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.
Medical Definition Of Intraductal Carcinoma
- Medical Editor: Charles Patrick Davis, MD, PhD
Reviewed on 3/29/2021
Intraductal carcinoma: A condition characterized by the proliferation of malignant cells in the lining of a breast duct without evidence of spreading outside the duct to other tissues in the breast or outside the breast. Also known as ductal carcinoma in situ, abbreviated DCIS. DCIS is clearly a precursor of invasive breast ‘cancer. DCIS originates in a single glandular structure but may spread within the breast through the ductal system. The goal in treating DCIS is to prevent local recurrence and, in particular, invasive breast cancer.
What Are The Symptoms
You cant usually see or feel the abnormal cells in your milk duct. As a result, you may not have any symptoms. In fact, in the vast majority of cases, DCIS is detected during a breast cancer screening using a mammogram.
The abnormal cells typically show up on a mammogram as clusters of bright white flecks with irregular shapes.
In some cases, DCIS may cause symptoms such as:
- discharge coming from a nipple that isnt milk
- a small lump
Most breast symptoms or changes arent caused by cancer, but tests are often needed to rule out the possibility of abnormal breast cells.
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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
How Is Intraductal Papilloma Of Breast Diagnosed
Intraductal Papilloma of Breast may be diagnosed in the following manner:
Biopsies are the only methods used to determine whether an abnormality is benign or cancerous. These are performed by inserting a needle into a breast mass and removing cells or tissues, for further examination. There are different types of biopsies:
- Fine needle aspiration biopsy of breast mass: In this method, a very thin needle is used to remove a small amount of tissue. FNAB cannot help definitively diagnose Intraductal Papilloma of Breast. It only helps determine if the tumor is malignant or benign. This can help the healthcare provider discuss and plan the next steps
- Core needle biopsy of breast mass: A wider needle is used to withdraw a small cylinder of tissue from an abnormal area of the breast. A definitive diagnosis on a core biopsy may be difficult. Hence, a follow-up surgical procedure to obtain a larger breast biopsy specimen is often performed
- Open tissue biopsy of breast mass: A surgical procedure used less often than needle biopsies, it is used to remove a part or all of a breast lump for analysis
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
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Dcis Of The Male Breast
DCIS accounts for approximately 5% of breast cancers in men.84 It usually presents clinically with symptoms of a retro-areola cystic-type mass or bloody nipple discharge. Clinical, rather than mammographic, detection possibly accounts for the different incidence of DCIS between men and women. The predominant histological subtypes of DCIS in men are papillary and cribriform. Standard treatment is total mastectomy with excision of the nippleareola complex but wide excision and radiotherapy is being used more frequently.85 Pure DCIS in men is usually of low or intermediate grade; less than 3% of cases are high grade. In a series of 114 patients, 84 with pure DCIS and 30 with DCIS and invasive cancer, there were no cases of high-grade comedo DCIS in men without an invasive tumour.86 The percentage of men with DCIS that eventually develop an invasive cancer is not known.
Jonathan J. James, Andrew J. Evans, in, 2011
Expert Review And References
- American Cancer Society. Breast Cancer. 2015: .
- Foxson SB, Lattimer JG & Felder B. Breast cancer. Yarbro, CH, Wujcki D, & Holmes Gobel B. . Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett; 2011: 48: pp. 1091-1145.
- Martini FH, Timmons MJ, Tallitsch RB. Human Anatomy. 7th ed. San Francisco: Pearson Benjamin Cummings; 2012.
- Morrow M, Burstein HJ, and Harris JR. Malignant tumors of the breast. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 79: 1117-1156.
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Types Of Breast Cancer
There are many types of breast cancer, and many different ways to describe them. Its easy to get confused over a breast cancer diagnosis.
The type of breast cancer is determined by the specific cells in the breast that are affected. Most breast cancers are carcinomas, which are tumors that start in the epithelial cells that line organs and tissues throughout the body. When carcinomas form in the breast, they are usually a more specific type;called adenocarcinoma, which starts in cells in the ducts or the lobules .
Men With Breast Cancer Usually Have Lumps That Can Be Felt
Lumps and other signs may be caused by male breast cancer or by other conditions. Check with your doctor if you have any of the following:
- A lump or thickening in or near the breast or in the underarm area.
- A change in the size or shape of the breast.
- A dimple or puckering in the skin of the breast.
- A nipple turned inward into the breast.
- Fluid from the nipple, especially if it’s bloody.
