Search results for: dcis-of-the-breast

Ductal Carcinoma In Situ and Microinvasive Borderline Breast Cancer

Author : Lisa A. Newman
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This volume reviews the evolution of information regarding the epidemiology of DCIS and its modes of detection, as well as treatment options as a function of both clinical trial data and ongoing investigational therapeutic prospects. Several of the challenging and clinically-relevant scenarios of DCIS that appear in daily practice is discussed, including the difficulties of distinguishing “true” DCIS from borderline patterns of other breast diseases and the therapeutic implications of differentiating these various diagnoses. Particular attention is paid to pathologic evaluation of DCIS, including histologic patterns and the importance of margin evaluation/margin control. The text also explores the data regarding DCIS in medical research in hereditary susceptibility for breast cancer and race/ethnicity-associated disparities in breast cancer. Written by experts in the field, Ductal Carcinoma In Situ and Microinvasive/Borderline Breast Cancer is a comprehensive, state-of-the art review of the field, and serves as a valuable resource for clinicians, surgeons and researchers with an interest in breast cancer.

Ductal Carcinoma in Situ of the Breast

Author : Carlo Mariotti
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This book provides up-to-date information on all aspects of ductal carcinoma in situ of the breast, including epidemiology, imaging, pathologic and biologic features, interventional diagnostics, nonpalpable lesion localization, and treatment. Surgical procedures are described in detail, covering breast conservation techniques, conservative mastectomies, breast reconstruction options, and axillary surgery. Guidance is provided on how to ensure adequacy of surgical excision and avoid local recurrence when performing breast conservation surgery and how to minimize morbidity from axillary surgery. The role and techniques of partial and whole breast irradiation are described, and the use of adjuvant systemic therapy options, including endocrine therapy and chemotherapy, is explained. A concluding chapter addresses the issue of recurrence and its current management. This book, designed for ease of consultation, will be of value for all involved in the multidisciplinary care of patients with ductal carcinoma in situ of the breast, including surgeons, medical oncologists, pathologists, radiologists, and radiotherapists.

Ductal carcinoma in situ DCIS of the breast

Author : Cristina Carrera
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Prognostic Factors in Ductal Carcinoma in Situ DCIS and Invasive Breast Cancer

Author :
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DCIS Dilemmas Discussions about Ductal Carcinoma In Situ the Research Behind It

Author : Deborah E. Collyar
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Women often think that their risk of getting Ductal Carcinoma In Situ (DCIS) or Invasive Breast Cancer (IBC) is much higher than real numbers show. This fear is often fed by new stories about research, and sometimes by their own doctors. Many doctors and researchers say that DCIS is not Invasive Breast Cancer (IBC) because it stays in the breast duct. HOWEVER... DCIS is also called Stage 0 breast cancer, and is treated as if it were IBC. There are many dilemmas about DCIS, and this book tries to clear them up. We know how easy it is to end up more confused after looking at different websites, books, and research results. We present a new way to approach DCIS that combines the latest research with practical information. Even though we state things plainly, many scientific resources and references were used to make sure this book is accurate. Please be aware that those resources may use older language that we are learning is not accurate for DCIS. For example, DCIS lesions do not have the ability to "recur," even though this term is commonly used by many scientists and doctors. You will learn about DCIS and how it fits into breast diseases, including breast cancer. The process of getting diagnosed is also explained, as are the different types of treatments that are commonly given for DCIS. Risks are also explained clearly. This includes the risk of being diagnosed with DCIS, as well as the risk of getting another DCIS or a future Invasive Breast Cancer. This book also highlights the various kinds of ongoing research for DCIS. A list of terms, and additional resources and references are also included to help you find more detailed information. We hope this book offers useful information to help you make decisions about DCIS, and look forward to hearing how you use it!

