subject: Ductal Carcinoma in Situ of the Breast [print this page] Ductal Carcinoma in Situ of the Breast Ductal Carcinoma in Situ of the Breast
One of the more confusing areas in breast pathology for patients is the difference between ductal carcinoma in situ and lobular carcinoma in situ (DCIS vs. LCIS). DCIS arises in the larger ducts of the breast and LCIS arises within the lobules of the breast. However, the ducts and lobules are connected which means that DCIS may travel into the lobules and LCIS may travel up the ducts. For this reason, pathologists rely on the type of cells and pattern of growth to determine the diagnosis of DCIS vs. LCIS.
Ductal Carcinoma In Situ is referred to as a Stage 0 cancer, but it is taken very seriously by doctors. Treatment for DCIS is usually much more aggressive than it's in situ cousin, LCIS (or lobular neoplasia). Even though it is a serious condition, there is plenty of time to educate yourself and weigh all your options concerning treatment and possible reconstruction. There is close to a 100% rate of success in treating DCIS with the standard medical treatment. Breast cancer is not only one disease, but rather is a wide-ranging term applied to explain numerous various types of cancers that happen in the breast. Most of them could be categorized into one of the classifications: infiltrating ductal carcinoma, infiltrating lobular carcinoma, ductal carcinoma in situ, lobular carcinoma in situ, inflammatory carcinoma, paget's disease, and cystosarcoma phyllodes.
Proponents for radiation therapy underscore the fact that the risk of a recurrence in the breast can be a more aggressive or even an invasive recurrence. Half of these recurrences are due to invasive breast cancer. The latter has the potential to spread to lymph nodes of the underarm and to other parts of the body. Without radiation therapy, the risk of a local recurrence is approximately 20%. By adding radiation therapy, the risk of such a failure is reduced by half. Needless to say, this is a substantial benefit.
Women who have breast-conserving surgery, known as lumpectomy, for ductal carcinoma in situ, without following some rules of the right nutrition, which according to many doctors and nutritionist is the best treatment method, have much more chances to have a recurrence in the future.
Lobular carcinoma in situ (LCIS): This state starts in the milk-making glands but does not go through the wall of the lobules. Even though not a true cancer, having LCIS raises a woman's risk of getting cancer later on. Therefore, it's significant that women with LCIS ensure they have habitual mammograms.
Lobular cancer is often termed "infiltrating" lobular cancer because the cancer cells infiltrate the supporting tissue in a linear fashion. Cancer cells appear as interspersed cords among normal breast tissue, making both mammographic diagnosis and detection by palpation more difficult. The association of infiltrating lobular cancer with a change in the terminal lobular units of the breast duct characterized by atypical lobular cells thought to be the pre-invasive phase of infiltrating lobular cancer. This proliferation of cells was called lobular carcinoma in situ and seemed to be similar to ductal carcinoma in situ in invasive ductal cancer.
Yet indeed, ductal breast cancer is diagnosed at a breathtaking rate in the US, and these cases might as well be decided on a coin toss for all the accuracy they achieve. This is the finding of The United States Preventive Services Task Force. The College of American pathologists has said that it plans a voluntary certification system. Any pathologist in the country can take the certifying exam if they read at least 250 ductal breast cancer cases every year. But it's voluntary.
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