Treatment for DCIS
Chemotherapy, mastectomy, and radiation are the standard treatments for breast cancer. The first is not used with DCIS cancers because this form of the disease is small and localized and cannot be targeted easily by chemicals, while the second type of treatment is only considered if a woman diagnosed with breast cancer has a genetic mutation or strong family history of the disease.
The usual course of treatment for ductal carcinoma in situ is a lumpectomy followed by radiation therapy to eliminate any cancerous cells that might remain after the surgery. Standard external radiation treatments can take as long as 5-7 weeks to finish; but internal partial-breast radiation is a relatively new alternative that can shorten this time period considerably. This treatment involves the insertion of small radioactive pellets or seeds directly into the area where cancer had been located before the lumpectomy. Another alternative is to perform a lumpectomy without the accompanying radiation. While recurrence rates of DCIS drop from 30% when it is treated by a lumpectomy alone to 15% when lumpectomy and radiation are used together, because DCIS is a non-invasive Stage 0 type of cancer with a survival rate above 95% even when it recurs, some breast cancer patients choose to forgo the radiation when they are diagnosed with DCIS.
One additional type of treatment used for DCIS cancers that test positive for female hormone (estrogen and progesterone) receptors is hormonal therapy. Drugs like tamoxifen or a class called aromatase inhibitors can interfere with the process through which receptor-positive cancers capture female hormones and use them as a fuel source to facilitate cell division and rapid growth.
Prognosis
In no sense can a diagnosis of breast cancer ever be considered good news. But when the diagnosis is ductal carcinoma in situ, women can feel a sense of relief knowing that they have a type of breast cancer that is eminently curable and almost never fatal. Because of the possibility that DCIS might evolve into the more serious invasive ductal carcinoma, however, if it is allowed to develop for too long, early detection and treatment should still be considered critically important, just as they are with any other type of breast cancer.
Ductal Carcinoma In Situ (DCIS)
When speaking about breast cancer, it is actually more correct to speak of 'breast cancers', in the plural. There are several different varieties of this disease, all of which have certain unique characteristics and patterns of development. Some varieties of breast cancer are rare; but others are quite common, and one of the most frequently diagnosed is ductal carcinoma in situ, also known as DCIS.
Characteristics of DCIS
Most breast cancers are divided into two broad categories: invasive and non-invasive. There are indeed many subtypes within these categories, but the main characteristic that is generally used to distinguish breast cancer types is whether or not they have the capacity to spread and invade other parts of the body. DCIS is the most commonly diagnosed form of non-invasive breast cancer – about 20% of all new cases of the disease diagnosed will be of this subtype.
DCIS cancerous cells are found inside the breasts’ milk ducts. Generally DCIS tumors are small and difficult to detect; breast self-exams and physical exams performed by a doctor may occasionally find a small lump, but abnormal formations confined to the milk ducts usually cannot be felt by touch. Because this type of cancer does not spread beyond the ductal system, it is classified as Stage 0, which basically means that DCIS is both non-aggressive and non-life threatening.
Rates of DCIS diagnosis have gone up significantly over the past few decades, and this is usually credited to an increase in the number of women who are coming in for screening mammograms. But this increase in the number of DCIS cancers found reveals a complication in the overall picture. It is possible that some of the cases of DCIS found early by mammogram may have eventually developed into a more serious type of breast cancer called invasive ductal carcinoma (IDC), which is the most common form of breast cancer. DCIS and IDC cancer cells are basically indistinguishable in their earliest stages, and it seems likely that some of the cases of DCIS that have been diagnosed and treated may have revealed themselves to have been invasive ductal carcinomas instead, if they had had more time to develop.
Diagnosis of DCIS
Because lumps detectable by feel are unusual with this type of cancer, almost all DCIS cancers are found as small anomalies on x-rays from screening mammograms. When suspicious areas have been spotted, doctors will order a biopsy to test for cancer. This procedure involves the extraction of cells or tissue samples from the vicinity of the anomalous formation with a fine needle, after which these samples will be examined closely for signs of cancer. DCIS cancer cells do not appear much different than normal breast cells at first glance, but it is the slight distinctions that do exist that will reveal not only the fact that cancerous cells are present, but that the tumor found is of the DCIS variety.
Add new comment