DCIS of the Breast

Author : John Boyages
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This is the second book by Professor John Boyages for patients who have been diagnosed with cancer. The first book was designed for breast cancer patients and this second project for patients with DCIS (ductal carcinoma in situ) of the breast. The book is written in an approachable style, with lots of photographs and patient stories which serves both to illustrate medical points and break up the text, making it more readable. The book is divided into three parts and has 20 control points where patients are guided through the process of making very important decisions regarding their diagnosis and treatment. John uses many botanical references and metaphors to explain difficult concepts and present information in a less threatening way.

Diagnosis and Management of Ductal Carcinoma in Situ DCIS

Author : U. S. Department of Health and Human Services
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Ductal carcinoma in situ (DCIS) is noninvasive breast cancer that encompasses a wide spectrum of diseases ranging from low-grade lesions that are not life threatening to high-grade lesions that may harbor foci of invasive breast cancer. DCIS is characterized histologically by the proliferation of malignant epithelial cells that are bounded by the basement membrane of the breast ducts. DCIS has been classified according to architectural pattern (solid, cribriform, papillary, and micropapillary), tumor grade (high, intermediate, and low grade), and the presence or absence of comedo histology. Prior to the advent of widespread screening mammography, DCIS was usually diagnosed by surgical removal of a suspicious breast mass. DCIS was rarely diagnosed before 1980, but currently about 25 percent of breast cancers diagnosed in the United States are DCIS. The incidence of DCIS has risen from 1.87 per 100,000 women from 1973-1975 to 32.5 per 100,000 in 2004. The incidence of DCIS increased in all age categories with the greatest rise among those older than 50 years of age. Age adjusted DCIS incidence rates increased 7.2-fold from 1980 to 2004. The annual incidence among those older than 50 years of age demonstrated an exponential increase from five per 100,000 in 1980 to 59-77 per 100,000 in 2004. While other countries have also observed increases in DCIS in recent years, no country has experienced as steep an increase in DCIS as the United States. The increase in DCIS has not, however, been uniform across histologic types. Comedo histology is associated with a particularly high risk of recurrence and has been stable over recent years. In contrast, low-grade DCIS, generally considered to be less likely to recur or develop into invasive breast cancer, has accounted for the majority of the recent increase. Many studies point to increased use of mammography as the likely explanation for the increased incidence, but the increased incidence cannot be entirely explained by an increase in screening. Cumulative incidence per 1,000 mammograms increased from 0.9 in January 1997 to 1.7 in December 2003. We assessed the impact of screening by comparing patterns of incidence using two different definitions: DCIS incidence per 100,000 female population and per 1,000 screened women. Incidence of DCIS in the United States increased over time according to both definitions. Older women had higher incidence according to both definitions. Proportional changes, when compared across the studies, tend to be larger for incidence per 100,000. The data revealed greater increases over time in incidence per 100,000 population than per 1,000 screened. Important scientific questions that deserve further investigation include gaining a better understanding of the relationship between mammography use and DCIS incidence, whether it is possible to modify current imaging technologies or screening guidelines to better identify lesions that are unlikely to become clinically problematic as well as tumors that are likely to contain some invasive component. The following proposed recommendations are organized by the original questions: Question 1. What are the incidence and prevalence of DCIS and its specific pathologic subtypes, and how are incidence and prevalence influenced by mode of detection, population characteristics, and other risk factors? Question 2. How does the use of MRI or SLNB impact important outcomes in patients diagnosed with DCIS? Question 3. How do local control and systemic outcomes vary in DCIS based on tumor and patient characteristics? Question 4. In patients with DCIS, what is the impact of surgery, radiation, and systemic treatment on outcomes?

