Source: Breast Cancer, Network of Strength
Ductal carcinoma in situ (DCIS)
Ductal carcinoma in situ (DCIS) is the earliest possible clinical diagnosis of breast cancer and is frequently diagnosed with screening mammography that has detected small areas of calcification in the breast. Patients rarely suspect that they have breast cancer. If DCIS is untreated, approximately 30 percent of patients will develop invasive breast cancer an average of 10 years from the initial diagnosis. A variety of factors ultimately influence a patient's decision to receive treatment for cancer. The purpose of receiving cancer treatment may be to improve symptoms through local control of the cancer or to prolong a patient's survival. The potential benefits of receiving cancer treatment must be carefully balanced with the potential risks of receiving cancer treatment. Most new treatments are developed in clinical trials.
DCIS can be thought of as a pre-cancerous or early-stage growth of abnormal cells in the ducts of the breast. Historically, DCIS was an extremely uncommon finding in women and little attention was given to defining its optimal treatment. This is because DCIS can be cured almost 100 percent of the time with a surgical mastectomy. Other treatment options now include lumpectomy and radiation. With the increased use of screening mammography, women are more likely to have cancer diagnosed at an earlier stage, and therefore the number of women diagnosed with DCIS is increasing.
Infiltrating ductual carcinoma (IDC)
Infiltrating ductal carcinoma is the most common invasive breast cancer, accounting for 70 percent of all cases. A very hard lump that has irregular borders and seems anchored in surrounding tissues is characteristic of infiltrating ductal carcinoma. The skin over the area or the nipple may retract (pull in). On mammography, there are often micro-calcifications found in the tumor area, since this tumor has a history of internal cell death (necrosis). The tumor varies in size and cell division time, with some cells growing more rapidly than others.
Infiltrating lobular carcinoma
Infiltrating lobular carcinoma accounts for about 5 percent of all malignant, invasive cancers. It occurs most frequently in women between the ages of 45 and 56. The tumor grows in the terminal (last part) of the lobules where milk is produced. It usually does not show up on mammography and may feel like a thickening in the upper-outer quarter of the breast (from the nipple to under the arm) as it infiltrates the walls of the lobules. In about 30% of cases, this cancer is frequently found in the opposite breast. It is often found in other parts of the same breast (multicentric). Late signs of a large tumor area may be the retraction or puckering of the skin over the area. Most tumors are positive for estrogen and progesterone receptors and thus respond well to hormonal therapy. Infiltrating lobular carcinoma sometimes has an increased incidence of spreading to the uterus and ovaries.
Lobular Carcinoma in Situ (LCIS)
The treatment of lobular carcinoma in situ (LCIS) is somewhat controversial. LCIS is thought to be an indicator for an increased risk of developing invasive breast cancer, but may not be a direct precursor to invasive breast cancer. This abnormality is generally widely distributed throughout the breast and frequently occurs in both breasts simultaneously.
A variety of factors influence a patient's decision to receive treatment of cancer. The purpose of receiving cancer treatment may be to improve symptoms through local control of the cancer, increase a patient's chance of recovery, or prolong a patient's survival. The potential benefits of receiving cancer treatment must be carefully balanced with the potential risks of receiving cancer treatment.
The following is a general overview of the treatment of LCIS. Circumstances unique to your situation and prognostic factors of your cancer may ultimately influence how these general treatment principles are applied. The information on this Web site is intended to help educate you about your treatment options and to facilitate a mutual or shared decision-making process with your treating cancer physician.
From long-term retrospective studies, it is estimated that approximately 25 percent of patients with LCIS will develop invasive breast cancer within 25 years of diagnosis. Thus, this diagnosis is being used to identify patients at high risk of subsequently developing invasive breast cancer. Current approaches for management of LCIS include surgical removal of the LCIS or treatment with anti-estrogens to reduce the risk of developing invasive cancer
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