Treatment of Non-invasive Breast Cancer

In non-invasive breast cancer, the cancer cells remain confined to the ducts or lobules. The medical name for non-invasive breast cancer is ductal carcinoma in situ (DCIS) if it occurs in the milk gland ducts (tubes), or lobular carcinoma in situ (LCIS) if it occurs in the gland lobules.

LCIS is not considered cancer as such. The presence of this abnormality in a breast biopsy means that the patient has an increased risk of developing breast cancer. The risk means that about 1 in 3 women with LCIS will develop breast cancer within 30 years of being diagnosed with the original condition.

DCIS usually appears as small white spots on the mammogram, called micro-calcifications (Figure 10 – image below). Occasionally, it shows as a lump in the breast or as a blood stained nipple discharge. However, this type of cancer does not usually spread beyond the breast. It is a relatively commonly finding in women participating in the screening programme. The likelihood of non-invasive cancer/DCIS spreading to the lymph glands in the armpit is approximately 1 in 200 cases. This small number is why armpit surgery (sential muscle biopsy) is not routinely performed for DCIS, unlike the invasive type of breast cancer.

Figure 10. A mammogram showing white spots of calcium (micro-calcifications) suggestive of non-invasive breast cancer (DCIS)

Like invasive breast cancer, DCIS is graded as low, intermediate or high. High-grade DCIS is relatively aggressive, especially if associated with cell death (mecrosis), and is more likely to progress into invasive cancer.

For more information on Pleomorphic LCIS from articles by Professor K. Mokbel 

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