carcinoma | In situ breast carcinoma-treatments

In situ breast carcinoma-treatments

Several therapeutic options are considered in a diagnosis of breast cancer whether in situ ductal carcinoma or lobular carcinoma in situ. The point about the possible treatments of these breast cancers and their indications.


Definition
The different stages
Treatment of ductal carcinoma in situ
Partial mastectomy (conservative surgery)
Total mastectomy: non-conservative surgery
Possible Complications related to surgery
Radiotherapy
Support Lobular carcinoma in situ
Prognosis
Source
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Definition
Carcinoma is said to be "in situ" when the cancer cells are only present in the breast canals (in situ ductal carcinoma) or lobules (lobular carcinoma in situ), without affecting the surrounding tissues. In situ ductal carcinoma is the most common of non-invasive breast cancers in women.
The different stages
In situ breast carcinoma corresponds to stage 0, on a scale of up to four, which allows to evaluate the spread of cancer in the breast and outside the breast. Stage 0 Breast cancer is non-invasive. A tumor is also evaluated by its grade, from 1 to 3, which refers to its aggression. Grade I corresponds to the least aggressive tumors, grade III to the most aggressive tumors.

Treatment of ductal carcinoma in situ
In situ ductal carcinoma represents 85 to 90% of in situ breast cancers. A number of treatment options are considered as appropriate.
Partial mastectomy (conservative surgery)
A conservative breast surgery (partial mastectomy, or lumpectomy) involves removing the tumor and a small amount of the tissues around it to keep the bulk of the breast. This intervention is privileged when the tumor is small enough (margin of healthy tissues around). In some cases, this procedure may be accompanied by the ablation of the Sentinel ganglion. A partial mastectomy associates with a "remodeling" of the gland to avoid post-operative deformations. The deformation caused by a partial mastectomy can only be assessed 3 to 4 months after the procedure. The lumpectomy is followed by radiotherapy (see below).

Total mastectomy: non-conservative surgery
A so-called non-conservative breast surgery (total mastectomy) is to remove in its entirety the breast where the tumor sits. This type of surgery is privileged when the tumor is too large in relation to the breast size, when its shape is not compatible with a conservative surgery, or when several tumors are diagnosed in the same breast.

Possible Complications related to surgery
Mastectomy is a routine procedure that is simple in most cases. The most frequent post-operative suites are pain, usually moderate. Hematomas or wound infections are possible complications, as well as the formation of a liquid pouch called "Lyphocele formation" under the scar. This liquid is evacuated by a simple puncture. Other possible complications include difficult scarring, more rarely skin necrosis.


Radiotherapy
An external radiotherapy of the mammary gland is almost always performed after a conservative surgery in the area where the tumor was removed. The most common short-term side effects of radiation therapy are skin rash and fatigue.
Support Lobular carcinoma in situ
Lobular carcinoma in situ (CLIS), also known as lobular neoplasia, accounts for about 10-15% of in situ breast cancers. This type of cancer takes shape in the lobules, the glands that secrete the milk. The management of lobular carcinoma in situ is based on regular monitoring, since it increases the risk of infiltration breast cancer. However, CLIS rarely spreads outside the walls of the lobules and generally not to other parts of the body. Depending on the diagnostic elements collected, a surgical biopsy (partial removal of the carcinoma, and examination of the cells of the tissues taken) or a resection (total withdrawal) may be proposed.

Prognosis
In situ breast carcinoma is a good prognosis cancer-when diagnosed at this stage-with overall survival at 10 years greater than 95%. In case of conservative treatment without radiotherapy, the recidivism rate is around 13%.