Chapter 55: Breast- DCIS Flashcards

1
Q

What does DCIS stand for?

A

Ductal Carcinoma In Situ

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2
Q

What is DCIS also known as?

A

Intraductal carcinoma

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3
Q

Describe DCIS

A

Cancer cells in the duct without invasion (in situ: cells do not penetrate the basement membrane)

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4
Q

What are the signs/symptoms?

A

Usually none; usually nonpalpable

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5
Q

What are the mammographic findings?

A

Microcalcifications

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6
Q

How is the diagnosis made?

A

Core or open biopsy

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7
Q

What is the most aggressive histologic type?

A

Comedo

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8
Q

What is the risk of LN metastasis with DCIS?

A

<2% (usually when microinvasion is seen)

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9
Q

What is the major risk with DCIS?

A

Subsequent development of infiltrating ductal carcinoma in the same breast

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10
Q

What is the treatment for DCIS in the following cases:

Tumor <1 cm (low grade)?

A

Remove with 1-cm margins and XRT

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11
Q

What is the treatment for DCIS in the following cases:

Tumor >1 cm?

A

Perform lumpectomy with 1-cm margins and radiation or total mastectomy(no axillary dissection)

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12
Q

What is a total (simple) mastectomy?

A

Removal of the breast and nipple without removal of the axillary nodes (always remove nodes with invasive cancer)

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13
Q

When must a simple mastectomy be performed for DCIS?

A
  • Diffuse breast involvement (e.g., diffuse microcalcifications)
  • >1 cm and contraindication to radiation
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14
Q

What is the role of axillary node dissection with DCIS?

A

No role in true DCIS (i.e., without microinvasion)

some perform a sentinel LN dissection for high-grade DCIS

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15
Q

What is adjuvant Rx for DCIS?

A

Tamoxifen if ER+

Postlumpectomy XRT

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16
Q

The breast in which DCIS breast cancerarises?

A

Cancer arises in the same breast as DCIS