Mar 24 2009
Breast Cancer (2 of 3): Ductal Carcinoma in Situ, Lobular Carinoma in Situ, Invasive Carcinomas
This is the second post in a series of 3 regarding the topic of breast cancer. In the first post of the series we discussed the basic anatomy and benign diseases of the breast. This post will discuss the malignant breast diseases.
Over 200,000 new cases of breast cancer will be discovered this year with nearly 40,000 women dying from the disease. Nearly 1 in 8 women will be diagnosed with some form of breast cancer in their lifetime. Breast cancer is the leading cause of death for women in their forties and the second most common cause of death in women overall - second to lung cancer.
Lobular Carcinoma in Situ (LCIS):
This cancer arises from the lobular and terminal ducts of the breast that were mentioned in our anatomy review. Previously, LCIS was thought to not be a true cancer but a precursor for future breast cancer. However, LCIS is now thought to be the beginnings of a more invasive breast cancer. Patients with LCIS need to have it removed as these women will have a 10x increased risk for getting an invasive cancer. However, some physicians suggest getting annual mammograms to watch the disease to see if it will progress. Some physicians suggest taking Tamoxifen (we will discuss more in the next post) which is a selective estrogen receptor modulator and is though to reduce the risk of future cancer.
Ductal Carcinoma in Situ (DCIS):
This cancer is thought to arise from malignant epithelial cells within the milk ducts of the breast system (see first post), but this is not an invasive process. Ductal carcinoma in situ is not a malignant disease but localized within the milk duct. Thus, DCIS itself is not life threatening. However, if DCIS is not removed, it can progress into a more invasive disease. In 70% of DCIS cases, the cancer cells are positive for estrogen receptor. In 50% of cases of DCIS, the cancer cells are Her2/neu positive as well. These markers are important for how the cancer will be treated. Currently, most women are treated with breast-conserving treatment (such as a lumpectomy). Most women will be at risk for a recurrence of DCIS or an invasive tumor. Thus, in some cases, women will opt for bilateral mastectomies to lower their risk for a recurrence.
Invasive Lobular Carcinoma and Invasive Ductal Carcinoma:
Invasive breast cancers are described as invading into the breast tissue and ducts. In these cases, the cancer cells can spread to your lymph nodes and metastasize throughout the body. Invasive ductal carcinoma is the most common malignant breast cancer and will often be found on mammogram or felt as a lump in the breast. About 10% of cases of breast cancer are invasive lobular carciomas. This cancer can present as a mass that can felt within the breast, but not always. In either cases, these invasive cancers are obviously worse due to their potential to metastasize or spread throughout the body.
The third post in this series will review treatments of these diseases.
This is a very informative blog, and your post is very detailed.
Thanks for visiting my blog, and leave comment! I forgot to include the link on the side effects of soy, but have fixed it if you want to know more.
This is very informative. I actually had a mammogram earlier this week. Now that I’m 40, I’m going to start doing this every year.
Glad you find the information helpful. Mammograms are important…they should be done once yearly at this point. Of coure, always speak to your personal physician.
Yikes, the hospital just called me after my mammogram earlier this week. They want me to come back for more views of one of my breasts. Are callbacks common? How worried should I be? I’m going back tomorrow morning.
Callbacks are common for the most part. The mammogram is not 100% accurate you have to remember. Its only about 80%, not the best, but best out there for screening. Thus, if something does not look right, or its unclear, the physicians will have you come back in for some more views. This will either confirm a finding or allow the physician to be more sure that nothing is currently wrong with you. Speak further with your physicians regarding any concerns of course. Best of luck.
Okay, I went back and they found some calcifications, but they were scattered and the radiologist said they appear benign. I mentioned your series about breast cancer on my site at http://www.takingofme.today.com.
As frightening as it may seem, the abnormal findings on mammography and follow-up visits are necessary in order to detect if something concerning is going on..such as DCIS or an invasive/infiltrating process. Remember, the purpose for screening IS to find something new and abnormal in order to treat/cure it before it becomes something deadly. Glad to hear everything is ok.