breast carcinoma in situ

Breast Carcinoma In Situ (BCIS): An Overview

Breast carcinoma in situ, also known as ductal carcinoma in situ (DCIS), is a condition where abnormal cells are found in the tissues of the breast. This type of cancer is non-invasive or pre-invasive, meaning that the cancer cells have not spread outside the ducts to other tissues in the breast.

Characteristics and Symptoms

• DCIS typically doesn't cause symptoms, but some people may notice a lump, itchy skin, or nipple discharge (like blood) [3].
• A lump, an area of puckered or otherwise unusual skin, a thickened region under the skin, and nipple discharge are possible changes to look for [1].

Types and Stages

• There are two types of breast carcinoma in situ: ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS).
• DCIS is further classified into different stages based on its severity.
• Stage 0 includes Tis, N0, M0; Tis refers to carcinoma in situ, N0 indicates no regional lymph node metastasis, and M0 signifies no distant metastasis [10].

Treatment Options

• Treatment for breast carcinoma in situ usually involves surgery, such as breast-conserving surgery (BCS), where the surgeon removes the tumor and a small amount of normal breast tissue around it [8].
• Other treatment options may include radiation therapy or hormone therapy.

References:

[1] Changes to look for may include a lump, an area of puckered or otherwise unusual skin, a thickened region under the skin, and nipple discharge. [2] A condition in which abnormal cells are found in the tissues of the breast. [3] Ductal carcinoma in situ doesn't generally cause symptoms. But a few people with DCIS may notice a breast lump, itchy skin or nipple discharge (like blood). [4] Nov 19, 2021 — DCIS is a non-invasive or pre-invasive breast cancer. [5] by S Tomlinson-Hansen · 2023 · Cited by 32 — Ductal carcinoma in situ is a clonal proliferation of epithelial cells in the breast ductal-lobular unit confined to the myoepithelial cell basement membrane. [6] Ductal carcinoma in situ (DCIS) is an early breast cancer. It means that some of the cells lining the breast ducts have started to turn into cancer cells. [7] Jul 18, 2024 — DCIS (ductal carcinoma in situ), also known as stage 0 breast cancer, is non-invasive breast cancer that starts in the milk ducts. [8] Breast-conserving surgery (BCS). In breast-conserving surgery (BCS), the surgeon removes the tumor and a small amount of normal breast tissue around it. [9] A condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the ... [10] Result: stage 0 includes: Tis, N0, M0; Tis: carcinoma in situ; N0: no regional lymph node metastasis; M0: no distant metastasis

Breast Carcinoma In Situ (DCIS) Signs and Symptoms

Breast carcinoma in situ, also known as ductal carcinoma in situ (DCIS), is a type of non-invasive breast cancer where abnormal cells are found in the milk ducts. While it's not possible to feel or see DCIS, some people may experience certain symptoms. Here are the signs and symptoms of breast carcinoma in situ:

• No symptoms: In most cases, DCIS does not cause any noticeable symptoms [3]. It is often detected by mammogram before any symptoms appear.
• Lump or thickening: A small lump or thickening under the skin may be felt in some cases [1][4].
• Nipple discharge: Clear fluid or blood may be discharged from the nipple, although this is rare [6][9].
• Breast pain or tenderness: Some women with DCIS may experience breast pain or tenderness, but this is not a common symptom [7].
• Changes in skin texture: A change in skin texture, such as puckered or unusual skin, may be noticed in some cases [1][8].

It's essential to note that these symptoms can also be caused by other conditions, and only a healthcare professional can determine if they are related to DCIS.

Early Detection

Regular mammograms and breast self-exams can help detect DCIS early on. If you notice any changes in your breasts or experience any of the above symptoms, make an appointment with your doctor for further evaluation [8].

References: [1] Context result 1 [3] Context result 3 [4] Context result 4 [6] Context result 6 [7] Context result 7 [8] Context result 8 [9] Context result 9

Diagnostic Tests for Breast Carcinoma in Situ

Breast carcinoma in situ, also known as ductal carcinoma in situ (DCIS), can be diagnosed through a combination of procedures. The following tests are commonly used to diagnose DCIS:

• Mammogram: A mammogram is an X-ray image of the breast that can help detect DCIS. It is usually done as part of breast cancer screening or to investigate a breast lump.
• Breast Physical Examination: A physical examination by a healthcare provider can also be used to diagnose DCIS, although it is not always necessary.
• Core Needle Biopsy: A core needle biopsy involves removing a small sample of tissue from the breast using a needle. This sample is then examined under a microscope for cancer cells.
• Laboratory Tests: Additional laboratory tests may be performed on the biopsy sample to determine if the DCIS has certain characteristics, such as hormone receptor status or HER2/neu status.

Common Laboratory Tests

The following laboratory tests are commonly used to diagnose and characterize DCIS:

• Hormone Receptor Test: This test determines whether the cancer cells have receptors for estrogen and progesterone.
• HER2/neu Test: This test determines whether the cancer cells have an overexpression of the HER2/neu protein.

Diagnostic Process

The diagnostic process for DCIS typically involves a combination of these tests. The specific tests used may vary depending on individual circumstances, such as the presence of symptoms or a family history of breast cancer.

