What Is Ductal Breast Cancer

Side Effects And Complications

All treatments have some side effects that range from mild to severe. Most clear up when treatment ends, but there can be some lasting complications.

Its important to tell your oncologist about all symptoms, even if they seem minor. Your healthcare team will work with you to ease side effects and deal with complications.

Can Dcis Be Left And Not Treated

Because theres no way of knowing when or if DCIS will become invasive, treatment is usually recommended. Its possible this may lead to unnecessary treatment for some people.

The aim of treatment is to remove all the DCIS from within the breast to reduce the chance of it becoming an invasive cancer.

Research is looking at which cases of DCIS are more likely to develop into invasive breast cancer and which could be closely monitored instead of being treated. If you are diagnosed with low-grade DCIS, you may be invited to join a clinical trial.

If you have any questions or concerns about your diagnosis and treatment, talk to your treatment team.

How Is Dcis Treated

Because DCIS involves the diagnosis of abnormal cells at a very early stage, treatments are usually highly effective.

Also, since the abnormal cells are only found in your breast duct, chemotherapy is never needed for DCIS.

Lets take a closer look at some treatment options you and your healthcare team may decide to use, based on your specific diagnosis and situation.

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What Are The Symptoms Of Lobular Carcinoma

Often, in the earliest stages, lobular carcinoma causes no signs or symptoms. Lobular invasive breast cancer may cause an area of thickening in the breast. Likewise, there may be an area of fullness or swelling in the breast.

The appearance of the skin over the affected breast may change and appear dimpled. The nipple can become inverted.

Please note, however, that lobular breast cancer is less likely than other types to cause a firm breast lump.

What Does It Mean If My Report On Ductal Carcinoma In Situ Mentions Estrogen Receptor Or Progesterone Receptor

ER and PR are special tests that the pathologist does that are important in predicting response of the DCIS to hormone therapy . Testing for ER is done for most cases of DCIS, but testing for PR is not typically needed. Results for ER and PR are reported separately and can be reported in different ways:

• Negative, weakly positive, positive
• Percent positive with something saying whether the staining is weak, moderate, or strong

Ask your doctor how these results will affect your treatment.

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Hierarchical Clustering Of Lobular Tumors

Seventeen lobular and 6 reduction mammoplasty samples were analyzed by hierarchical clustering on a subset of â¼3500 genes to explore tumor grouping and gene clustering in the lobular samples. These genes were chosen on the basis of being present in at least 80% of the lobular and normal cases.

Several clusters of related genes were evident by hierarchical clustering, the largest of which was related to proliferation . This cluster included genes such as cyclin E1, cdc6, PCNA, B-myb, histones and histone related centromeric proteins , the chek1 mitotic checkpoint gene, and GART . Three groups of tumors were evident. Group I, which included the normal samples, was characterized by low levels of expression of genes in the proliferation-associated cluster, group II tumors showed the highest levels of expression, and group III showed mixed expression levels.

Can Dcis Develop Into Invasive Breast Cancer

If DCIS is not treated, the cancer cells may develop the ability to spread outside the ducts, into the surrounding breast tissue. This is known as invasive breast cancer. Invasive cancer has the potential to also spread to other parts of the body.

In some cases, DCIS will never develop further or grows so slowly that it would never cause harm during a persons lifetime. Although the size and grade of the DCIS can help predict if it will become invasive, there is currently no way of knowing if this will happen. is more likely to become an invasive breast cancer and to do so over a shorter time than low-grade DCIS.

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What Clinical Trials Are Available For Women With Inflammatory Breast Cancer

NCI sponsors clinical trials of new treatments for all types of cancer, as well as trials that test better ways to use existing treatments. Participation in clinical trials is an option for many patients with inflammatory breast cancer, and all patients with this disease are encouraged to consider treatment in a clinical trial.

Descriptions of ongoing clinical trials for individuals with inflammatory breast cancer can be accessed by searching NCIs list of cancer clinical trials. NCIs list of cancer clinical trials includes all NCI-supported clinical trials that are taking place across the United States and Canada, including the NIH Clinical Center in Bethesda, MD. For information about how to search the list, see Help Finding NCI-Supported Clinical Trials.

People interested in taking part in a clinical trial should talk with their doctor. Information about clinical trials is available from NCIs Cancer Information Service at 18004CANCER and in the NCI booklet Taking Part in Cancer Treatment Research Studies. Additional information about clinical trials is available online.

Selected References

What Is A Breast Cancers Grade

Cancer cells are given a grade when they are removed from the breast and checked in the lab. The grade is based on how much the cancer cells look like normal cells. The grade is used to help predict your outcome and to help figure out what treatments might work best.

A lower grade number usually means the cancer is slower-growing and less likely to spread.

A higher number means a faster-growing cancer thats more likely to spread.

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How Is Dcis Diagnosed

DCIS doesnt usually appear as a breast lump or breast change. As a result, most women with DCIS do not show any signs or symptoms of having breast cancer.

