Q. Is surgery the suggested treatment option for breast cancer in situ?

Hello,

Welcome to icliniq.com.

I have gone through your reports. (attachment removed to protect patient identity).

As far as I was able to understand, the lesion is a high grade (microcalcification and necrosis). Though I had to use google translation.

What I am going to tell you is as per recognized and approved evidences it does not include newer theories and understanding which are though upcoming have not yet come in clinical practice.

High-grade DCIS (ductal carcinoma in situ) increases the risk of invasive cancer. What above article has mentioned regarding mortality being the same in DCIS patients and normal individuals is not totally correct. The study which showed mortality of three percent, these patients were treated and it is not sure whether the similar mortality is due to treatment or nature of the disease.

The medical community is clear that some DCIS are low grade and may not need treatment and thus have removed DCIS from premalignant. But high-risk DCIS increases risk of having invasive component which might be missed just by biopsies. There is some evidence that we can avoid RT (radiotherapy) in low risk group, but none of the mainstream studies have avoided surgery.

The use of hormonal therapy is to avoid recurrence. Now the above article mentions that it does not change overall mortality. But this is due to the fact that we usually detect recurrences earlier and treat them before progressing to advanced stage. If we have not then there is a chance that some of them will progress to aggressive disease.

Regarding biopsy there is enough evidence that it does not increase the chance of cancer spreading. These are just hypotheses. Also, it definitely does not affect overall prognosis. Lastly, being from a medical background I do not have an idea regarding natural treatment. Though I would say that all these are just hypotheses and not proven things. As per my idea, she would need a breast conservation therapy plus radiotherapy, and endocrine treatment depending on the final biopsy result.

DCIS.

Wide local excision, radiotherapy and endocrine therapy depending on the final report, hormone status and invasive component.

Six monthly mammography.

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Dr. Pawar Satyajit Jalinder

Experience: 10 + Yrs

Medical Oncology

---

Related Questions:
My biopsy report showed granulomatous mastitis. Was the biopsy specimen autolyzed?

.. self-digestion of tissue by our own enzymes. To prevent autolysis, the specimen should be transferred to 10 % buffered formalin immediately after tissue removal by a surgeon. Formalin fixes the tissue and prevents autolysis, so that tissue preserved i   Read full

Tips to Prevent Breast Cancer

There are a few risk factors that make you more susceptible to get breast cancer, which cannot always be prevented ... Breast cancer risk factors mean anything that affects your chance of getting   Read full

My mother underwent a breast surgery for breast cancer. Please explain her pathology report.

.. gone through your reports (attachment removed to protect patient identity). Please answer my questions. What type of surgery was done? Is it MRM (modified radical mastectomy) or breast conservation.   Read full