DCIS (Ductal carcinoma in Situ) is the earliest form of breast cancer. In general, it is the presence of abnormal cells within a milk duct.
DCIS may not be an emergency. So, there is no need for an evaluation and a consideration of treatment options. Also, DCIS does not usually show any symptoms. But, some may experience signs like a breast lump or bloody nipple discharge. Almost every DCIS is treatable, but there are numerous treatment options to think of.
To learn more about DCIS breast cancer and its treatment, read further.
What Causes DCIS Breast Cancer?
There may be no clarity about the causes of DCIS breast cancer. This form of cancer develops when genetic mutations happen in the DNA of breast duct cells. Due to the genetic mutations, the cells look abnormal. However, the cells still cannot escape the breast duct.
What exactly stimulates the abnormal growth of cells that causes DCIS is yet unknown. Your genes, lifestyle, and environment are a few factors that may play a crucial role in this.
Take a look at the risk factors associated with DCIS breast cancer.
Risk Factors Of DCIS
The following are the risk factors that might raise the chance of DCIS breast cancer:
- Aging
- Family history of breast cancer
- Having the first period before 12 years of age
- Having the first child after the age of 30 years.
- Personal history of benign breast disease
- Menopause after the age of 55 years.
Symptoms of DCIS Breast Cancer
Here are the most common signs of DCIS breast cancer symptoms:
- Bleeding nipple
- Itching or a rash near the nipple
- A lump in the breast
Is DCIS Breast Cancer Hereditary?
It may not be necessary that DCIS breast cancer is hereditary. But, a family history of DCIS might raise the risk of cancer. The other risk factors can be aging, infertility, and giving birth after the age of 30.
DCIS Diagnosis: How To Know If You Have DCIS?
A mammogram can help in exposing the abnormalities in the breast tissue. Your doctor may examine this later on during a biopsy.
Mammogram
A mammogram is an X-ray imaging method for examining abnormal areas in the breast. When the old cells die and gather in your milk ducts, they leave small deposits of calcium (breast calcifications).
Breast Calcifications look like a shadow or white spot on a mammogram. Abnormalities of the calcifications might show abnormal cell development; it can be DCIS or any other type of breast cancer.
Biopsy
Your doctor, to confirm the presence of cancer cells in your breast, may perform a core needle biopsy. During the core needle biopsy, the doctor inserts a big needle into the breast to obtain a sample of the abnormal breast tissue. A pathologist will also examine the cells in a laboratory to see whether there are any cancer signs.
With images, the doctor will be able to detect the accurate location of the abnormal tissue. They might use an X-ray or an ultrasound during your biopsy. A biopsy involving the use of X-rays is called stereotactic breast biopsy. On the other hand, a biopsy that involves an ultrasound is referred to as an ultrasound-guided breast biopsy.
What Are The Different Stages of DCIS?
The stages of DCIS breast cancer start from stage 0 to stage 5. With some DCIS stages, there are numerous variables. Let us take a close look at every stage of DCIS:
DCIS Stage 0 Breast Cancer
Stage 0 is the earliest stage of DCIS, wherein the non-invasive breast cancers or precancers are defined. In this stage, there is no evidence of the invasion of cancerous cells or other abnormalities in the surrounding normal tissue.
DCIS Stage I Breast Cancer
Stage I of DCIS is the beginning stage of invasive cancer. Within this stage, tumor cells might have spread to the nearby tissue. However, they are contained in a small region. DCIS stage I has two subcategories: stage IA and stage IB.
Stage IA shows a tumor of up to 20 mm and no cancer within the lymph nodes. On the other hand, stage IB shows a tumor, less than 20 mm, and small clusters of cancerous cells within the lymph nodes.
DCIS Stage II Breast Cancer
In stage II, a cancer in a narrow area of the breast has grown big in size. It shows the number of lymph nodes having cancerous cells. Stage II has two subcategories, which are stage IIA and stage IIB.
