What Causes Ductal Carcinoma in Situ (DCIS) and How Is It Treated?

Ductal carcinoma in situ (DCIS) is characterized by the formation of abnormal cells in a milk duct in your breast. It has a good cure rate because the aberrant cells have not moved beyond the milk duct to the surrounding tissue.

 

DCIS is classified as a stage 0 malignancy or preinvasive cancer. In other words, it is a risk factor for breast cancer. In this post, we’ll look at DCIS in further detail, as well as the known risk factors, treatment choices, and prospects.

DCIS is an abbreviation for ductal carcinoma in situ

Your breasts are composed of three kinds of tissue:

  • the lobes (which are made up of smaller sacs called lobules, which make milk)
  • ductwork (which transport milk to your nipple)
  • connective tissue that is either fatty or fibrous

DCIS occurs when a cluster of abnormal cells begins to form within the lining of a milk duct. It is referred to be a preinvasive or noninvasive cancer since the malignant cells have not moved beyond the duct to adjacent breast tissue.

When these aberrant cells are not treated promptly, they may progress to an aggressive type of breast cancer. Breast cancer that is invasive has the potential to spread to other places of your body. When this occurs, breast cancer is considered to have spread.

DCIS accounts for around 16% of all breast cancer diagnoses in the United States, according to the American Cancer Society.

What are the signs and symptoms?

The aberrant cells in your milk duct are typically not visible or palpable. As a consequence, you may have no symptoms. In reality, DCIS is diagnosed in the great majority of instances via a mammogram-based breast cancer screening. On a mammogram, the abnormal cells generally appear as clusters of brilliant white specks (known as microcalcifications) with uneven forms.

 

DCIS may induce the following symptoms in certain cases:

  • a little lump
  • secretion from a nipple that isn’t milk

The majority of breast symptoms or changes are not caused by cancer, however, tests are often required to rule out the potential of abnormal breast cells.

Are there any risk factors for DCIS?

It is unknown what causes DCIS. Nonetheless, research has shed light on some of the potential risk factors that may raise your chances of having breast cancer.

It’s important to understand that your chance of getting breast cancer isn’t generally determined by a single factor. You may have multiple risk factors for breast cancer, but this does not guarantee that you will get the disease.

Understanding your risk factors, on the other hand, might help you make better choices regarding your health and healthcare.

The following variables may increase one’s chance of developing breast cancer:

Risk factors you have no influence over that

  • Growing older: The majority of patients diagnosed with breast cancer are above the age of 50.
  • Your ancestors: Mutations in the BRCA1 and BRCA2 genes, in particular, may raise your risk of cancer.
  • Hormone exposure over a longer period of time: If you started having periods before the age of 12 or went through menopause after the age of 55, you may be at a greater risk of breast cancer.
  • Breast tissue that is dense: Breasts with a high concentration of connective tissue may be predisposed to breast cancer. On mammography, thick tissue might make it difficult to spot troubled regions.
  • Personal experience with breast cancer: Breast cancer risk may be increased if you have a history of atypical hyperplasia or lobular carcinoma in situ.
  • There is a family history of breast or ovarian cancer: You are more likely to get breast or ovarian cancer if you have a close family (parent, sibling, kid) who has had the disease.
  • Radiation treatment: According to 2017 research, if you received radiation treatment for another ailment and your breasts were in the radiation field, your chance of breast cancer may be increased.

Some risk factors, such as your age, are beyond your control. However, some components of your lifestyle may have an impact on your general health and your chance of getting breast cancer.

Lifestyle risk factors

  • Hormone replacement therapy: A meta-analysis published in 2019 A reliable source and a 2018 study review According to Trusted Source, if you use combined estrogen and progesterone hormone replacement treatment (HRT) or some birth control pills for an extended length of time, you may have an increased chance of breast cancer.
  • The usage of alcohol: Alcohol use has been linked to an increased risk of getting breast cancer.
  • Weight: According to a 2019 scientific review, obesity may increase your chance of developing breast cancer and may also limit the efficiency of several breast cancer therapies. Reliable Source.
  • Physical exertion: According to a 2017 review of the evidence, a sedentary lifestyle may increase your chance of developing breast cancer.
  • Breastfeeding and pregnancy: A scholarly review published in 2014 According to a reliable source, if your first pregnancy occurred beyond the age of 30, or if you never brought a baby to term, you may be at a greater risk of having breast cancer. You may also be at danger if you do not breastfeed.

