Description

Ductal carcinoma in situ is a very early form of breast cancer. In ductal carcinoma in situ, cancer cells are confined in the interior of a milk duct in the breast. The cancer cells have not spread to the breast tissue. Ductal carcinoma in situ is often abbreviated as DUCTAL carcinoma in situ. Sometimes called non-invasive, preinvasive or stage 0 breast cancer.

DUCTAL carcinoma in situ is usually found during a mammogram as part of breast cancer screening or to investigate a breast lump. DUCTAL carcinoma in situ has a low risk of spreading and becoming life-threatening. However, it does require an evaluation and a review of treatment options.

The treatment for DUCTAL carcinoma in situ often requires surgery. Other treatments can be combined surgery with radiotherapy or hormone therapy.

Symptoms

Ductal carcinoma in situ does not usually cause symptoms. This early form of breast cancer is also called DUCTAL carcinoma in situ.

DCIS can sometimes cause symptoms such as:

  • A lump in the breast.
  • Bloody discharge from the nipple.

DUCTAL carcinoma in situ is usually found on a mammogram. It appears in the form of small spots of calcium in the breast tissue. These are deposits of calcium, often referred to as calcifications.

When to see a doctor

Make an appointment with your doctor or other health care professional if you notice a change in your breasts. Changes to look for may include a lump, an area of puckered or otherwise unusual of the skin, thickening of the region under the skin, and nipple discharge.

Ask your health care professional when you should consider the possibility of breast cancer screening and how often it should be repeated. Most health professionals recommend that you consider routine screening for breast cancer beginning in their 40s.

Causes

It is not clear what causes ductal carcinoma in situ, also called DUCTAL carcinoma in situ.

This early form of breast cancer occurs when the cells in the interior of a duct of the breast develop changes in their DNA. A cell's DNA contains the instructions that tell the cell what to do. In healthy cells, the DNA contains the instructions to grow and multiply at a set rate. The instructions that tell cells to die at a set time. In cancer cells, changes in DNA to give different instructions. The changes, to tell the cancer cells to make many more cells quickly. Cancer cells can continue living when healthy cells would die. This makes too many cells.

In DCIS, the cancer cells do not have the ability to break the duct of the breast and spread into the breast tissue.

Health professionals do not know what exactly causes changes in the cells which leads to DCIS. Factors that may play a role include the lifestyle, the environment and the changes in the DNA that are run in families.

Risk factors

Several factors can increase the risk of ductal carcinoma in situ, also called DUCTAL carcinoma in situ. DCIS is an early form of breast cancer. Risk factors for breast cancer can include:

  • A family history of breast cancer. If a parent, brother or son had cancer of the breast, the risk of breast cancer is higher. The risk is higher if her family has a history of breast cancer at an early age. The risk is also greater if you have multiple family members with breast cancer. Even so, the majority of people diagnosed with breast cancer do not have a family history of the disease.
  • A personal history of breast cancer. If you have had cancer in one breast, you have a higher risk of developing cancer in the other breast.
  • A personal history of breast conditions. Certain breast conditions are a sign of an increased risk of breast cancer. These conditions include lobular carcinoma in situ, also called LCIS and atypical hyperplasia of the breast. If you have had a breast biopsy that found one of these conditions, you have a higher risk of breast cancer.
  • In the beginning of your period at a younger age. In the beginning of your menstrual period before age 12 increases your risk of breast cancer.
  • Beginning menopause at an older age. Starting menopause after age 55 increases the risk of breast cancer.
  • The fact of being a woman. Women are much more likely than men to suffer from breast cancer. Everyone is born with some breast tissue, so anyone can get breast cancer.
  • Dense breast tissue. The tissue of the breast is composed of fatty tissue and dense fabric. Dense tissue is made up of milk glands, milk ducts and fibrous tissue. If you have dense breasts, you have more dense tissue than fatty tissue in their breasts. Having dense breasts may make it more difficult to detect breast cancer on a mammogram. If a mammogram showed that they have dense breasts, your risk of breast cancer is higher. Talk with your health care team about other tests you might have in addition to mammograms to detect breast cancer.
  • The consumption of alcohol. Drinking alcohol increases the risk of breast cancer.
  • Having your first child at an older age. Give birth to your first child after 30 years of age may increase the risk of breast cancer.
  • Having never been pregnant. Having been pregnant one or more times, reduces the risk of breast cancer. Never having been pregnant increases the risk.
  • The increase of the age. The risk of breast cancer increases as you get older.
  • Inherited changes in the DNA that increase the risk of cancer. Certain changes in DNA that increase the risk of breast cancer can be passed from parents to children. The most well-known of the changes are called BRCA1 and BRCA2. These changes may increase your risk of breast cancer and other types of cancer, but not all of these changes in the DNA is sick of cancer.
  • Hormone therapy for the menopause. Taking certain medications for hormonal therapy to control the symptoms of menopause can increase the risk of breast cancer. The risk is linked to the hormone therapy medications that combine estrogen and progesterone. The risk decreases after you stop taking these medicines.
  • Obesity. People with obesity have a higher risk of breast cancer.
  • The exposure to radiation. If you have received radiation treatments to your chest as a child or a young adult, your risk of breast cancer is higher.

