How to effectively treat ductal carcinoma?

Question

Hello doctor,

My sister, who is 39 years old, has just been diagnosed with stage 1 ductal carcinoma. Her hormone test reports say HER2 positive, ER, and PR positive. Doctors also did some genetic testing and identified a BRCA mutation. We are completely lost and have a lot of concerns and confusion. What treatments do you advise for this case? Why did she develop breast cancer in her 30s? How can we permanently cure her condition? Are there any recently approved or advanced medicines for her condition? What are the chances of the cancer returning after the treatment? Can she have a satisfactory life afterward? Who from the family has to do the BRCA testing? If a BRCA mutation is detected, what do we have to do to prevent cancer?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Ductal carcinoma in situ (DCIS) is a type of very early breast cancer where cancer cells line your milk ducts within one or both breasts. Milk ducts are tubes that carry milk from the lobes of your breasts to your nipples so you can breastfeed (chestfeed). The cancer is “in situ,” or situated (contained) inside of your milk ducts.

Healthcare providers may call DCIS noninvasive or pre-invasive breast cancer. This means that the cancer cells have not spread beyond the walls of your milk ducts. Ductal carcinoma in situ does not typically metastasize or spread to other organs in your body, as aggressive or invasive cancers do.

While DCIS can not spread outside of your breast, it can turn into invasive ductal carcinoma, which can spread outside of your breast in some cases. That is why talking to a healthcare provider is so important. They can discuss treatment options to help reduce this risk. Risk of cancer In ductal carcinoma is less than 0.1 %

Risk factors for DCIS: Certain factors can increase your risk of ductal carcinoma in situ, like:

A biological family history of breast cancer.
A personal history of breast cancer or atypical hyperplasia.
Being assigned female at birth (AFAB).
Being over the age of 30.
Getting your period before age 12.
Having a baby after 30.
Having dense breast tissue.
Having gene mutations associated with increased cancer risk, BRCA1 (breast cancer gene 1) and BRCA2 (breast cancer gene 2).
Having previous radiation therapy directed at your breasts or chest.
Never being pregnant or breastfeeding.
Starting menopause after age 55.

Investigation of ductal carcinoma -

Mammography - In addition to a routine screening mammogram, your healthcare provider might order a diagnostic mammogram. This test provides more detailed views of your breast tissue. It takes longer than a screening mammogram.
Breast biopsy - Healthcare providers use this test to confirm that cancer cells are in your breast.

Treatment -

Breast-conserving surgery (BCS) or lumpectomy removes all cancer cells, along with healthy breast tissue bordering the cancer growth. Removing small amounts of nearby healthy tissue increases the chance that no abnormal cells are left behind. Your provider will leave most of your breasts intact.
Radiation therapy typically follows BCS. Some people need this therapy for a few days, others for a few weeks. Your healthcare provider can tell you about your personalized treatment plan.
Mastectomy removes the entire affected breast or both breasts (double mastectomy). You may need a mastectomy if you are not a candidate for BCS. Mastectomy may be a better option if the cancer has spread throughout multiple milk ducts or if a tumor is especially large.

I hope this information helps you.

Take care.