Cancer Ductal carcinoma in situ

Ductal carcinoma in situ (DCIS) of the breast is a very initial neoplasm in cells with malignant characteristics do not invade the subepithelial basement membrane. For this does not affect veins and lymphatics, do not give metastasis, and can be considered as a pre-carcinoma. Once rare condition nowadays DCIS assumed great importance in practice since, with the more widespread use of mammographic screening, is now 10-30% of cases of breast cancer treated in a service Mastology.
It is difficult to predict the natural history of DCIS lesions classified as, because this involves long-term monitoring of patients untreated. A valid methodological strategy to circumvent this obstacle is to review biopsies that were initially considered benign and that actually correspond to cases of DCIS. Thus, some investigators found in about 30% of cases progress to form infiltrative up to 10 years.
Treatment
Total mastectomy, lumpectomy preserving skin, adenectomia, segmental resection and radiotherapy are the treatment options that can be employed.
A mastectomy confers very high curability rate - 98% - regardless of subtype or nuclear grade; must be accompanied by immediate breast reconstruction can be performed by new variants, techniques that preserve the breast skin (areola complex papillary or in selected cases ), and is always an excellent therapeutic option in terms of cancer protection. The best surgical approach seems to be individualized, tailored to each case, depending on the risk of recurrence (MRI is the best imaging method for evaluating the extent of disease) and the availability of adequate follow up.
As a general rule, for tumors up to 4 cm maximum, and with free surgical margins, has preferred recommend segmental resection and radiotherapy, indicating mastectomy in other cases, especially if the patient is unwilling to monitoring clinical-image tests . Surgery may be type-preserving mastectomy skin or adenectomia, followed by immediate breast reconstruction. Under these circumstances is omitted radiotherapy.
Obviously, from the point of view of theoretical CDIS in should not be held to axillary dissection because there normally risk of lymphatic invasion, however, in practice more aggressive and extensive cases microscopically, often have areas of micro invasion or invasion weak in isolated spots, hard to detect and can then be axillary lymph nodes. Under these conditions it is recommended that sentinel node biopsy.
It is demonstrated that tamoxifen should be recommended in a complementary way, in women with DCIS treated conservatively and whose tumors had estrogen receptors. Reduces the chances of recurrence in the breast tumor and avoids the other side.
Prevention
Many risk factors, such as your genes and family history, can not be controlled. However, maintaining a healthy diet and make some changes in your lifestyle can decrease the chance of getting cancer. Breast cancer is more easily treated and is often curable if it is detected early.