Try adjusting your type
14th October, 2009
European Survey on Standards of Care in paediatric oncology centres. J. R. Kowalczyk, M. Samardakiewicz, K. Pritchard-Jones, R. Ladenstein, S. Essiaf, E. Fitzgerald, G. Petrarulo, G. Vassal - EJC , Volume 61, pp 11-19
8th December, 2014
The purpose of this website is to provide good and clear information about the long-term effects of childhood cancer and to refer to the various late-effects outpatient clinics (LATER outpatient clinics) that exist in the Netherlands.
8th September, 2015
Cancer in young people is rare, but it is still a major health issue in Europe. Each year, more than 6,000 young people in Europe die of cancer. There are more than 300,000 European childhood cancer survivors (in 2020, they will be nearly half a million): two-thirds of them have some late side effects of treatment, that are severe and impact on the daily life of half of those affected.
Ductal Carcinoma In Situ (DCIS) refers to a type of early-stage breast cancer where abnormal cells are found in the lining of the breast milk duct, confined to the area where they started and haven’t invaded surrounding tissues. Though non-invasive, it can progress to invasive cancer if untreated.
The world of oncology, specifically breast cancer, comprises an array of differing types. Understanding these distinctions is crucial for both awareness and treatment. Among these types, Ductal Carcinoma, a subtype of breast cancer, holds a significant place. A deeper analysis of this entity, particularly Ductal Carcinoma in situ (DCIS), will boost the understanding on the subject.
There are several different types of breast cancer. These can be classified based on their origin, namely the ducts or the lobules, the two key parts of the breast. These types range from the fairly common to the extremely rare, and include invasive ductal carcinoma, invasive lobular carcinoma, medullary carcinoma, and Paget disease of the breast.
Ductal Carcinoma, as the name suggests, originates from the ducts of the breast, which transport milk from the lobules to the nipple. It is further divided into two, Invasive Ductal Carcinoma (IDC), which spreads to surrounding breast tissues, and Ductal Carcinoma in Situ (DCIS) which does not invade beyond the ductal wall.
Being privy to DCIS is pivotal because it is the most common form of non-invasive breast cancer. DCIS is often deemed as a precursor to invasive breast cancer and thereby, early detection and proper understanding can potentially prevent its progression.
Ductal Carcinoma in Situ (DCIS) refers to the condition where abnormal cells are found exclusively within the lining of the breast ducts, and have not spread to nearby tissues. Being a non-invasive type, it is considered an early form of breast cancer.
The term “in situ” comes from Latin, meaning “in its place”. In medical oncology, it’s used to describe cancer in which abnormal cells have not crossed the boundaries of their origin. In context of DCIS, it means the abnormal cells remain contained within the ducts.
DCIS occurs in the milk ducts of the breast. These are the pathways that bring milk from the lobules, where it’s made, to the nipple. The carcinoma is termed ‘in situ’ because the cancerous cells remain ‘in place’, that is, within the ducts, without spreading to nearby tissue.
The prevalence of DCIS has seen a significant rise over the past few decades, largely due to the increased usage of mammographic screening. It accounts for approximately 20-25% of all breast cancer cases diagnosed.
General risk factors for breast cancer, inclusive of DCIS, range from age, gender, family history and genetics, to lifestyle factors such as alcohol consumption, obesity, and lack of physical activity.
For DCIS, in particular, hormone replacement therapy, especially combined estrogen-progestin therapy, and past radiation therapy to the chest area are considered influential risk factors.
Often, DCIS does not present with any evident symptoms. Occasionally, a lump or bloody nipple discharge might be noticed. Mostly, DCIS is picked up during routine mammogram screenings even before any symptoms appear.
DCIS is usually diagnosed during a routine mammogram which often highlights microcalcifications, small deposits of calcium that may indicate the presence of DCIS. After the mammogram, if DCIS is suspected, a biopsy sampling the suspicious tissue is performed to confirm the diagnosis by analysing the cells for cancerous changes.
DCIS is classified according to the amount of cell growth and variation from normal cells. Known as grading, DCIS can fall into three categories: low, intermediate, or high grade. While it is not typically staged (as it is non-invasive), its size, growth rate, and cell characteristics guide treatment decisions.
The primary treatments for DCIS include surgery—either a lumpectomy or mastectomy—often combined with radiation therapy or hormone therapy. These usually depend on the grade, size, and location of the DCIS, as well as patient preferences and overall health status.
Lumpectomy involves removing the DCIS and a small area of normal tissue around it, whereas mastectomy entails the removal of the entire breast containing DCIS. A sentinel lymph node biopsy may also be done to see if the cancer has spread to the lymph nodes.
Following a lumpectomy, radiation therapy is often used to eliminate any remaining DCIS cells. It reduces the risk of recurrence, but it comes with a potential set of side effects including skin changes and fatigue.
If the DCIS cells are found to be hormone-receptor-positive (which most are), hormone therapy using drugs like Tamoxifen might be advised to block the effects of hormones on the breast cancer cells. This helps in preventing the recurrence of DCIS or the development of invasive breast cancers.
The survival rate of DCIS is extremely high due to its non-invasive nature, and timely and effective treatments. Nearly all patients with DCIS can expect to live a normal life span.
Clinical trials are continuously investigating novel ways to treat DCIS, including the development of new drugs, surgical techniques and more targeted radiation therapies. These aim to improve the benefits of treatment and reduce side-effects.
Post DCIS treatment, regular follow-up care including mammograms, breast exams, and other tests are crucial to monitor recovery and watch for a recurrence. Embracing a healthier lifestyle such as a balanced diet, regular physical activity and cessation of smoking can markedly help in recovery and prevention of recurrence.
Early detection and understanding of DCIS is pivotal. Timely mammograms and awareness about the symptoms are key to early identification and successful treatment of DCIS, thereby preventing its possible progression to invasive cancer.
A diagnosis of DCIS, just like any other form of cancer, can be challenging. There are resources available that provide support, including counseling services, online communities, and cancer support groups. Your healthcare provider can provide information on these resources.
1. What is the primary difference between Ductal Carcinoma in Situ (DCIS) and Invasive Ductal Carcinoma (IDC)?
The primary difference lies in how far the cancer cells have spread. In DCIS, the cancer cells remain within the ducts, whereas in IDC, the cells have spread beyond the ducts into the surrounding breast tissue.
2. Is Ductal Carcinoma in Situ (DCIS) considered pre-cancer or actual cancer?
DCIS is considered a form of non-invasive or pre-invasive cancer. While the cells are cancerous, they remain contained within the ducts and haven’t yet invaded surrounding tissues.
3. Are there any lifestyle changes that can help prevent DCIS?
While there’s no sure way to prevent DCIS, certain changes like maintaining a healthy weight, regular exercise, limiting alcohol and not smoking can lessen your overall risk of breast cancer.
4. If I have DCIS, does it mean I will definitely develop invasive cancer?
Not necessarily. While DCIS can sometimes progress to invasive cancer, it doesn’t always do so. Timely treatment can often eliminate DCIS and reduce the risk of invasive cancer.
5. How often should I get a mammogram if I’ve been diagnosed with DCIS?
Your healthcare provider will guide you, but typically, you should have a mammogram every six to twelve months after treatment.
6. What are the side effects of treatment for Ductal Carcinoma in Situ (DCIS)?
Side effects vary depending on the treatment. Surgery may cause pain and impact body image. Radiation therapy can cause skin changes, swelling and fatigue. Hormone therapy may lead to menopausal symptoms.
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