Ductal carcinoma in situ (DCIS) is a noninvasive type of breast cancer involving cells within the milk ducts of the breast. It is occasionally referred to as a precancerous or pre-invasive condition. The cancer cells typically stay contained within these milk ducts, unless they are left untreated for a long period of time, in which case they may grow through to surrounding breast tissue. DCIS may be local to one area of the breast or can affect multiple areas of the breast. Treatment may involve chemotherapy, radiation and/or hormonal therapy.
Ductal Carcinoma in Situ
According to the National Cancer Institute, DCIS accounts for approximately 18 percent of all diagnosed noninvasive breast cancers in the United States. DCIS rarely results in an identifiable tumor or lump and is therefore diagnosed by a mammogram in 80 percent of cases. There is dispute within the medical community as to the frequency with which DCIS would eventually grow into invasive breast cancer if left untreated, so annual mammograms are essential for women at risk of developing cancer.
Diagnosis
Because DCIS is generally asymptomatic, it is typically initially diagnosed when a doctor finds an abnormal area during a mammogram. The doctor will then take a biopsy of the abnormal tissue to identify whether the cells are cancerous. Occasionally, a localized biopsy may be necessary, in which a radiologist uses wire to guide the surgeon to remove a specific piece of tissue in the breast for a biopsy.
Treatment
Treatment varies depending on a patient's condition and physician and patient preferences. Treatment may involve a mastectomy or removal of the cancer while preserving the breast. A clinical study by the Radiation Therapy Oncology Group was intended to study the success of breast-preserving surgery vs. a mastectomy, but the study ended early due to technical problems with the study. In either case, surgery may be accompanied by tamoxifen in certain circumstances.
Surgery
It is essential that all cancer cells are removed during surgery, along with a sufficient surrounding area, to ensure that all the DCIS is removed. If the DCIS is large, affects multiple areas of the breast and/or is high grade, a mastectomy may be recommended. This is generally a complete cure for most women and no other treatment is required. If the cancer has spread into the lymph nodes or is suspected to have spread, some lymph nodes will be removed during the mastectomy as well.
In certain instances, women opt for breast-saving surgery called wide local extension. In this case, the majority of the breast is saved and only the DCIS and some surrounding tissue is removed.
Radiotherapy
Radiotherapy or radiation involves the use of X-rays to destroy remaining abnormal/ cancerous or precancerous cells. Typically, only women with high-grade DCIS are given radiation after surgery. Typically, when necessary, radiation is given five days a week for between three and six weeks.
Hormone Therapy
If the cancer cells have estrogen receptors, or are ER positive, tamoxifen may be prescribed to block the effects of estrogen on the cancer's growth.
Tags: cancer cells, areas breast, breast cancer, Ductal Carcinoma Situ, left untreated