Mammograms and ultrasounds are the most common ways in which DCIS is diagnosed. If DCIS is suspected, a biopsy is usually required to confirm whether DCIS is present.

Pathologists usually attribute a grade to DCIS. The grade indicates the patterns of cancer cell growth and how fast the cells are growing. Based on what the DCIS cancer cells look like under a microscope, DCIS can be graded as high, intermediate or low.

If left untreated, high grade DCIS is likely to develop into invasive breast cancer. Low or intermediate grades of DCIS may remain as they are for many years. In some cases, however, low or intermediate grades of DCIS can develop into invasive breast cancer.

While the size and grade of DCIS can help doctors predict whether the cancer is likely to become invasive, there are no certain answers. Unfortunately it is not currently possible to know for certain if a woman will go on to develop invasive breast cancer.

What Are The Symptoms Of Inflammatory Breast Cancer

Symptoms of inflammatory breast cancer include swelling and redness that affect a third or more of the breast. The skin of the breast may also appear pink, reddish purple, or bruised. In addition, the skin may have ridges or appear pitted, like the skin of an orange . These symptoms are caused by the buildup of fluid in the skin of the breast. This fluid buildup occurs because cancer cells have blocked lymph vessels in the skin, preventing the normal flow of lymph through the tissue. Sometimes the breast may contain a solid tumor that can be felt during a physical exam, but more often a tumor cannot be felt.

Other symptoms of inflammatory breast cancer include a rapid increase in breast size sensations of heaviness, burning, or tenderness in the breast or a nipple that is inverted . Swollen lymph nodes may also be present under the arm, near the collarbone, or both.

It is important to note that these symptoms may also be signs of other diseases or conditions, such as an infection, injury, or another type of breast cancer that is locally advanced. For this reason, women with inflammatory breast cancer often have a delayed diagnosis of their disease.

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Are There Risk Factors Associated With Dcis

Exactly what causes DCIS isnt known. Still, research has shed light on some of the possible factors that may increase your risk of developing a breast cancer diagnosis.

Its important to know that your risk of developing breast cancer isnt usually dependent on a single factor. You may have several risk factors, but that doesnt necessarily mean youll get breast cancer.

However, understanding your risk factors can help you make better decisions about your health and healthcare.

The following factors may contribute to a higher risk of breast cancer:

Some risk factors your age, for example are things beyond your control. But some aspects of your lifestyle can affect your overall health and your risk of developing breast cancer.

What Should A Person With Stage 0 Or Stage 1 Breast Cancer Expect Regarding Treatment

Even though Stage 0 breast cancer is considered non-invasive, it does require treatment, typically surgery or radiation, or a combination of the two. Chemotherapy is usually not part of the treatment regimen for earlier stages of cancer.

Stage 1 is highly treatable, however, it does require treatment, typically surgery and often radiation, or a combination of the two. Additionally, you may consider hormone therapy, depending on the type of cancer cells found and your additional risk factors. Like stage 0, Chemotherapy is often not necessary for earlier stages of cancer.

Material on this page courtesy of National Cancer Institute

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How Can Invasive Ductal Carcinoma Of Breast Be Prevented

The following measures may help in reducing the risk for Invasive Ductal Carcinoma of Breast :

General lifestyle changes:

• Maintain a healthy weight and exercise regularly physical activity can reduce risk, especially in post-menopausal women
• Implement and follow a well-balanced diet a high intake of fiber via fresh fruits and vegetables can reduce the risk
• Drink alcohol in moderation limit to one or two drinks a day
• Limit combination hormone therapy used to treat symptoms of menopause. It is advised that individuals be aware of the potential benefits and risks of hormone therapy
• Cancer screenings can help detect any breast cancer, at its earliest stages
• Learn to do âbreast self-examsâ, in order to help identify any unusual lumps, signs in the breasts

In women with a high risk for developing Invasive Ductal Carcinoma of Breast , the physician may suggest the following:

• Preventative medications: The medications tamoxifen and raloxifene are estrogen-blocking drugs that can help prevent the onset of breast cancer in women at high risk. Both drugs have potential side effects including being at a higher risk for blood clots
• Preventative mastectomy: Prophylactic mastectomy, a procedure to surgically remove healthy breasts, is another possible preventative option for women, at a high risk for breast cancer

Ductal Carcinoma In Situ

DCIS is the most common type of noninvasive breast cancer, with about 60,000 new cases diagnosed in the United States each year. About one in every five new breast cancer cases is ductal carcinoma in situ.

Also called intraductal carcinoma or stage 0 breast cancer, its considered a noninvasive breast cancer. With DCIS, abnormal and cancerous cells havent spread from the ducts into nearby breast tissue nor anywhere else, such as the lymph nodes.

DCIS is divided into several subtypes, mainly according to the appearance of the tumor. These subtypes include micropapillary, papillary, solid, cribriform and comedo.

Patients with ductal carcinoma in situ are typically at higher risk for seeing their cancer return after treatment, although the chance of a recurrence is less than 30 percent. Most recurrences occur within five to 10 years after the initial diagnosis and may be invasive or noninvasive. DCIS also carries a heightened risk for developing a new breast cancer in the other breast. A recurrence of ductal carcinoma in situ would require additional treatment.