Prevention

Make changes in your everyday life can help to reduce the risk of ductal carcinoma in situ. This early form of breast cancer is also called DUCTAL carcinoma in situ. To reduce your risk of breast cancer, try the following:

Ask about breast cancer screening

Talk with your doctor or other health care professional about when to start screening for breast cancer. Ask about the benefits and risks of the test. Together, you can decide which screening tests for breast cancer are right for you.

Become familiar with your breasts through breast self-exam for breast awareness

You can choose to become familiar with their breasts from time to time inspection of them during a breast self-exam for breast awareness. If you find a new change, lumps or other unusual signs in your breasts, tell a health professional immediately.

Breast awareness can't prevent breast cancer. But it can help to better understand the look and feel of your breasts. This may make it more likely that you'll notice if something changes.

Drink alcohol only in moderation, if at all

If you choose to drink alcohol, limit the amount you drink to no more than one drink per day. For the prevention of breast cancer, there is no safe amount of alcohol. So if you are very concerned about your risk of breast cancer, you can choose not to drink alcohol.

Exercise most days of the week

Try to do at least 30 minutes of exercise most days of the week. If you haven't been active lately, ask your health care professional if the exercise is well and start slowly.

Limit of hormone therapy during menopause

The combination of hormone therapy may increase the risk of breast cancer. Talk with a health professional about the benefits and risks of hormone therapy.

Some people have symptoms during menopause, causing discomfort. These people may decide that the risks of hormone therapy are acceptable to obtain relief. To reduce the risk of breast cancer, the use of the lowest dose of hormone therapy possible for the least amount of time.

Maintain a healthy weight

If your weight is healthy, work to maintain that weight. If you need to lose weight, consult with a health care professional about the healthy ways to lose your weight. Eating fewer calories, and gradually increase the amount of exercise you do.

Diagnosis

Ductal carcinoma in situ, also called DUCTAL carcinoma in situ, it is most often discovered during a mammogram to detect breast cancer. A mammogram is an x-ray of the breast tissue. If the mammogram shows something about, you will probably have additional breast imaging and biopsy.

Mammography

If an area of concern was found during a screening mammogram, you may need a diagnostic mammogram. A diagnostic mammogram takes views at higher magnification from more angles of mammography used for screening. This examination evaluates both the breasts.

A diagnostic mammogram gives your health care team for a closer look at any of the deposits of calcium detected in the breast tissue. The calcium deposits, also called calcifications, can sometimes be cancerous.

If the area of interest of the needs assessment, the next step may be in for an ultrasound and a biopsy of the breast.

Breast ultrasound

The ultrasound uses sound waves to make pictures of structures inside the body. A breast ultrasound can give to your health care team more information about the area of interest. The health care team uses this information to decide what tests you might need next.

Removal of breast tissue samples for testing

A biopsy is a procedure to remove a sample of tissue for testing in a lab. For DUCTAL carcinoma in situ, a health care professional removes the tissue sample from the breast using a special needle. The needle that is used is a hollow tube. The healthcare provider puts a needle through the skin in the chest and in the area of interest. The health care professional points out some of the tissues of the breast. This procedure is called a core needle biopsy.

Often the health care provider uses a test image to help guide the needle into the right place. A biopsy that uses ultrasound is called a guided breast biopsy. If you are using X-rays, is called a stereotactic breast biopsy. The tissue samples are sent to a laboratory for analysis.

In a laboratory, a medical doctor who specializes in the analysis of the blood and the tissue of the body is seen in the tissue samples. This doctor is called a pathologist. The pathologist can tell if cancer cells are present and, if so, how aggressive the cells appear to be.

Treatment

Ductal carcinoma in situ can often be cured. The treatment for this early form of breast cancer often involves surgery to remove the cancer. Ductal carcinoma in situ, also called DUCTAL carcinoma in situ, can also be treated with radiation therapy and medications.

DUCTAL carcinoma in situ treatment has a high probability of success. In most cases, the cancer is removed and has a low chance of coming back after treatment.

