Treatment of Breast Cancer

Treatment of
Breast Cancer

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Treatment of Stage 0 (in situ) Breast Cancer

       Stage 0 breast cancer is known as carcinoma in situ. This type of breast cancer is confined to the limiting layers of the tissue and has not infiltrated in to the surrounding tissues. There are two types of carcinoma in situ. ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS). Even though they are both non-invasive (in-situ) cancers, there is inherent difference between the two. Lobular carcinoma in situ (LCIS), even though the name suggest cancer is not a true cancer. Even if the LCIS is not removed it does not grow in to full cancer. The importance of LCIS is that, if a woman develops LCIS, she is at a very high risk of developing breast cancer. This breast cancer usually doesnt occur in the previous LCIS spot, and for this reason can be in the other breast, which did not have any LCIS, diagnosed. No immediate or active treatment is given to patients with LCIS. They are kept under close follow up because of this high risk of occurrence of breast cancer in future. This may include a yearly mammogram and a six monthly clinical examination of the breast by a physician. Such women who have very high risk of breast cancer may take tamoxifen to prevent the occurrence of breast cancer. Bilateral simple mastectomy is another options for some of these patients especially if they have other factors like family history of breast cancer, which may further increase the risk of cancer occurrence. DCIS on the other hand is an early form of breast cancer and needs immediate treatment. The treatment decision will depend up on the mammogram findings and biopsy results. Patients who have small areas of low-grade DCIS may have a choice of lumpectomy followed by radiation therapy. If DCIS is high grade or involves larger areas or multiple areas in the breast, patient may have to undergo a simple mastectomy. Lymph node exploration (axillary dissection) is not usually undertaken in these patients. In patients who are having lumpectomy, if the edge of lumpectomy sample is found to be involved with DCIS, a re-resection is usually done. If the re-excision specimen is also found to be involved with DCIS, the surgeon will usually recommend a simple mastectomy. Patients should undergo a mammogram after lumpectomy to make sure that no more suspicious spots are visible. Sometimes the surgically removed tumor sample may be subjected to an X-ray to make sure that all the abnormalities that were previously detected have been removed. Patients may be offered tamoxifen after a successful removal of DCIS. This is especially true if a hormone receptor study was done on the tumor sample and was found to have positive hormone receptors.

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