Chapter 55: Breast- DCIS Flashcards
What does DCIS stand for?
Ductal Carcinoma In Situ
What is DCIS also known as?
Intraductal carcinoma
Describe DCIS
Cancer cells in the duct without invasion (in situ: cells do not penetrate the basement membrane)
What are the signs/symptoms?
Usually none; usually nonpalpable
What are the mammographic findings?
Microcalcifications
How is the diagnosis made?
Core or open biopsy
What is the most aggressive histologic type?
Comedo
What is the risk of LN metastasis with DCIS?
<2% (usually when microinvasion is seen)
What is the major risk with DCIS?
Subsequent development of infiltrating ductal carcinoma in the same breast
What is the treatment for DCIS in the following cases:
Tumor <1 cm (low grade)?
Remove with 1-cm margins and XRT
What is the treatment for DCIS in the following cases:
Tumor >1 cm?
Perform lumpectomy with 1-cm margins and radiation or total mastectomy(no axillary dissection)
What is a total (simple) mastectomy?
Removal of the breast and nipple without removal of the axillary nodes (always remove nodes with invasive cancer)
When must a simple mastectomy be performed for DCIS?
- Diffuse breast involvement (e.g., diffuse microcalcifications)
- >1 cm and contraindication to radiation
What is the role of axillary node dissection with DCIS?
No role in true DCIS (i.e., without microinvasion)
some perform a sentinel LN dissection for high-grade DCIS
What is adjuvant Rx for DCIS?
Tamoxifen if ER+
Postlumpectomy XRT