In most people, the treatment options for DUCTAL carcinoma in situ include:

  • Conservative surgery of the breast, is called a lumpectomy and radiation therapy.
  • Breast-removal surgery, called a mastectomy.

In some people, the treatment options may include:

  • The lumpectomy only.
  • Lumpectomy and hormone therapy.

Surgery

If you are diagnosed with DUCTAL carcinoma in situ, one of the first decisions you'll have to make is whether to treat the condition with lumpectomy or mastectomy.

  • The lumpectomy.A lumpectomy is surgery to remove the breast cancer and some healthy tissue around it. The rest of the breast tissue is not removed. Other names for this surgery are breast-conserving surgery and wide local excision. Most of the people who have a lumpectomy, also the therapy with radiation. The research suggests that there is a slightly higher risk of the cancer coming back after lumpectomy compared with the mastectomy. However, the survival rates between the two treatment approaches are very similar. If you have other serious health conditions, you might consider other options, such as lumpectomy plus hormonal therapy, lumpectomy alone, or no treatment.
  • The mastectomy. A mastectomy is surgery to remove all breast tissue from a breast. Breast reconstruction to restore the appearance of the breast can be done at the same time or in a later procedure, if you so wish.

The lumpectomy. A lumpectomy is surgery to remove the breast cancer and some healthy tissue around it. The rest of the breast tissue is not removed. Other names for this surgery are breast-conserving surgery and wide local excision. Most of the people who have a lumpectomy, also the therapy with radiation.

The research suggests that there is a slightly higher risk of the cancer coming back after lumpectomy compared with the mastectomy. However, the survival rates between the two treatment approaches are very similar.

If you have other serious health conditions, you might consider other options, such as lumpectomy plus hormonal therapy, lumpectomy alone, or no treatment.

Lumpectomy is a good choice for most people with DUCTAL carcinoma in situ. But mastectomy may be recommended if:

  • You have a large area of DCIS. If the area is large in relation to the size of your chest, a lumpectomy may not produce cosmetic results are acceptable.
  • There is more than one area of DCIS. When there are multiple areas of DUCTAL carcinoma in situ, is called multifocal or disease. It is difficult to remove several areas of DUCTAL carcinoma in situ with a lumpectomy. This is especially true if the DCIS is found in different parts of the breast.
  • Results of the biopsy shows cancer cells in or near the edge of the tissue sample. There may be more of DUCTAL carcinoma in situ of what was originally thought. This means that a lumpectomy may not be sufficient to eliminate all areas of DUCTAL carcinoma in situ. A mastectomy may be necessary to remove all of the breast tissue.
  • You are not a candidate for radiation therapy. The radiation is given after a lumpectomy. The radiation may not be an option if you're in the first trimester of pregnancy or if you have received radiation to their chest or breast in the past. It is also possible that it is not recommended if you have a condition that makes you more sensitive to the side effects of the radiation, such as systemic lupus erythematosus.
  • You prefer to have a mastectomy. For example, you might not want a lumpectomy if you don't want to have radiation therapy.

Due to DUCTAL carcinoma in situ is an invasive technique, general surgery, do not involve the removal of the lymph nodes under the arm. The probability of finding cancer in the lymph nodes is extremely small.

If your health care team believes that cancer cells may have spread outside the duct of the breast, or if you are having a mastectomy, then, some of the lymph nodes may be removed as part of the surgery.

Radiation therapy

Radiation therapy treats cancer with powerful rays of energy. The energy can come from X-rays, protons or other sources.

For the treatment of DUCTAL carcinoma in situ, radiation is the frequency of external-beam radiation. During this type of radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body. Less frequently, the radiation can be placed inside the body. This type of radiation is known as brachytherapy.

Radiation therapy is often used after lumpectomy to reduce the possibility that DCIS will come back, or that it will progress to invasive cancer. But it may not be necessary if you have only a small area of DCIS is considered slow-growing, and was completely removed during surgery.

Hormone therapy

Hormone therapy, also called endocrine therapy, which uses drugs to block certain hormones in the body. It is a treatment for breast cancers are sensitive to hormones estrogen and progesterone. Health professionals call these types of cancer positive for estrogen receptor and progesterone receptor positive. Cancers are sensitive to hormones, the use of hormones to fuel your growth. Blocking the hormones can cause cancer cells to shrink or die.

For DUCTAL carcinoma in situ, the hormone therapy is commonly used after surgery or radiation. It reduces the risk that the cancer will come back. It also reduces the risk of developing another type of cancer of the breast.