References:

• [1] A mammogram is usually done as part of breast cancer screening or to investigate a breast lump. (Source: #7)
• [2] Ninety percent of all cases of DCIS are found via screening mammograms. (Source: #2)
• [3] Diagnosing DCIS involves a combination of procedures and almost always includes: Breast physical examination, Core needle biopsy, and Laboratory tests. (Source: #3)
• [4] Additional laboratory tests may be performed on the biopsy sample to determine if the DCIS has certain characteristics. (Source: #5)

Treatment Options for Ductal Carcinoma In Situ (DCIS)

Ductal carcinoma in situ, also known as DCIS, is a non-invasive form of breast cancer where the cells are contained within the milk ducts. While it's not considered "cancer" in the classical sense, it can potentially develop into invasive breast cancer if left untreated.

Surgical Options

• Surgery to remove the cancer is often the primary treatment for DCIS. This can be done through a lumpectomy (removing the tumor and a small margin of surrounding tissue) or mastectomy (removing the entire breast).
• The goal of surgery is to remove all the affected ducts, thereby preventing the development of invasive breast cancer.

Radiation Therapy

• Radiation therapy may also be used in conjunction with surgery to ensure that any remaining cancer cells are eliminated.
• This treatment approach has been shown to result in successful outcomes for most patients.

Hormone Therapy

• Tamoxifen is a medication that can attach itself to the receptors on hormone-receptive breast cancer cells, preventing them from receiving growth signals.
• In women at high risk of breast cancer, tamoxifen can be used to help lower the risk of developing breast cancer.

Aromatase Inhibitors

• Aromatase inhibitors, such as anastrozole (Arimidex), exemestane (Aromasin), and letrozole, are also approved for breast cancer treatment.
• These medications work by blocking the production of estrogen, which can fuel the growth of hormone-receptive breast cancer cells.

Other Treatment Options

• Vitamin and mineral combinations, cardioselective beta blockers, nonsteroidal anti-inflammatory agents, and miscellaneous uncategorized agents have been studied as potential treatments for DCIS.
• However, more research is needed to fully understand their effectiveness in treating this condition.

References

1. The primary goal of DCIS treatment is to keep DCIS from progressing to invasive breast carcinoma [3].
2. Surgery (lumpectomy or mastectomy) and radiation therapy are the standard treatments for DCIS [5].
3. Tamoxifen can be used to help lower the risk of developing breast cancer in women at high risk [7].

Differential Diagnosis of Breast Carcinoma In Situ

Breast carcinoma in situ (DCIS) refers to a non-invasive or pre-invasive form of breast cancer where the cells lining the ducts have changed to cancer cells but have not invaded surrounding tissues. The differential diagnosis of DCIS includes several conditions that can mimic its presentation.

Key Conditions to Consider:

• Benign Breast Disease: Benign breast lesions, such as fibroadenomas or cysts, can be mistaken for DCIS on imaging studies.
• Atypical Ductal Hyperplasia (ADH): ADH is a condition where the cells lining the ducts are abnormal but not yet cancerous. It can be difficult to distinguish from DCIS based solely on histological features.
• Lobular Carcinoma In Situ (LCIS): LCIS is a non-invasive form of breast cancer that affects the lobules rather than the ducts. While it shares some similarities with DCIS, it has distinct histological and clinical features.
• Intraductal Epithelial Proliferations: These are benign or malignant growths within the ducts that can be confused with DCIS.

Clinical Features to Consider:

• Age: DCIS is more common in older women, typically above 50 years of age.
• Symptoms: Patients with DCIS may present with a palpable mass, nipple discharge, or skin changes overlying the affected breast.
• Imaging Studies: Mammography and ultrasound can help identify lesions suspicious for DCIS.

Pathological Features:

• Histology: The histological features of DCIS include atypical cells within the ducts, often with a comedonecrosis pattern (necrotic cells).
• Immunohistochemistry: IHC staining can be used to differentiate DCIS from other conditions, such as ADH or LCIS.

Prognostic Factors:

• Grade: The grade of DCIS is an important prognostic factor, with higher-grade lesions associated with a greater risk of recurrence.
• Size and Location: Larger lesions and those located in the upper outer quadrant are more likely to be associated with a higher risk of recurrence.

References:

1. by HM Maluf · 2004 · Cited by 17 — This article reviews the histological criteria employed to separate ductal carcinoma in situ from lobular carcinoma in situ, the role of immunohistochemistry in [3]
2. by LC Collins · Cited by 7 — The goal of therapy of DCIS is to prevent the occurrence of an invasive breast cancer. The diagnosis, evaluation, and differential diagnosis [4]
3. by SE Pinder · 2010 · Cited by 169 — However, the differential diagnosis of DCIS includes other intraductal epithelial proliferations and lobular in situ neoplasia. Atypical ductal hyperplasia (ADH) [5]
4. by KP Siziopikou · 2013 · Cited by 102 — DIFFERENTIAL DIAGNOSIS. The differential diagnosis of DCIS includes a number of other breast lesions. At the low end of the spectrum, low-grade [6]