The type of therapy selected may affect the likelihood of recurrence. Treating DCIS with a lumpectomy , and without radiation therapy, carries a 25 percent to 35 percent chance of recurrence. Adding radiation therapy to the treatment decreases this risk to about 15 percent. Currently, the long-term survival rate for women with ductal carcinoma in situ is nearly 100 percent.

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Is Breast Cancer Painful

Breast pain is not commonly an early sign of breast cancer. However, there are some rare types of breast cancer that can commonly cause pain as one of the first symptoms. This includes inflammatory breast cancer, in which pain or tenderness is often one of the first symptoms, followed by reddening and dimpling of the skin, as well as Pagets disease of the nipple, which can cause pain and burning as an early symptom. Most breast pain is due to normal changes in the breast resulting from changes in hormone levels. Some women have non-cancerous lumpy breast tissue called fibrocystic breasts, which may be more painful during certain times of the month. Certain medications can also cause breast pain. If a person experiences breast pain along with any other symptoms of breast cancer, as listed in the symptoms section above, they should contact their doctor.

Breast cancer is more likely to cause pain in more advanced stages, either if the tumor pushes into nearby healthy tissue or if cancer spreads to other parts of the body, where it may cause pain. Pain can be a side effect of chemotherapy and radiation therapy treatment for breast cancer. For more information, see the resource on chemotherapy side effects.

How Is Noninvasive Breast Cancer Treated

The standard treatment for DCIS is surgery. In most cases, women can opt for lumpectomy, which is breast-conserving surgery. It only removes the area with the cancer and some healthy tissue surrounding it. Radiation therapy is usually necessary after to decrease the risk of the cancer returning. Sometimes, doctors recommend mastectomy, which removes the entire breast. This may be the best choice if the DCIS is large or there are multiple spots within the breast.

Your preference also plays a role in the extent of surgery. A second opinion can help you make this decision. The process can give you another point of view or verify what you have already heard. In either case, you will be making an informed decision, which can increase your confidence.

Hormone therapy will be a treatment option for hormone receptor-positive tumors. Your pathology report will tell your doctor whether or not this treatment is appropriate.

LCIS does not require treatment, but it does increase your risk of breast cancer in the future. Your doctor may recommend additional screening exams, estrogen blocking, or preventive mastectomy.

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Radiation Therapy For Idc

Radiation therapy directs high-energy rays at the breast, chest area, under the arm, and/or the collarbone area to destroy any cancer cells that may be left behind after surgery. This treatment also reduces the risk of recurrence .

Radiation therapy is most often recommended after surgeries that conserve healthy breast tissue, such as lumpectomy and partial mastectomy. Radiation therapy may be recommended after mastectomy as well, especially if the tumor was large and/or the lymph nodes were involved.

Like surgery, radiation is considered a local treatment because it treats just the tumor and surrounding area.

There are different ways of giving radiation therapy, including:

Researchers are studying partial-breast radiation for use after lumpectomy to see how the benefits compare to the current standard of radiation to the whole breast. Because this technique is still under investigation, it is not yet widely available.

You and your doctor can work together to determine what form of radiation therapy is best for you.

What Are Some Advantages Of Receiving Treatment For Dcis At Msk

At MSK, we have a very thoughtful approach to personalizing treatment for each person with DCIS. The doctors and patients make treatment decisions as a team. Much of the research determining risk factors for DCIS-related recurrence was done at MSK, and we have a computerized prediction model that can help calculate an individuals risk of recurrence, which helps us decide what treatments are best. Weve tried to figure out who really needs additional treatments, such as radiation or hormone therapy, and who may be able to avoid certain treatments. Our goal is to find the right treatment for each patient, so that they can remain cancer free with an excellent quality of life moving forward.

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Hormone Therapy After Surgery

If the DCIS is hormone receptor-positive , treatment with tamoxifen or an aromatase inhibitor for 5 years after surgery can lower the risk of another DCIS or invasive cancer developing in either breast. If you have hormone receptor-positive DCIS, discuss the reasons for and against hormone therapy with your doctors.

How Is Inflammatory Breast Cancer Treated

Inflammatory breast cancer is generally treated first with systemic chemotherapy to help shrink the tumor, then with surgery to remove the tumor, followed by radiation therapy. This approach to treatment is called a multimodal approach. Studies have found that women with inflammatory breast cancer who are treated with a multimodal approach have better responses to therapy and longer survival. Treatments used in a multimodal approach may include those described below.

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Is Breast Cancer Hereditary

Most breast cancers are not caused by inherited genetic factors. However, some people may inherit an increased risk of breast cancer. Inherited mutations in the BRCA1 and BRCA2 genes, which produce tumor suppressor proteins, can increase a persons chance of developing breast cancer. These genes can be inherited from either the mother or the father. Not all people who inherit such mutated genes will develop cancer.