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Treating breast cancer at its earliest possible stage

Bookmark and Share This year, more and more American women will be treated for ductal carcinoma in situ (DCIS). Just what is this strange sounding form of breast cancer, and why are so many women being diagnosed with it? Advanced technology
What is ductal carcinoma in situ?
The uncertainty of DCIS
Unique assessment and treatment for every case
Breast cancer support groups
Advanced technology
Virtua surgeon Eric Miller, MD, Medical Director of Fox Chase Virtua Health Breast Evaluation Service explains: "We're seeing far more DCIS than ever before because of mammography. Great numbers of women are being screened, so we're identifying mammographic changes that may represent cancer at their earlier stages thanks to our advanced technology." Alexis Harvey, MD, Virtua radiation oncologist elaborates: "On mammography, DCIS often appears as microcalcifications. These are miniscule calcium deposits found in the breast tissue. Calcifications may be benign or could be a sign of breast cancer. Often a woman will need a biopsy to further evaluate what is going on in the breast." What is ductal carcinoma in situ?
Simply put, breast is comprised of three main parts. There is a network of ducts or channels which carry milk to the nipples; the lobules where the milk is made; and surrounding connective tissue with the blood vessels and lymphatic vessels. The lymph vessels carry fluids to the lymph nodes andultimately into the blood stream. Breast cancer often develops in the small ducts of the breast and is called ductal carcinoma in situ (DCIS) or intraductal carcinoma. DCIS, by definition, is cancer that is contained within the milk ducts and has not broken through to the surrounding breast tissue. It is not invasive cancer, and usually presents as microcalcifications on mammogram. DCIS infrequently presents as a breast mass or lump. The uncertainty of DCIS
Although DCIS is not technically invasive breast cancer, it is still treated aggressively. This is because a certain number of women with the disease may, over time, develop invasive breast cancer. Unique assessment and treatment for every case
As with all forms of cancer, treatment for DCIS depends on many factors. The pathologist, the physician who analyzes the DCIS cell samples microscopically, will determine the "grade" of DCIS, or how aggressively the cancer cells are changing or growing. DCIS has three grading classifications: well differentiated, moderately differentiated, or poorly differentiated. Patients with poorly differentiated DCIS may have an increased risk to develop the more serious, invasive form of breast cancer. Other factors that will help determine which treatment a woman receives is the size of the lesion: is it a pinpoint-size lesion or a larger lesion? The site or sites where the disease is found also influence the therapy: Are these a group of tiny lesions all in one section of the breast, or is the DCIS spread diffusely throughout the breast? Depending on what is found, in selected patients, a lumpectomy with or without a follow-up course of radiation and/or tamoxifen may be indicated. A lumpectomy is an operation that removes the cancerous tissue and a minimum surrounding rim of healthy, normal tissue to create what doctors call a clear margin to help minimize the risk of cancer recurrence. In other cases, when a woman has diffuse disease (DCIS in many ducts throughout the breast), a mastectomy or removal of the breast may be the recommended treatment, possibly with additional therapy such as tamoxifen. There is no such thing as one size fits all in cancer treatment. Each woman with DCIS has a unique disease process and must be treated accordingly. Breast cancer support groups
Virtua has special support groups to help breast cancer survivors, 40 and under, gain strength from each other. There are also support groups for breast cancer survivors of all ages and programs to help women look and feel better while going through treatment. For a complete list of groups, call 1-888-Virtua-3 (1-888-847-8823).