EGFR Pathway Modulation in Ductal Carcinoma in Situ of the Breast

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We proposed a clinical trial to study the modulation of the EGFR pathway in DCIS. Eligible patients have either a mammogram highly suspicious for DCIS or a recent diagnosis of DCIS through a core biopsy. Subsequently, patients whose DCIS expresses EGFR are randomized to receive an EGFR inhibitor (Iressa) or placebo for 3 weeks prior to surgery. The protocol was generated, approved by the IRB and an efficient system for specimen collection was implemented. Since EGFR expression was a crucial requirement to enter the study we developed the immunohistochemical assay for the detection of the EGFR and P-EGFR proteins. We conducted an IRB- approved, retrospective study of DCIS cases diagnosed by core biopsy at our institution. A total of 42 cases were studied for EGFR and P-EGFR. We showed that EGFR expression is present in 18.6% of DCIS and correlates with high grade. P-EGFR expression was low at 7%. We also conducted a retrospective study using paraffin embedded tissues. 50 cases of DCIS were obtained from the Cooperative Breast Cancer Tissue Resource (CBCTR). IHC studies were performed for EGFR, P-EGFR, Ki67, p27, P-ERK, P-AKT. We confirmed that the rate of EGFR positivity in DCIS is 20%. P-EGFR expression was 5%.

Medifocus Guidebook On Ductal Carcinoma in Situ of the Breast

Author : Medifocus. com Inc.
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The MediFocus Guidebook onDuctal Carcinoma in Situ of the Breast is the most comprehensive, up-to-date source of information available. You will get answers to your questions, including risk factors of Ductal Carcinoma in Situ of the Breast, standard and alternative treatment options, leading doctors, hospitals and medical centers that specialize in Ductal Carcinoma in Situ of the Breast, results of the latest clinical trials, support groups and additional resources, and promising new treatments on the horizon. This one of a kind Guidebook offers answers to your critical health questions including the latest treatments, clinical trials, and expert research; high quality, professional level information you can trust and understand culled from the latest peer-reviewed journals; and a unique resource to find leading experts, institutions, and support organizations including contact information and hyperlinks. This Guidebook was updated on February 2, 2012.

Protocol of the UK Randomised Trial for the Management of Screen Detected Ductal Carcinoma in Situ DCIS of the Breast

Author : UK Co-ordinating Committee on Cancer Research. Working Party of the Breast Cancer Trials Co-ordinating Subcommittee
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Guidelines for the Care and Treatment of Breast Cancer

Author : Canada. Health and Welfare Canada
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Health care, treatment.

Dr Michael Hunter s Breast DCIS

Author : Michael Hunter
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Dr. Michael Hunter's Breast DCIS book is the must-have resource for those with DCIS. Anyone interested in the management of non-invasive (DCIS) breast cancer should buy this book. In this comprehensive overview, you will learn about the causes of breast cancer, diagnosis, staging, prognosis, management, and potential risk-reducing maneuvers in the lifestyle realm. Anyone who cares about non-invasove breast ductal carcinoma in situ (DCIS) can find the guidance he or she needs here, in easy-to-understand language.

Markers of Increased Risk in Pre Invasive Breast Cancer

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The understanding of the risk of recurrence and progression of breast cancer, particularly, from a pre-invasive lesion is evasive and challenging. Our goal has been to identify changes in early breast cancer using techniques to profile global gene expression. In previous work, we have employed cDNA array techniques to identify relatively small changes in gene expression between low and high risk pre-invasive cancer. We have therefore optimized the alternative SAGE (serial analysis of gene expression) technique to also apply to this problem and compare with our cDNA results. We have tested SAGE initially in a small pilot experiment, using transfected cell lines that differ in their expression of the psoriasin gene, that is commonly overexpressed in pre-invasive cancer. A pilot experiment using two SAGE libraries showed that differences can be detected and larger experiment is now underway. Clones with inserts have been screened by PCR and agarose gel analysis and are now being sequenced. We anticipate that this experiment will establish the capability of this assay to detect differential gene expression and lay the foundation for its application to pre-invasive tumor samples, and may identify gene that are overexpressed in pre-invasive disease.

