Ductal carcinoma of the breast: what you need to know

Ductal carcinoma of the breast (DCIS) is the earliest form of breast cancer. They are usually asymptomatic but are discovered incidentally during physical examination or laboratory testing. So is ductal carcinoma of the breast dangerous for the patient? How is ductal carcinoma of the breast treated? Let's find out with SignsSymptomsList

content

• overview
• Symptoms of ductal carcinoma of the breast
• When should you see a doctor?
• Causes of ductal carcinoma of the breast:
• The danger elements:
• How is ductal carcinoma of the breast (DCIS) diagnosed?
• How is DCIS treated?

overview

Ductal carcinoma in situ is usually caused by an abnormality in the cells of the ducts that carry milk in the breast. DCIS is considered the earliest form of breast cancer. Usually DCIS is not invasive. But that doesn't mean it hasn't spread in the duct and there is still a risk of invasion around. DCIS is often discovered during breast cancer screening or a palpable mass in the breast .

Usually DCIS is not an emergency. We therefore need to evaluate and consider the best treatment option. Treatment must include breast conservation and radiation therapy combined with surgery. One study found that active monitoring could replace surgery.

Symptoms of ductal carcinoma of the breast

DCIS usually has no symptoms or signs. However, sometimes there are some of the following signs:

• Breast tumor
• Bleeding nipples

DCIS is seen on mammography as a calcified spot of irregular shape and size.

>> You can refer to  the early warning signs of breast cancer every woman needs to know  

When should you see a doctor?

You should see a doctor when you see abnormal changes in your breast to detect ductal carcinoma in time, such as:

• Tumor or an area of ​​abnormal skin discoloration
• Thicker skin and nipple discharge.

You can ask your doctor when breast cancer screening is and when it should be repeated. Most recommend getting screened for breast cancer at age 40 or older. Even breast cancer can come back after initial treatment.

Causes of ductal carcinoma of the breast:

Currently, the cause of DCIS remains unclear. Some suggest that DCIS is caused by mutations in the DNA of breast milk duct cells. Currently, it is not clear what factors trigger the abnormal cell proliferation. However, it is possible that unhealthy lifestyle, environment and genetics increase the risk of disease.

The danger elements:

Factors that increase the risk of breast cancer include:

• Old
• Personal history of benign breast disease, such as atypical ductal dysplasia.
• Having a family member with breast cancer?
• Never been pregnant
• Having your first child after the age of 30
• Started menstruation before the age of 12
• Menopause after 55 years
• Certain gene mutations increase breast cancer risk, such as BRCA1 and BRCA2

How is ductal carcinoma of the breast (DCIS) diagnosed ?

Some tools to help with diagnosis include:

• Mammography. DCIS is often discovered incidentally on mammograms. If the results show an abnormal white spot (microcalcification) of an unusual shape and size, your doctor may recommend additional tests.
• Biopsy. During a biopsy, the radiologist or surgeon uses a needle to remove a small sample of tissue from an area suspected of having an abnormality, under ultrasound or X-ray guidance. The tissue sample will be sent to the laboratory. The pathologist will evaluate these tissue samples for abnormalities.

How is DCIS treated ?

DCIS is often treated with great success. Usually, surgery will remove the tumor and prevent its recurrence.

In most people, treatment options include:

• Conserving surgery (lumpectomy) of breast tumors combined with radiation therapy
• Surgery to remove the entire breast (mastectomy)

In some cases, treatment options are:

• Only surgery to remove the tumor
• Tumor removal surgery and hormone therapy
• Some only active monitoring combined with surgery

Surgery

Once a DCIS diagnosis is made, one of the top decisions is to choose between a lumpectomy or a mastectomy.

• Surgical removal of the tumor. This is a method of removing the area with DCIS and surrounding tissues that are completely normal. That's why it's also called surgical biopsy or local excision. This procedure allows as much breast tissue as possible to be preserved, depending on the amount of tissue removed. Often an additional breast reconstruction step will be required. Research shows that women who have surgery to remove the tumor are more likely to have a recurrence. However, compared with total breast surgery, survival rates are similar. If the patient has some other medical condition, other options should be considered. The tumor may be surgically removed with hormone therapy, tumor removal alone, or no treatment.
• Removal of one breast . This is a method of completely removing tissue from one breast. Breast reconstruction during a mastectomy or later for cosmetic reconstruction.

Most women with DCIS (ductal carcinoma of the breast) only need surgery to remove the tumor. However, a mastectomy may still be considered if:

• Large size DCIS block. If you use surgery to remove the tumor, it will lose its aesthetics
• There is more than one DCIS tumor. Surgical removal of multiple tumor areas will be very difficult.
• After the biopsy, the tissue surrounding the DCIS tumor was found to be abnormal. At this time, preference should be given to surgery to remove the entire breast.
• Radiation therapy is not possible. Usually after surgery, radiation therapy will be given. However, for some reason, you cannot receive radiation therapy. For example, if you are pregnant in the first trimester, have recently had radiation therapy, or are too susceptible to radiation side effects, such as systemic lupus erythematosus.
• Patients prefer to have a full mastectomy rather than just a lumpectomy.

Because DCIS tumors are usually noninvasive, there is no need to surgically remove nearby lymph nodes. The risk of metastatic lymphoma is extremely low. However, if the biopsy shows abnormal tissue around the tumor or you need a total mastectomy, a nearby lymph node biopsy or lymph node dissection is considered part of the surgery.

Radiotherapy

Using X-rays or high-frequency protons to cut away abnormal cells. Usually radiation therapy is given after the tumor has been removed. The main aim is to reduce the chance of the cancer coming back or progressing to an invasive form. There is usually a machine that moves around the patient's body (external beam radiation), but there is also a type of radiation therapy to only the affected breast tissue (brachytherapy). However, if the DCIS mass is too small and the malignancy is low, surgery alone may be necessary.

Hormone therapy

This is a way of blocking hormones from attaching to cancer cell receptors in order to stop tumor growth (breast cancer hormone receptor positive).

Often treating DCIS does not require hormone therapy. However, it may be considered in combination with surgery or radiation therapy to reduce the chance of recurrence of DCIS mass or invasive breast cancer.

Some alternative treatments 

It is not known to date that any alternative treatment for DCIS can reduce the likelihood of an invasive cancer. However, complementary or alternative medicine is used to help reduce the side effects of other treatments, such as stress. If you find it difficult to sleep or think too much, you are easily irritable or sad. Talk to your doctor more. Your doctor will consider a combination of several medications to help relieve symptoms. According to the doctor's recommendation, some of the following therapies should be considered:

• Painting therapy
• Do exercise
• Meditation
• Music therapy
• Exercise to relax the body
• Mental therapy

Supportive therapy

When you're diagnosed with a ductal tumor in your breasts (DCIS), you'll be terrified. To feel better, you should:

• Research information about DCIS disease and choose appropriate treatment. You can talk to your doctor to get more information
• Thanks for everyone's help. You can talk to your friends about your feelings or worries. There are also teams that will listen and support you
• Change to a healthy lifestyle. This will help you feel better. Eat healthy foods like fruits, vegetables, and whole grains. Exercise for at least 30 minutes a day most days of the week. Getting enough sleep each night will help you feel good.

Ductal carcinoma of the breast is a common disease in elderly women. Symptoms are often not obvious. However, early detection and appropriate treatment are essential. If you notice any abnormalities in your breasts, seek medical attention immediately. Your doctor will help you find the cause and choose the best treatment for you.

Doctor Vu Thanh Do