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Ductal Carcinoma In Situ -- A highly
treatable Breast Cancer
Newswise — Doctors and their patients with a
specific type of breast cancer called ductal
carcinoma in situ (DCIS) are successfully
employing treatments to beat the disease,
with 10-year survival rates approaching
nearly 100 percent.
But questions remain on how aggressively to
treat this cancer. The October issue of
Mayo Clinic Women’s HealthSource lays
out the issues and treatment choices.
DCIS occurs when abnormal cells multiply and
form a growth within a breast’s milk duct.
The cells are considered cancerous but have
remained in place within the milk duct. “In
situ” means “in place.”
More than 62,000 cases of DCIS are diagnosed
in the United States annually, making it the
most rapidly increasing type of noninvasive
cancer. The majority of DCIS cases -- about
90 percent -- are discovered during routine
mammograms. DCIS usually has no outward
signs or symptoms.
DCIS isn’t considered life threatening, but,
if not detected and treated, it can progress
to a more serious form of invasive cancer.
The best treatment approach is still being
debated.
Lumpectomy or mastectomy: Most women with
DCIS are good candidates for a lumpectomy,
where a portion of breast tissue is removed.
However, there’s a slightly higher chance
that the cancer will return after a
lumpectomy than after a mastectomy, which
involves removal of breast tissue, skin,
areola and nipple.
Mastectomy is commonly recommended when the
area of DCIS is large or in several parts of
one breast. Women may choose this option if
they can’t have or don’t want radiation.
Some women choose to have both breasts
removed to prevent recurrence or a new
cancer.
Radiation therapy: Radiation therapy is
almost always recommended after a
lumpectomy. Research has shown that it
significantly reduces the chances that DCIS
will recur or progress to an invasive form
of cancer. Radiation is usually given five
days a week for five to six weeks. Some
research has questioned whether this
approach is overly aggressive, particularly
for older women with small, slow-growing
tumors.
Tamoxifen therapy: Tamoxifen is a synthetic
hormone that can be used to help treat or
prevent the development of breast cancers.
It’s
approved as therapy after surgery or
radiation to prevent recurrence of DCIS or a
new cancer in the opposite breast. But, some
doctors don’t recommend it because no
evidence shows that tamoxifen improves
long-term survival with this type of cancer.
Taking tamoxifen can result in side effects
such as hot flashes. And tamoxifen may
increase the risk of blood clots and cancer
of the uterus.
Researchers are attempting to better
understand which women with DCIS are at
highest and lowest risk of recurrence. That
information would help in determining the
most appropriate treatment. In the meantime,
patients and their care providers should
discuss the pros and cons of all treatment
approaches.
Mayo Clinic Women’s HealthSource
is published monthly to help women enjoy
healthier, more productive lives. Revenue
from subscriptions is used to support
medical research at Mayo Clinic.
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