When you're diagnosed with ductal carcinoma in situ, the abnormal cells associated with this disease are confined to the ducts of the breast. And while DCIS is considered a noninvasive form of cancer, there is the potential to have slight metastasis, known as microinvasion. This metastasis typically occurs within tissues of your breast nearest the malignancy. If this were to occur, your doctor will recommend treatment.
Mastectomy
For some women, ductal carcinoma in situ with microinvasion (DCIS-MI) requires a total mastectomy. In this surgical procedure, a surgeon removes the entire breast affected with the cancer. At the same time, a lymph node dissection, which is the removal of some or all of the lymph nodes under the associated arm, is commonly performed. This is used to determine whether or not the abnormal cells have spread into this region of the body.
Breast-Conserving Surgery
For other women, DCIS-MI requires what is known as a breast-conserving surgery. With this type of operation, only the malignant tumor or a portion of the breast is removed, through either a lumpectomy or partial mastectomy, respectively. Both procedures involve the removal of the cancerous tissue as well as the surrounding healthy tissue. This may be followed by a lymph node dissection.
Radiation
Many times, a breast-conserving surgery is followed by radiation therapy to kill any remaining abnormal cells. This is accomplished through either external or internal radiation. When external therapy is used, a beam of ionized energy is targeted over the affected area. Internal radiation is administered through a radioactive device implanted near the site of the tumor. Both application methods kill the DNA of the abnormal cells.
Hormone Therapy
With any of the DCIS-MI treatments, a form of hormone therapy may also be used to ensure that the cancer doesn't recur. Hormone therapy may include a selective estrogen receptor monitor. Tamoxifen is by far the most common drug used in the treatment of DCIS-MI, since it blocks the way in which estrogen interacts with abnormal cells. Exposure to estrogen can stimulate the abnormal cells to rapidly divide, prompting further progression of the cancer.
