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DCIS and LCIS
Many breast cancers being
found are very early cancers known as breast cancer in situ or
noninvasive cancer. Most of these cancers are found by
mammography. These very early cell changes may become invasive
breast cancer. Two types of breast cancer in situ are:
DCIS
(ductal carcinoma in
situ), which means that abnormal cells are found
only in the lining of a milk duct of the breast. These
abnormal cells have not spread outside the duct. They have not
spread within the breast, beyond the breast, to the lymph
nodes under the arm, or to other parts of the body. There are
several types of DCIS. If not removed, some types may change
over time and become invasive cancers. Some may never become
invasive cancers. (DCIS is sometimes called intraductal
carcinoma.)
LCIS
(lobular carcinoma in
situ), which
means that abnormal cells are found in the lining of a milk
lobule. Although LCIS is not considered to be actual breast
cancer at this noninvasive stage, it is a warning sign of
increased risk of developing invasive cancer. LCIS is
sometimes found when a biopsy is done for another lump or
unusual change that is
found on a mammogram. Patients with LCIS have a 25 percent
chance of developing breast cancer in either breast during the
next 25 years.
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Specific
Patterns of Breast Cancer
STAGE
0 - Very early breast cancer. This type of cancer has not
spread within or outside the breast. It is sometimes called
DCIS,
LCIS,
or breast
cancerin situ or
noninvasive cancer. STAGE 1 - The cancer is no larger
than about 1inch in size and has not spread outside the
breast. (Also described as early breast cancer.)
STAGE
II
-
The cancer
is no larger than 1 inch, but has spread to the lymph
nodes under the arm.
-
The cancer
is between 1 and 2 inches. It may or may not have spread
to the lymph nodes under the arm.
-
The
cancer is larger than 2 inches, but has not spread to
the lymph nodes under the arm.
STAGE
III is divided into stages IIIA and IIIB: The doctor may
find either of the following:
-
The cancer
is smaller than 2 inches and has spread to the lymph
nodes under the arm. The cancer also is spreading
further to other lymph nodes.
-
The
cancer is larger than 2 inches and has spread to the
lymph nodes under the arm.
The
doctor may find either of the following:
-
The cancer
has spread to tissues near the breast (skin, chest wall,
including the ribs and the muscles in the chest).
-
The
cancer has spread to lymphnodes inside the chest wall
along the breast bone.
STAGE
IV - The cancer has spread to other parts of the body, most
often the bones, lungs, liver, or brain. Or, the tumor has
spread locally to the skin and lymph nodes inside the neck,
near the collarbone. Inflammatory Breast Cancer
- Inflammatory breast cancer is a rare, but very serious,
aggressive type of breast cancer. The breast may look red
and feel warm. You may see ridges, welts, or hives on your
breast; or the skin may look wrinkled. It is sometimes
misdiagnosed as a simple infection. Recurrent
Breast Cancer -Recurrent disease means that the
cancer has come back (recurred) after it has been treated.
It may come back in the breast, in the soft tissues of the
chest (the chest wall), or in another part of the body.
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MICROCALCIFICATIONS
Microcalcifications
are very small specks of calcium
that can't be felt, but can be seen on a mammogram.
They are formed by rapidly dividing cells. When they are
clustered in one area of the breast, this could be an early
sign of breast cancer in situ. About half of the breast
cancers found by mammography appear as clusters of
microcalcifications. The other half appear as lumps.
To
be sure that you have a correct diagnosis if breast cancer in
situ is detected, an experienced pathologist should
examine your biopsy slides. You may want to have yourslides
examined also by a second pathologist at a university
hospital, cancer center, or breast clinic. This is important
because it is sometimes difficult to make an accurate
diagnosis. The pathologist needs to determine the types of
cells that are present in the tissue sample, how fast the
cells are changing, and whether it is likely to become
invasive cancer. The diagnosis will help your doctor decide on
the appropriate treatment from a wide range of choices. The
decision could be to have frequent followup exams to watch the
suspicious area, or surgery to remove only
the affected tissue, or surgery to remove one or both breasts.
Surgery removing only the affected area is sometimes followed
by radiation therapy to the breast.
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