Breast Cancer (Facts, Stages) (cont.)
Jerry R. Balentine, DO, FACEP
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Breast cancer facts
- 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?
- What causes breast cancer?
- What are breast cancer risk factors? How do you get breast cancer?
- What about antiperspirants or deodorants as causes of breast cancer?
- What are breast cancer symptoms and signs?
- What tests do physicians use to diagnose breast cancer?
- What is HER2-positive breast cancer?
- What tests detect HER2?
- Do symptoms and signs of HER2-positive breast cancer differ from those of HER2-negative breast cancer?
- What are therapies for HER2-positive breast cancers?
- How are breast cancer stages determined?
- What are breast cancer treatments?
- What are breast cancer survival rates by stage? What is the prognosis of breast cancer?
- Is it possible to prevent breast cancer?
- What research is being done on breast cancer? Is it worthwhile to participate in a breast cancer clinical trial?
- 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?
- What type of medical team do I need for the most accurate breast cancer diagnosis?
- Is my family history relevant to my breast cancer diagnosis?
- What other studies should be done on my breast tissue biopsy?
- How urgent is it that I make decisions and begin breast cancer treatment?
- 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?
- Breast Cancer FAQs
- Find a local Oncologist in your town
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.
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