DCIS and Invasive Cancer: Section 4.d.

CONTENTS:

4.5 DCIS and Invasive Cancer: How May Invasive Breast Cancer Develop from Atypical and In-Situ Lesions?

Gosh that’s a short one!

That’s a rather personal comment, Betty.

I meant, this page.

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4.5 DCIS and Invasive Cancer: How May Invasive Breast Cancer Develop from Atypical and In-Situ Lesions?

Most invasive breast cancers evolve through a series of increasingly abnormal ‘stages’ over long periods of time, probably decades. The stages are referred to as hyperplasia, atypical hyperplasia, and in-situ carcinoma.

What do you call an alligator in a vest? An investigator?

Ductal Carcinoma in Situ (DCIS) is the most common  type of in-situ carcinoma of the breast (80%–90%).  So, DCIS represents a late-stage or advancement of premalignant tumor progression.   In addition, clinical studies support the belief that DCIS is a direct precursor of most invasive breast cancers.  Indeed, there is some indirect but compelling evidence to support the link between DCIS and invasive cancer. (Allred, 2009).

For a full up-to-date post on survival rates and DCIS and invasive cancer please click here.

Nearly all invasive breast cancers are associated with DCIS, and foci of continuity can be found between them when examined histologically. The main risk factors for developing invasive breast cancer are the same for DCIS (Allred, 2008).

DCIS that has been diagnosed in a woman’s past is a strong risk factor for developing invasive breast cancer in the future (Dupont & Page, 1985).

It must be really difficult for women with DCIS because the cancer is ‘in-situ’ or confined which is good news….

Yes, but with the risk of becoming ‘invasive’ (or spreading) – choosing a treatment plan must be so hard.

That is why treatment plans are individually tailored to each woman’s needs with the whole multi-disciplinary team.

DCIS and Invasive Cancer of the Breast

DCIS and invasive cancer of the breast share genetic abnormalities, most commonly when they are in the same breast. Genetically engineering using animal models of breast cancer show a progression from in-situ to invasive disease (Allred, 2008).

The progression from non-invasive cancer to invasive cancer occurs in other organs, where it is easier to observe, such as skin and cervix.

For women who receive a diagnosis of ‘atypia,’ ‘in-situ carcinoma,’ ‘glandular’ lesion or ‘papillary’ lesion of the breast, there is an abundance of information available.

But for every individual woman, her case will be unique and individual and the best advice is to speak with one’s own physician.

References

Allred, D.C., Wu, Y., Mao, S., et al. (2008). Ductal carcinoma in situ and the emergence of diversity during breast cancer evolution. Clin Cancer Res. 14(2), 370-378. (Retrieved November 6^th 2014):  https://www.semanticscholar.org/paper/Ductal-carcinoma-in-situ-and-the-emergence-of-Allred-Wu/0ac920673c9954e3a6d5a899b3c0f2e32b37e016

Allred, D.C. Biological features of human premalignant breast disease and the progression to cancer. In: Harris JR, Lippman ME, Morrow M, Osborne CK, editors. Diseases of the Breast. 4th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2009.

Allred, D.C. (2010). Ductal carcinoma in situ: terminology, classification, and natural history. J Natl Cancer Inst Monogr. 41:134-8. (Retrieved November 6^th 2014): https://www.ncbi.nlm.nih.gov/pubmed/20956817

More references for this section are on this page

Patient Information

WebMD (2012) Breast Health Center: Invasive Breast Cancer: Symptoms, Treatments, Prognosis (Retrieved November 7th 2014): https://www.webmd.com/breast-cancer/invasive-breast-cancer#1

Center for Disease Control and Prevention. What are the risk factors for Breast Cancer? (Retrieved February 24^th 2015): http://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm

More patient information for this section is on this page.

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