What does ductal carcinoma in situ mean?

The existence of various malignant tumors poses a great threat to people's life and health, and there are many types of malignant tumors, some of which are not well understood by ordinary people, such as carcinoma in situ. So, what does hose carcinoma in situ mean?

Carcinoma in situ of the breast is a type of breast cancer, accounting for about 15% to 25% of the lesions detected by breast screening. It is a complex precancerous lesion. About 20% of cases will progress to invasive cancer of the breast. Therefore, the vast majority of carcinoma in situ of the breast will not progress to invasive cancer and have a good prognosis. The 20-year breast cancer mortality rate is 3.3. Women who are diagnosed with carcinoma in situ of the breast by doctors can choose breast lumpectomy, mastectomy, radiotherapy, chemotherapy, etc.

If the lump is removed, the axillary lymph nodes do not need to be treated, but whole breast radiotherapy and chemotherapy are required. If the lump is removed without treating the axillary lymph nodes, radiotherapy and chemotherapy are not required, but whole breast removal, plus sentinel lymph node biopsy and breast reconstruction are required. The effect will be better. In addition, a DCIS, resection or breast-conserving surgery are all possible, but breast-conserving surgery is recommended first.

Surgical treatment of carcinoma in situ in the breast tube includes simple tumor removal and total mastectomy. Total mastectomy is the radical treatment for DCIS and approximately 98% to 99% of patients undergo this surgical treatment1,2. Cancers that develop after total mastectomy are basically invasive cancers, which are mainly manifested as partial onset or partial non-onset with distant migration. Total mastectomy is the most effective treatment for DCIS, but for a DCIS patient who is unlikely to develop invasive cancer in her lifetime, performing this type of surgery may be excessive treatment. The success of breast-conserving surgery for invasive breast cancer has led people to discuss the possibility of breast-conserving surgery in the treatment of DCIS.

Because more than half of the partial failures after DCIS breast-conserving surgery are due to invasive tumors, it is very important to treat this type of tumor with salvage therapy. Two studies have reported the prognosis of these patients and emphasized that these patients who develop invasive carcinoma have a potential risk of metastasis. Therefore, when treating patients with DCIS, attention should be paid to reducing the risk of these malignant events. Based on past scientific research, before performing breast-conserving surgery, patients should be informed that postoperative chemotherapy and radiotherapy are part of the surgery. If the patient is younger than 40 years old, has high-grade pathology, is ER-negative, and does not benefit from tamoxifen treatment, then removal should be done with caution. Whether to perform postoperative chemotherapy and tamoxifen treatment ultimately needs to be decided based on pathophysiological results, and the risks and benefits of the two should also be informed to the patient. It is feasible to repeat breast-conserving partial excision and chemotherapy after partial recurrence. However, partial recurrence often causes severe psychological distress to patients. In the NSABP B-17 study, only 44% underwent partial excision again.