Ductal Carcinoma in Situ DCIS

Author : National Breast Cancer Centre
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The Heredity of the Size and the Form of the Seeds of Phaseolus Vulgaris

Author : Gerrit Pieter Frets
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DCIS of the Breast

Author : Charlotta Wadsten
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Molecular Genetics of Lobular Breast Cancer Ductal Carcinoma in Situ

Author : Christos Petridis
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Prognostic Significance of Telomere Attrition in Ductal Carcinoma in Situ of the Breast

Author :
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We are using an innovative, quantitative assay for telomere DNA content (TC) developed and characterized by the PI, to test the hypothesis that TC predicts the likelihood of disease recurrence in women with ductal carcinoma in situ (DCIS). In Year One, we collaborated to determine whether TC measured in bulk DCIS tumor tissue is comparable to that measured in tumor epithelial cells purified by laser-capture microscopy. In 7/10 instances, TC in microdissected specimens was 72-112% of that in the undissected control. In Years Two and Three, we confirmed and extended these results in our own laboratory. TC in microdissected samples was compared to TC in unfractionated samples; in 10/10 instances, TC in the microdissected sample was 75-124% of that in the undissected (i.e. bulk) control. These results confirm that it is not necessary to microdissect DCIS specimens prior to TC analysis. In Years One-Three, we measured TC in 75 normal breast, 126 DCIS and 657 breast tumor specimens. In Year Two, we used a Kaplan-Meier plot and log-rank test to show that low TC predicts a shorter survival interval. TC was not associated with ethnicity, menopausal status, or the expression of several other markers, including ER, PR, p53, Ki67, and Her2. In Years Three-Four, we demonstrated an association between TC, the extent of allelic imbalance and tumor stage. In Year Four, we obtained longer follow-up to confirm and extend these results. In summary, we have shown that (i) meaningful TC measurements can be obtained with bulk DCIS tissues, (ii) TC is associated with tumor stage and (iii) TC in DCIS is associated with breast cancer-free survival.

Killing Pre invasive Breast Cancer by Targeting Autophagy

Author : Virginia Espina
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Breast cancer progression is thought to be a multi-step process involving a continuum of changes from a normal phenotype through hyperplastic lesions, carcinoma in situ, invasive carcinoma, to metastatic disease. Previously it was assumed that the invasive phenotype acquired major genetic changes during the phenotypic transition from ductal carcinoma in situ (DCIS) to invasive carcinoma. In direct contradiction to this previous assumption, herein we demonstrate the pre-existence of genetically abnormal, tumorigenic carcinoma progenitor cells within human breast DCIS lesions. Human DCIS cells were cultivated "ex vivo" without "a priori" enzymatic treatment or sorting. The DCIS organoid cultures induced the emergence of neoplastic epithelial cells exhibiting the following characteristics: a) spontaneous generation of spheroids and duct-like 3-D structures in culture within 2-4 weeks, b) tumorigenicity in NOD SCID mice, and c) "in vitro" migration and invasion of autologous breast stroma. Proteomic characterization revealed that DCIS cells up-regulate signaling pathways directly, and indirectly, linked to cellular autophagy. Cells proliferate and accumulate within the non-vascular intraductal space under hypoxic and metabolic stress. Autophagy was found to be required for survival and anchorage independent growth, in the patient's original DCIS lesion and the mouse xenograft. Molecular karyotyping demonstrated DCIS cells to be cytogenetically abnormal (copy number loss or gain in chromosomes including 1, 5, 6, 8, 13, 17) compared to the normal karyotype of the non-neoplastic cells in the patient's breast tissue. To demonstrate the dependence of the cytogenetically abnormal DCIS cells on autophagy as a survival mechanism, primary human DCIS cell cultures were treated with chloroquine phosphate, a lysosomotropic inhibitor of autophagy. Chloroquine treatment completely suppressed generation of DCIS spheroids, suppressed "ex vivo" invasion of autologous stroma, induced apoptosis, suppressed autophagy associated proteins including Atg5, AKT/PI3K, and mTOR, eliminated cytogenetically abnormal spheroid forming cells, and abrogated xenograft tumor formation. A phase I/II clinical trial (PINC; Preventing Invasive breast Neoplasia with Chloroquine) was established for evaluating safety and efficacy of chloroquine phosphate to treat breast Ductal Carcinoma in Situ. Therapy that induces regression, or prevents progression, of pre-invasive lesions could comprise a new treatment strategy for pre-invasive cancers independent of hormone receptor status.