- Scaly, red, or swollen skin on the breast, nipple, or areola .
- Dimples in the breast that look like the skin of an orange, called peau dorange.
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What Is Invasive Ductal Carcinoma
Doctors divide breast cancers into types depending on where the cancer starts and how far it spreads. IDC begins in cells that make up the milk ducts, which carry milk from the breast lobules, where it is made, to the nipple. Ductal carcinoma in situ is another type of breast cancer that develops in cells of the milk ducts. In DCIS, the cancer stays inside the milk ducts.
A growing tumor can eventually spread. Breast cancer is called invasive when it grows into the surrounding tissue. IDC develops when milk duct cells turn cancerous and then spread into the nearby fatty or connective tissue within the breast. Eventually, IDC may also metastasize . Other types of invasive breast cancer include invasive lobular carcinoma, triple-negative breast cancer, and inflammatory breast cancer.
Who Is Affected By Ductal Carcinoma In Situ
Most women who get DCIS do not have a family history of breast cancer. Only about 5-10% of breast cancer cases are related to a genetic mutation or family history. Red flags for this include having a family history of breast cancer, especially if the cancer was discovered at a younger age, or before 50 years old. Other red flags for breast cancer that may be related to a genetic mutation include a family history of ovarian cancer, male breast cancer, multiple other cancers in the family and Ashkenazi Jewish ancestry. The most common risk factors for breast cancer include being female and getting older, and these are risk factors that cannot be changed.
Because the tissue in mens breasts do not fully develop the way that the tissue in womens breasts do, men do not usually get breast cancer of this type.
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Lumpectomy With Radiation Therapy
In this procedure, the surgeon will remove the tumor and some healthy breast tissue close by as a precaution.
Sometimes they may also remove the lymph nodes and request a biopsy to confirm that the cancer has not spread. Healthcare professionals call this a sentinel lymph node biopsy . They are more likely to do this if the tumor is large.
After surgery a person will receive radiation therapy to destroy any remaining cells.
What Is Invasive Breast Cancer Versus Noninvasive Breast Cancer
Noninvasive cancer means the abnormal cells are contained in the milk ducts of the breast and lack the ability to spread to surrounding tissue or elsewhere in the body. Invasive breast cancer means the cancer has grown beyond its original location into surrounding normal breast tissue and has the potential to spread to other parts of the body.
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What Is The Prognosis Of Patients With Inflammatory Breast Cancer
The prognosis, or likely outcome, for a patient diagnosed with cancer is often viewed as the chance that the cancer will be treated successfully and that the patient will recover completely. Many factors can influence a cancer patients prognosis, including the type and location of the cancer, the stage of the disease, the patients age and overall general health, and the extent to which the patients disease responds to treatment.
Because inflammatory breast cancer usually develops quickly and spreads aggressively to other parts of the body, women diagnosed with this disease, in general, do not survive as long as women diagnosed with other types of breast cancer.
It is important to keep in mind, however, that survival statistics are based on large numbers of patients and that an individual womans prognosis could be better or worse, depending on her tumor characteristics and medical history. Women who have inflammatory breast cancer are encouraged to talk with their doctor about their prognosis, given their particular situation.
Ongoing research, especially at the molecular level, will increase our understanding of how inflammatory breast cancer begins and progresses. This knowledge should enable the development of new treatments and more accurate prognoses for women diagnosed with this disease. It is important, therefore, that women who are diagnosed with inflammatory breast cancer talk with their doctor about the option of participating in a clinical trial.
How Is Intraductal Papilloma Of Breast Treated
The following treatment methods for Intraductal Papilloma of Breast may be considered:
- A simple surgical excision and removal of the entire Intraductal Papilloma of Breast is normally sufficient treatment. It is the preferred treatment for papillomas
- The surgical procedure performed is known as a breast lumpectomy. It is a surgical procedure to remove the breast lump, which may be done under a general anesthetic
- During the surgery, a small incision is made in the skin of the breast and a hollow probe that is connected to a vacuum, inserted
- The breast tissue is sucked through the probe, using vacuum, until the lump has been removed;
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Reducing Your Risk Of Ductal Carcinoma
Reducing your risk of breast cancer means changing risk factors you can control. You may be able to lower your risk by maintaining a healthy weight, getting regular exercise, and drinking alcohol in moderation. However, you cant change the main risk factorbeing a womanand many of the other ones, such as age and dense breast tissue. This makes early detection with screening mammograms an important part of every womans healthcare.
