exams, will analyze the images. The radiologist will send a signed report to the doctor who requested the exam. Your doctor will then share the results with you. In some cases, the radiologist may discuss results with you after the exam.
You may need a follow-up exam. If so, your doctor will explain why. Sometimes a follow-up exam further evaluates a potential issue with more views or a special imaging technique. It may also see if there has been any change in an issue over time. Follow-up exams are often the best way to see if treatment is working or if a problem needs attention.
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Stage Of Breast Cancer
When your breast cancer is diagnosed, the doctors will give it a stage. The stage describes the size of the cancer and how far it has spread.
Ductal carcinoma in situ is sometimes described as Stage 0. Other stages of breast cancer describe invasive breast cancer .
- Stage 1 the tumour measures less than 2cm and the lymph nodes in the armpit aren’t affected. There are no signs that the cancer has spread elsewhere in the body.
- Stage 2 the tumour measures 2-5cm or the lymph nodes in the armpit are affected, or both. There are no signs that the cancer has spread elsewhere in the body.
- Stage 3 the tumour measures 2-5cm and may be attached to structures in the breast, such as skin or surrounding tissues. The lymph nodes in the armpit are affected. However, there are no signs that the cancer has spread elsewhere in the body.
- Stage 4 the tumour is of any size and the cancer has spread to other parts of the body .
This is a simplified guide. Each stage is divided into further categories: A, B and C. If you’re not sure what stage you have, ask your doctor.
How A Breast Cancers Stage Is Determined
Your pathology report will include information that is used to calculate the stage of the breast cancer that is, whether it is limited to one area in the breast, or it has spread to healthy tissues inside the breast or to other parts of the body. Your doctor will begin to determine this during surgery to remove the cancer and look at one or more of the underarm lymph nodes, which is where breast cancer tends to travel first. He or she also may order additional blood tests or imaging tests if there is reason to believe the cancer might have spread beyond the breast.
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What Do Lumps In My Breast Mean
Many conditions can cause lumps in the breast, including cancer. But most breast lumps are caused by other medical conditions. The two most common causes of breast lumps are fibrocystic breast condition and cysts. Fibrocystic condition causes noncancerous changes in the breast that can make them lumpy, tender, and sore. Cysts are small fluid-filled sacs that can develop in the breast.
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Palpation Of Benign Breast Masses
In contrast to breast cancer tumors, benign lumps are often squishy or feel like a soft rubber ball with well-defined margins. Theyre often easy to move around and may be tender.
Breast infections can cause redness and swelling. Sometimes it can be difficult to tell the difference between mastitis and inflammatory breast cancer, but mastitis often causes symptoms of fever, chills, and body aches, and those symptoms arent associated with cancer.
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