How is it identified?

The majority of the time, DCIS is discovered during a normal breast cancer screening.

If your doctor suspects you have DCIS, you will most likely need further testing to confirm the diagnosis. These tests may involve the following:

  • a mammogram for diagnosis
  • an MRI and an ultrasound
  • biopsies

     

The report from the pathologists in the lab may include some strange phrases, such as those listed below:

  • DCIS with a high grade, nuclear grade 3, and a high mitotic rate is more likely to recur the following therapy.
  • The labels intermediate-grade, nuclear grade 2, and intermediate mitotic rate suggest that DCIS is less likely to recur the following therapy.
  • DCIS that is low-grade, nuclear grade 1, and has a low mitotic rate is the least likely of the three to recur the following therapy.

A biopsy will also reveal the hormone receptor status of the DCIS cells. DCIS often has receptors that react to the hormones estrogen or progesterone. If these hormone receptors are present, your doctor may determine whether or not to provide anti-estrogen medicine to lower the chance of recurrence.

What is the treatment for DCIS?

Because DCIS includes the detection of aberrant cells at an early stage, therapies are typically quite successful. Furthermore, since the abnormal cells are exclusively identified in your breast duct, chemotherapy for DCIS is never required.

Let’s take a deeper look at some of the therapy choices you and your healthcare team could consider depending on your individual diagnosis and condition.

Lumpectomy

A lumpectomy, often known as breast-conserving surgery, removes the tissue containing the abnormal cells as well as some surrounding tissues. A lumpectomy saves as much of the breast as feasible. It is often followed by radiation treatment, which reduces the likelihood of the DCIS returning.

Mastectomy

This procedure eliminates as much breast tissue as feasible. Mastectomy may be the best choice for your treatment if DCIS is present in more than one location in your breast or if there is a big region of DCIS.

Radiation treatment

Radiation treatment is often performed after a lumpectomy to lower the chance of DCIS recurrence. High-energy beams are used in radiation treatment to destroy the DNA of cancer cells. This aids in the destruction of aberrant cells.

Radiation therapy is a localized sort of treatment, which means that it only targets the region being radiated. This helps to keep healthy cells safe.

Hormone replacement treatment

If your cancer cells are hormone-receptor-positive, hormone therapy may be a possibility. This suggests that the cancer cells proliferate as a result of estrogen or progesterone. Hormone therapy might be included in your post-surgery treatment plan to reduce the chance of DCIS reoccurring in the future.

The following are two regularly recommended hormonal therapies:

  • Tamoxifen (an oral hormone) works by blocking estrogen receptors. By binding to the receptors of cancer cells in place of estrogen, it helps to stop the growth signal to these cells.
  • Aromatase inhibitors are drugs that assist to lower the amount of estrogen generated in the body after menopause.

What is the future of DCIS?

People diagnosed with DCIS have a relatively high survival rate. A 2015 research that examined data from 100,000 women over a 20-year period found that just 3.3 percent of women treated for DCIS died from breast cancer, regardless of the kind of therapy they had.

AN IMPORTANT NOTICE

Women diagnosed with DCIS before the age of 35 and Black women had a greater chance of dying from breast cancer later in life, around 7% compared to 3% overall.

It is vital to emphasize that, in addition to hereditary variables, the stress of enduring racism, discrimination, and racist institutions may play a role in the disease’s development. Following DCIS therapy, it is important to follow up with your healthcare team on a frequent basis to ensure that the cancer cells do not reappear.

In conclusion

Ductal carcinoma in situ (DCIS) is a kind of preinvasive breast cancer with a good cure rate. DCIS has no symptoms and is most often found during a mammogram. DCIS therapy may include a lumpectomy or a mastectomy, depending on the size and location of the afflicted cells. Radiation and hormone treatment may also be used to prevent cancer cells from returning.

Overall, DCIS has a bright future.

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