Stage II either shows no tumor in the breast or a breast tumor about 20 mm in size. Also, it shows cancer spread to the lymph nodes under the arm. In the same stage, there can also be a breast tumor about 20 to 50 mm in size, but the cancer hasn’t spread to the lymph nodes.
In Stage IIB, there is a tumor sizing about 20 to 50 mm in the breast. Furthermore, cancer has spread to between one and three surrounding lymph nodes. There can also be a breast tumor sizing over 50 mm. But there is no cancer in the lymph nodes.
DCIS Stage III Breast Cancer
The cancer has spread further into the tumor in DCIS stage III. Additionally, compared with the earlier stages, the tumor size is larger. Unlike the earlier stages, DCIS stage III has three subcategories. These include Stage IIIA, Stage IIIB, and Stage IIC.
Stage IIIA may or may not show any tumor in the breast, and the cancer is present in four to nine surrounding lymph nodes. Also, in this stage, the tumor is bigger than 50 mm.
Stage IIIB shows a tumor spreading to the chest wall behind your breast. The cancer might spread to the skin and cause inflammation.
In stage IIIC, a tumor of any size is present within the breast. There can also be possibilities of no tumor at all. However, in both situations, the cancer has spread to various areas like the skin or lymph nodes around the collarbone.
DCIS Stage IV Breast Cancer
This is the most advanced stage of DCIS. The cancer goes into the nearby lymph nodes and distant areas of the body past the breast. It will probably include organs like the liver, brain, or lungs.
One can have DCIS stage IV breast cancer in the earliest diagnosis, or it can be recurred because of a prior breast cancer.
Also Read: IS IT POSSIBLE TO SURVIVE 20 YEARS WITH WALDENSTROM MACROGLOBULINEMIA?
Treatment For Ductal Carcinoma In Situ
DCIS is not invasive, but getting proper DCIS breast cancer treatment is essential. There can be chances of the DCIS becoming invasive if left untreated. This indicates that the cancer may spread further than the milk ducts. It may even go into the surrounding breast tissue.
Here are some of the most common DCIS cancer treatments:
Breast-Conserving Surgery (BCS)
Breast-conserving surgery takes out all the cancerous cells as well as the healthy breast tissue bordering the cancer growth. Taking out the tiny amounts of surrounding healthy tissue raises the possibility of no leftover abnormal cells.
The medical practitioner will leave most of the breasts unharmed during the procedure.
Many women undergo surgery to remove the area of DCIS and a border of the surrounding tissue. There may be a necessity to have radiotherapy after the surgery if the DCIS cells appear too abnormal.
Chemotherapy is generally not used for curing DCIS post-surgery. Is your DCIS estrogen receptor positive? It means that cancer needs estrogen for development. If yes, then your healthcare provider may recommend estrogen-blocking treatments.
Mastectomy
Mastectomy involves the removal of the whole affected breast. Sometimes, the patient needs a double mastectomy, which means removal of both breasts. You might be eligible for a mastectomy if you are not a candidate for breast-conserving surgery. Also, some patients might choose mastectomy over BCS.
Radiation Therapy
Usually, those who have breast cancer surgery go for radiation therapy later on. The primary purpose of radiation therapy is to get rid of the cancerous cells that remain post-surgery. The therapy generally lasts from 3 to 4 weeks.
The patient may experience short-term and long-term side effects following radiation therapy. The short-term side effects include breast pain, fatigue, and skin irritation. On the contrary, the long-term side effects may include spider veins, changes in breast size, and persistent fatigue.
Hormone Therapy
Your healthcare provider may recommend hormone therapy for five years if you have undergone breast-conserving surgery. Also, you can go for this therapy if you don’t have radiotherapy and your cancer cells are estrogen-positive.
Research shows that hormone therapy post-breast-conserving surgery lowers the odds of recurrence. In trials, it has been shown that hormone therapy can lower the number of further invasive DCIS breast cancers.
How To Reduce The Risk Of DCIS?
