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Ductal Carcinoma In Situ

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  • Ductal Carcinoma In Situ

    Ductal carcinoma in situ (DCIS) is the most common type of non-invasive breast cancer. Ductal means that the cancer starts inside the milk ducts, carcinoma refers to any cancer that begins in the skin or other tissues (including breast tissue) that cover or line the internal organs, and in situ means "in its original place." DCIS is called "non-invasive" because it hasn’t spread beyond the milk duct into any normal surrounding breast tissue. DCIS isn’t life-threatening, but having DCIS can increase the risk of developing an invasive breast cancer later on.

    Symptoms:

    • A breast lump
    • Bloody nipple discharge
  • Ductal Carcinoma In Situ

    Diagnosis:

    • Physical examination of the breasts: Your doctor may be able to feel a small lump in the breast during a physical examination, although a noticeable lump is rare with DCIS. In cases when DCIS cannot be felt during a physical exam, it can often be detected using mammography.
    • Mammography: DCIS is usually found by mammography. As old cancer cells die off and pile up, tiny specks of calcium (called "calcifications" or "microcalcifications") form within the broken-down cells. The mammogram will show the cancer cells inside the ducts as a cluster of these microcalcifications, which appear either as white specks or as a shadow.
    • Biopsy: If you do have a suspicious mammogram, your doctor will probably want you to have a biopsy.
  • Ductal Carcinoma In Situ

    Possible Treatment:

    • Lumpectomy followed by radiation therapy: This is the most common treatment for DCIS. Lumpectomy is sometimes called breast-conserving treatment because most of the breast is saved.
    • Mastectomy: Mastectomy, or removal of the breast, is recommended in some cases.
    • Lumpectomy alone
    • Hormonal therapy after surgery: These treatments, which block or lower the amount of estrogen in the body, are typically used if the DCIS tests positive for hormone receptors.

    Statistics:

    DCIS is often detected with mammographies but can rarely be felt. With the increasing use of screening mammography, noninvasive cancers are more frequently diagnosed and now constitute 15% to 20% of all breast cancers. Cases of DCIS have increased 5 fold between 1983 and 2003 in the United States due to the introduction of screening mammography. In 2009 about 62,000 cases were diagnosed.

  • Ductal Carcinoma In Situ

    Treatment:

    • Treatment for dural arteriovenous fistulae (DAVF) depends on the blood vessels involved. Endovascular techniques, which are minimally invasive procedures that are performed through the blood vessels, have been developed to safely treat DAVFs.
    • An approach, called embolization, reduces blood flow to the DAVF by obstructing surrounding blood vessels. During this procedure, the DAVF is filled with specially designed coils, glues or spheres that plug the vessels.

    Statistics:

    Recently, an epidemiological survey of the detected DAVF cases in Japan between 1998 and 2002 was conducted. The detection rate of DAVF per 100,000 adults per year is 0.29 for DAVF. Furthermore, unlike Europe and North America where cases of transverse-sigmoid sinus DAVF are predominantly detected, in Japan, a higher number of cases of cavernous sinus lesions are detected, indicating racial difference in the presentation of DAVF.

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