Comparative Effectiveness of Core Needle and Open Surgical Biopsy for the Diagnosis of Breast Lesions

Author : U. S. Department of Health and Human Services
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Breast cancer is the second most common malignancy of women. The American Cancer Society estimates that in the U.S. in 2009, 67,280 women will have been diagnosed with new cases of in situ cancer, 192,370 women will have been newly diagnosed as having invasive breast cancer, and there will be 40,170 deaths due to this disease. In the general population, the cumulative risk of being diagnosed with breast cancer by age 70 is estimated to be 6% (lifetime risk of 13%). Ductal carcinoma, including ductal carcinoma in situ (DCIS), is the most common malignancy of the breast. It arises within the ducts of the breast. DCIS is early breast cancer confined to the inside of the ductal system, and invasive (also called infiltrating) ductal carcinoma is a later stage that has broken through the walls of the ducts and invaded nearby tissues. Lobular carcinoma is similar to ductal carcinoma, first arising in the terminal ducts of the lobules and then invading through the walls of the ducts and into nearby tissues. Atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS) are caused by abnormal cellular proliferation within the terminal ducts of the lobules. The two conditions are distinguished primarily by the degree to which the ducts are filled by cells. Women diagnosed with ALH or LCIS are at elevated risk of developing an invasive carcinoma in the future. Other types of benign breast abnormalities that have been linked to an elevated risk of invasive carcinoma or a finding of associated invasive carcinoma upon excision are atypical ductal hyperplasia (ADH), papillary lesions, and radial scars. Breast cancer is usually first detected by feeling a lump on physical examination or by observing an abnormality during x-ray screening mammography. Survival rates depend on the stage of disease at diagnosis. At stage 0 (carcinoma in situ) the five-year survival rate is close to 100%. The five-year survival rate for women with stage IV (cancer that has spread beyond the breast) is only 27%. These observations suggest that breast cancer mortality rates can be significantly reduced by identifying cancers at earlier stages. Because early breast cancer is asymptomatic, the only way to detect it is through population-wide screening. Mammography is a widely accepted method for breast cancer screening. Mammography uses x-rays to examine the breast for clusters of microcalcifications, circumscribed and dense masses, masses with indistinct margins, architectural distortion compared with the contralateral breast, or other abnormal structures. The American College of Radiology has created a standardized system for reporting the results of mammography, the Breast Imaging Reporting and Data System (BI-RADS(r) ). There are seven categories of assessment and recommendation: 0 Need additional imaging evaluation and/or prior mammograms for comparison 1 Negative 2 Benign finding 3 Probably benign finding. Initial short interval follow-up suggested 4 Suspicious abnormality. Biopsy should be considered. 5 Highly suggestive of malignancy. Appropriate action should be taken. 6 Known biopsy-proven malignancy. Appropriate action should be taken. This systematic review was commissioned by the Agency for Healthcare Research and Quality (AHRQ) to address the following Key Questions; they include, but are not limited to: 1. In women with a palpable or non-palpable breast abnormality, what is the accuracy of different types of core-needle breast biopsy compared with open biopsy for diagnosis? 2. In women with a palpable or non-palpable breast abnormality, what are the harms associated with core-needle breast biopsy compared to the open biopsy technique in the diagnosis of breast cancer? 3. How do open biopsy and various core-needle techniques differ in terms of patient preference, availability, costs, availability of qualified pathologist interpretations, and other factors that may influence choice of particular technique?