Treatments that can be used in hormone therapy include:

  • Medications that block the hormones attach to the cancer cells. These medications are called selective modulators of the estrogen receptor. Examples include tamoxifen and raloxifene (Evista).
  • Medicines that stop the body from producing estrogen after menopause. These medications are called inhibitors of aromatase. Examples include anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara).

Discuss the benefits and risks of hormone therapy with your health care team.

Alternative medicine

There is No alternative medicine treatments have been found to cure ductal carcinoma in situ, also called DUCTAL carcinoma in situ. But the complementary and alternative medicine therapies may help you cope with the side effects of treatment.

Combined with your health care team recommendations of complementary and alternative medicine treatments may provide some comfort. Examples include:

  • Art therapy.
  • Exercise.
  • Meditation.
  • Music therapy.
  • The relaxation exercises.
  • Spirituality.

Coping and support

A diagnosis of ductal carcinoma in situ, also called DUCTAL carcinoma in situ, can be overwhelming. To cope with their diagnosis, it may be of help:

Learn enough about DCIS to make decisions about your care

Ask your health care team questions about your diagnosis and pathology results. The use of this information to research your treatment options.

To know more about cancer and your options can help you feel more confident when making treatment decisions. Even so, some people don't want to know the details of your cancer. If this is how you feel, that your care team that also.

Find someone to talk to about your feelings

Find a friend or family member who is a good listener. Or speak with a member of the clergy or a counselor. Ask your health care team for a referral to a counselor or other professional who works with people who have cancer.

Keep your friends and family close

Your family and friends can provide a crucial support network for you during your cancer treatment.

As you start to tell people about your diagnosis of breast cancer, the more likely it is to get a lot of offers of help. Think about the future, about things that you may need help with. Examples include listening when you want to talk or helping with the preparation of meals.

Preparing for your appointment

Make an appointment with a doctor or other health care professional if you have any symptoms that worry you. If an exam or imaging test shows that you might have ductal carcinoma in situ, also called DUCTAL carcinoma in situ, your health care team is likely to see a specialist.

Specialists who care for people with DUCTAL carcinoma in situ include:

  • Breast health specialists.
  • Breast surgeons.
  • Doctors who specialize in diagnostic tests, such as mammograms, called radiologists.
  • Doctors who specialize in the treatment of cancer, called oncologists.
  • The doctors who treat cancer with radiation, called radiation oncologists.
  • Genetic counselors.
  • The plastic surgeons.

Here's some information to help you prepare for your appointment.

What you can do

  • Enter your medical history, including any benign breast conditions with which you have been diagnosed. Also to mention the radiation therapy may be received, even years.
  • Write your family history of cancer. Note any of the members of the family who have had cancer. Keep in mind that each member has to do with you, the type of cancer, the age at the time of diagnosis, and if each person survived.
  • Make a list of all medications, vitamins or supplements you are taking. If you are currently taking or have previously taken hormone replacement therapy, tell your health care professional.
  • Consider the possibility of a family member or friend. Sometimes it can be difficult to absorb all of the information provided during an appointment. Someone who comes with you may remember something that you missed or forgot.
  • Write questions to ask their health professional.

Questions to ask your doctor

Your time with your health care professional is limited. Prepare a list of questions so that you can make the most of your time together. A list of questions from most important to least important in case time runs out. For breast cancer, some basic questions to ask include:

  • Do I have breast cancer?
  • What evidence do I need to determine the type and stage of the cancer?
  • What treatment approach do you recommend?
  • What are the possible side effects or complications of this treatment?
  • In general, how effective is this treatment?
  • Am I a candidate for tamoxifen?
  • Am I at risk of this recurrent condition?
  • Am I at risk of developing invasive breast cancer?
  • How are you going to treat DUCTAL carcinoma in situ if it is returned?
  • How often should I follow up visits after the end of the treatment?
  • What lifestyle changes can help reduce the risk of a recurrence of DUCTAL carcinoma in situ?
  • I need a second opinion?
  • Should I see a genetic counselor?

In addition to the questions you have prepared, do not hesitate to ask other questions to think about during your appointment.

What to expect from your doctor

Be prepared to answer some questions about your symptoms and your health, such as:

  • Have gone through menopause?
  • Is using or has used with any medication or supplement to help relieve the symptoms of menopause?
  • Have had other biopsies of breast or operations?
  • Have you been diagnosed with any of breast conditions, including disorders, non-cancerous?
  • Have you been diagnosed with any other medical condition?
  • Do you have any family history of breast cancer?
  • Have you or his wife's blood relatives ever been tested for mutations in the BRCA?
  • Have you ever had radiation therapy?
  • What is the typical daily diet, including the consumption of alcohol?
  • Are you physically active?
Symptoms and treatment of Ductal carcinoma in situ (DCIS)