Treatment Selection in Ductal Carcinoma In Situ

Article Abstract:

The treatment of ductal carcinoma in situ (DCIS) depends on the size of the tumor. DCIS is a proliferation of presumably malignant cells in the breast without evidence of invasion. The use of mammography has led to the detection of more cases than in the past because the tumor is too small to feel. In many cases, the tumor will never progress further and is unlikely to cause death. However, there is no way to determine which tumors are benign and which are likely to spread. Lumpectomy can be used in most cases, followed by radiation or chemotherapy if the woman wants further treatment.

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A 47-year-old woman with ductal carcinoma in situ

Article Abstract:

A 47-year-old woman with ductal carcinoma in situ (DCIS) in the left breast ultimately decided to have a full mastectomy, after considering breast conserving treatment. DCIS is abnormal cell growth believed to be precancerous. Research suggests that if DCIS is not treated it often develops into invasive cancer. In this patient's case, the risk of developing invasive cancer later in life was approximately 1% to 2% with mastectomy and 10% to 15% with lumpectomy and radiation therapy. The patient's mother had died of breast cancer. A diagnostic lumpectomy indicated previously undetected DCIS around the original site. The patient, who was particularly fearful of dying from breast cancer, chose to have a mastectomy of both breasts. Her right breast was then found to contain another type of cancer, lobular carcinoma in situ. Breast reconstruction is an option in such cases, however this woman chose to put off the decision to have this procedure.

Health aspects, Usage, Radiotherapy, Mastectomy, Lumpectomy

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Ductal carcinoma in situ of the breast: understanding the misunderstood stepchild

Article Abstract:

There is much clinical evidence that ductal carcinoma in situ of the breast (DCIS) is not a single disease with a single treatment option. The introduction of mammography revealed that many women had small lesions that did not spread to the rest of the breast. Some studies showed that the cancer recurred in the same exact site as a previous biopsy. Even so, many physicians still recommended mastectomy because they believed that DCIS would recur in other parts of the breast. In 1992, 30% of US women with DCIS received a lumpectomy with no radiation treatment. A 1996 study found that the incidence of mammographically detected DCIS continues to increase and also confirmed the benefits of lumpectomy. Subtyping of the tumor will reveal biological and clinical differences among the subtypes, which could encourage physicians to think of DCIS as a spectrum of diseases with multiple treatment options.

Editorial

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