Screening mammograms look forand often findbreast before you have symptoms. They are the most effective tool for finding breast cancer early. Talk with your doctor about your risk and find out when to start getting screening mammograms.
If you are at high risk for developing breast cancer, your doctor may discuss prevention strategies with you. This includes:
-
Chemoprevention with drugs to block the effect of estrogen on breast tissue. This may decrease the risk in some women.
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to remove both breasts. Women with known genetic mutations may want to consider this option. It can reduce the risk by about 97%.
If Cancer Is Found Tests Are Done To Study The Cancer Cells
- How quickly the cancer may grow.
- How likely it is that the cancer will spread through the body.
- How well certain treatments might work.
- How likely the cancer is to recur .
Tests include the following:
- Estrogen and progesterone receptor test: A test to measure the amount of estrogen and progesterone receptors in cancer tissue. If there are more estrogen and progesterone receptors than normal, the cancer is called estrogen and/or progesterone receptor positive. This type of breast cancer may grow more quickly. The test results show whether treatment to block estrogen and progesterone may stop the cancer from growing.
- HER2 test: A laboratory test to measure how many HER2/neu genes there are and how much HER2/neu protein is made in a sample of tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer is called HER2/neu positive. This type of breast cancer may grow more quickly and is more likely to spread to other parts of the body. The cancer may be treated with drugs that target the HER2/neu protein, such as trastuzumab and pertuzumab.
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Idc Type: Tubular Carcinoma Of The Breast
Tubular carcinoma of the breast is a subtype of invasive ductal carcinoma . Tubular carcinomas are usually small and made up of tube-shaped structures called “tubules.” These tumors tend to be low-grade, meaning that their cells look somewhat similar to normal, healthy cells and tend to;grow slowly.
At one time, tubular carcinomas accounted for about 1-4% of all breast cancers. Now that screening mammography is widely used, however, tubular carcinomas are being diagnosed more frequently often before you or your doctor would be able to feel a lump. Exact numbers aren’t available, but studies suggest that tubular carcinomas may account for anywhere from just under 8% to 27% of all breast cancers.
Studies also suggest that the average age of diagnosis for tubular carcinoma is the early 50s, although women can be diagnosed with it at any age. This type of cancer is rare in men.
Even though tubular carcinoma is an invasive breast cancer, it tends to be a less aggressive type that responds well to treatment. It isn’t likely to spread outside the breast and is considered to have a very good prognosis.
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What Medication Treat Ductal Carcinoma In Situ
Tamoxifen may be prescribed for woman of all ages who have been treated for DCIS. In those women past menopause, the doctor may prescribe an aromatase inhibitor. These medications help lower the risk of DCIS or another type of cancer developing in either breast. If either is prescribed, it is suggested that these drugs be taken for five years after surgery.
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Administration Of Pld Into The Dcis
Surgery was scheduled for 4 to 6 weeks after the procedure. Two to 3 days before the planned surgery, the women underwent a unilateral mammogram and breast MRI of the affected breast. The patients were followed every 6 months with clinical examination and breast imaging of the treated breast, and were followed-up by their breast surgeon for a minimum of 2 years, as is standard in all cases of DCIS.
Male Breast Cancer Is Sometimes Caused By Inherited Gene Mutations
The genes in cells carry the hereditary information that is received from a persons parents. Hereditary breast cancer makes up about 5% to 10% of all breast cancer. Some mutated genes related to breast cancer, such as BRCA2, are more common in certain ethnic groups.Men who have a mutated gene related to breast cancer have an increased risk of this disease.
There are tests that can detect mutated genes. These genetic tests are sometimes done for members of families with a high risk of cancer. See the following PDQ summaries for more information:
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Are There Any Adjuvant Treatments
After surgery, you may need other treatments. These are called adjuvant treatments and can include radiotherapy and, in some cases, hormone therapy.
The aim of these treatments is to reduce the risk of DCIS coming back or an invasive cancer developing.
Chemotherapy;and;targeted therapy;are not used as treatment for DCIS.
What Is The Prognosis For Patients Who Have Ductal Carcinoma In Situ
Because DCIS is contained within a specific area of the breast and has not spread, the disease can be controlled and cured with appropriate treatment. After treatment, the outcome for the patient with DCIS is usually excellent.
However, those patients who have had DCIS, even if treated successfully, are at a greater risk than people who have never had breast cancer to have the cancer return or for another type of breast cancer to develop.
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