Most of the risks for DCIS are unpreventable. But, you can increase the chances of treating DCIS by catching it in the early stage. Most females and people assigned female at birth (AFAB) must start getting the annual mammograms in their 40s.
Consult your healthcare provider regarding how often you need to go for a mammogram based on the risk factors.
When To Visit A Doctor?
Visit a doctor when you see any change in your breast size, feel a lump, unusual skin, or a nipple discharge. Ask the doctor when to go for a breast cancer screening and how often you should have it.
A majority of groups recommend starting routine breast cancer screening in the 40s. But you must consult with your doctor about what is the right time.
Follow-Up Care After DCIS Treatment
One must visit the healthcare provider for a physical test every six to 12 months for five years following the treatment. Later on, they must go for the test every year. They may also have to get yearly mammograms.
Since everyone’s case is unique, it is better to discuss with a healthcare expert to decide your follow-up care plan.
The Prognosis For Those With DCIS
The Ductal carcinoma in situ is contained within a particular area of your breast and has not spread. Thus, the disease can be cured and controlled with the proper treatment. The results of the treatment are often excellent. Also, there are rare chances of recurrence of DCIS. Even if it occurs, the cancer won’t be life-threatening.
What Is DCIS Grade?
On the basis of how the cells look under the microscope, the DCIS is graded. They are graded according to how different they appear from the normal breast cells and how swiftly they develop.
DCIS is graded as the following:
- High grade: The cancerous cells appear different from normal breast cells. They might be fast in growth.
- Low grade: The cancerous cells appear most like normal breast cells. They are generally slow in growth.
- Intermediate grade: The cancerous cells appear less like normal breast cells. They are fast-growing.
Are There Chances Of DCIS Becoming Invasive?
If you leave DCIS untreated, the cancerous cells might develop the capability of spreading out of the ducts into the nearby breast tissue. This is invasive breast cancer, and it can spread to other areas of the body.
Sometimes, DCIS will never develop further or grow so slowly that it won’t cause any damage to a person for life. The size and grade of the DCIS may help in foretelling whether it will become invasive. Still, there is no way of knowing whether this will happen. High-grade DCIS is more expected to turn invasive compared to low-grade DCIS.
Is DCIS Preventable?
There is no proven way of preventing DCIS breast cancer. However, you can detect DCIS in the earliest stage with yearly mammograms. By detecting early, you can have better results with minimally invasive treatment.
Prevention of DCIS specifically might be improbable. But, there are a few risks for breast cancer that you should know. Individuals with a strong family history or those who are anxious about breast cancer development must focus on maintaining a healthy lifestyle. Moreover, they should also stay away from bad habits like alcohol consumption.
What If DCIS Is Left Untreated?
As mentioned earlier, no proven method of knowing whether DCIS will turn invasive exists. But, a treatment is generally prescribed. This may result in unnecessary treatment for some individuals.
The treatment’s primary purpose is to eliminate all the DCIS in your breast and lower the risk of invasive cancer. If your diagnosis says you have a low-grade DCIS, your healthcare provider might ask you to join a clinical trial.
DCIS Breast Cancer Survival Rate
The survival rate is maximum during the earlier stages of DCIS Breast Cancer. On the contrary, cancer in stage IV indicates the final stage, and the chances of survival are less.
Stage 0 DCIS breast cancer is treatable with proper treatment. However, there are instances when the tumor can be of varying sizes and present in several milk ducts.
Conclusion
DCIS is not life-threatening. But if your diagnosis says you have DCIS, there might be a higher chance of having invasive breast cancer. This is the earliest form of breast cancer and does not usually spread to other body parts. Reach out to your healthcare provider if you experience signs like a bleeding nipple and a lump in the breast.
Book an appointment with University Cancer Centers for more details regarding DCIS Breast cancer. Our cancer experts not only help you understand the cancer better, but they will also tell you about if needed, which treatment option you must go for. For more information regarding Breast Cancer, connect with our experts.
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