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- What is breast cancer?
- What are the statistics on male breast cancer?
- What are the different types of breast cancer? Where does breast cancer come from?
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- I may have breast cancer. What questions should I ask my doctor?
- Is the doctor sure I have breast cancer?
- What type of breast cancer do I have?
- What difference does a precise breast cancer diagnosis make?
- What has been done to exclude cancer in other areas of the same breast or in my other breast?
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- Is my family history relevant to my breast cancer diagnosis?
- What other studies should be done on my breast tissue biopsy?
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- Should I stop taking hormone replacement therapy (HRT) after a breast cancer diagnosis?
- Even though my breast tumor does not have hormone receptors, should I take tamoxifen to reduce the risk of a new tumor?
- I have a ductal carcinoma in situ (DCIS), a type of localized cancer. Why have I been advised to have a mastectomy when other women with invasive breast cancer have lumpectomies?
- Should I start chemotherapy before surgery for breast cancer?
- If I am advised to have a mastectomy, what are the risks and benefits of immediate breast reconstruction?
- Should breast cancer patients have their lymph nodes removed?
- What is a sentinel lymph node biopsy, and what are its benefits and risks?
- Are there any other questions I should ask my doctor about breast cancer?
Quick GuideBreast Cancer Pictures Slideshow: A Visual Guide to Breast Cancer
I have a ductal carcinoma in situ (DCIS), a type of localized cancer. Why have I been advised to have a mastectomy when other women with invasive breast cancer have lumpectomies?
Ductal carcinoma in situ (DCIS) sometimes presents a difficult dilemma. Most patients with DCIS can undergo successful breast-conservation therapy but not all. The diagnosis implies that this is an "early" form of cancer in the sense that the cancer cells have not acquired the ability to penetrate normal tissue barriers or spread through the vascular or lymphatic channels to other sites of the body. It is important to realize that breast cancer is a wide spectrum of diseases, and no comparisons should be made just on the basis that someone you know has "breast cancer" and shares a different treatment approach with you.
However, the millions of cells forming the DCIS have accumulated a series of errors in their DNA programs that allow them to grow out of control. There are varying degrees of disturbance, called "grades," of the normal cellular patterns. Low grades are usually more favorable, and high grades are less favorable.
The DCIS cells originate from the inside of the breast gland ducts (microscopic tubes). As they multiply, the cells fill and spread through the normal ducts of the breast glandular tissue. With many DNA errors already in place and millions of these cells exposed to the usual risks of additional DNA damage, a few cells will ultimately become invasive. This invasive change is the real risk of DCIS.
Treatment that does not physically remove all of the DCIS seems to leave some risk of recurrence and, therefore, invasive disease. In cases where the DCIS has spread extensively through the breast ducts, even though the disease is in a sense "early" because it is not yet invasive, it may still require a large surgical resection, at times even a mastectomy (removal of all or part of the breast).
Your treatment team should be able to discuss the pros and cons of the different approaches and actively include you in the decision process.