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Breast Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
An abnormal thermogram can help identify the early stage of an invasive tumor's development. However, infrared imaging may be less helpful detecting growths that are at the pre-invasive stage, including Ductal Carcinoma in Situ (DCIS), as shown in Figure 9.2. DCIS is a noninvasive precursor neoplasm that, in many cases, will not progress to invasive BrCA. Low-grade DCIS represents an indolent disease in the majority of mammographically detected cases.22 Based on the best available evidence, about one-third of DCIS cases will become an invasive disease, and most of those cases have a favorable prognosis.23
Breast Cancer: Surgical Perspectives
Published in Raymond Taillefer, Iraj Khalkhali, Alan D. Waxman, Hans J. Biersack, Radionuclide Imaging of the Breast, 2021
Patricia J. Eubanks, Hernan I. Vargas, Stanley R. Klein
DCIS can present as a mass (rarely), a mammographic abnormality, nipple discharge, or Paget's disease of the nipple. Breast conservation treatment without radiation therapy produces a high local recurrence rate (19% to 43%), of which half may be invasive cancer [84]. This recurrence rate drops to 9% if the breast is irradiated after lumpectomy. NSABP B-17 reported recurrence rates of 16.4% without radiation therapy (8.2% being invasive cancer), as compared to 7% recurrence after radiation to the breast (2.9% being invasive cancer) [85]. NSABP B 17 data confirm that DCIS treated with excision alone has an unacceptably high recurrence rate.
Breast cancer
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
DCIS is curable in the vast majority of patients. However, local treatment must ensure that it is eradicated as there is a high risk of local recurrence; this recurrence may be invasive in breast cancer (approximately half of recurrences after treatment for DCIS are invasive cancer and half DCIS). Traditionally, simple mastectomy was the treatment of choice, and this is still the case for multifocal disease or when clear surgical margins cannot be attained. However, in recent years, the experience of breast conservation for invasive cancers has been extrapolated to DCIS. Whilst small foci of low/intermediate-grade DCIS can be treated with excision alone, if adequate margins of clearance are attained, local excision and adjuvant radiotherapy to the breast alone is now the standard treatment in many centres for unifocal DCIS that has been completely excised. There remains a debate about the role of tamoxifen after definite surgery and radiotherapy for DCIS. It may further reduce the risk of local recurrence within the breast after breast-conserving treatment if, as is usually the case, the DCIS is oestrogen receptor-positive. Pure DCIS should not spread to regional lymph nodes and therefore no axillary surgery is necessary. Similarly, DCIS has no potential for systemic spread, and therefore there is no role for chemotherapy in the management of DCIS.
Addressing the problem of overtreatment in breast cancer
Published in Expert Review of Anticancer Therapy, 2022
The incidence of ductal carcinoma in situ (DCIS) has increased significantly with the widespread use of screening mammography, and DCIS represents approximately 20% of all newly diagnosed breast cancers. Historically, DCIS was considered an obligate precursor to invasive cancer leading to the current standard-of-care approaches of excision, radiation, and anti-estrogen therapy. However, the relative incidence of invasive breast cancer has remained unchanged despite a marked increase in the detection and treatment of DCIS, and breast cancer-specific survival after treatment of DCIS exceeds 95% regardless of treatment approach [70]. These observations have raised concerns that DCIS is not only being overtreated, but also overdiagnosed. Strategies to de-escalate the treatment of DCIS or eliminate treatment altogether are predicated upon the ability to identify subsets of DCIS patients with a low risk of progression to invasive carcinoma.
Ratite oils for local transdermal therapy of 4-OH tamoxifen: development, characterization, and ex vivo evaluation
Published in Journal of Liposome Research, 2021
Usha Sundralingam, Saravanan Muniyandy, Ammu K. Radhakrishnan, Uma D. Palanisamy
Breast cancer (BC) is the most common cancer in women both in the developed and less developed countries. Initially, BC was thought to be a disease common in developed world but data to date shows that almost 50% of BC cases and 58% of BC-related deaths occur in less developed countries (GLOBACON 2013). Recent studies involving detection of BC by population-based BC screening programmes found that ductal carcinoma in situ (DCIS) now represents 20–25% of all BC (van Seijen et al.2019). Statistics show that one in 33 women are likely to be diagnosed with DCIS of the breast during their lifetime. The clinical significance of a DCIS diagnosis and optimal approaches to treatment are topics of uncertainty and concern for both patients and clinicians (Elmore and Fenton 2012, Ward et al.2015).
Toll-like receptor 3 -926T>A increased the risk of breast cancer through decreased transcriptional activity
Published in OncoImmunology, 2019
Lei Fan, Peng Zhou, Ao-Xiang Chen, Guang-Yu Liu, Ke-Da Yu, Zhi-Ming Shao
A total of 1,272 female cancer-free control subjects and 1,031 patients with breast cancer were identified as genetically unrelated Chinese in Shanghai City and its surrounding regions. Each participant was personally interviewed by doctors either in the outpatient department or in the inpatient department to obtain epidemiological and clinicopathological information. These subjects were recruited between January 2012 and June 2015 from the Department of Breast Surgery, Fudan University Shanghai Cancer Center. Patients with a previous history of other cancers (not breast cancer) were excluded. Primary ductal carcinoma in situ (DCIS) or infiltrating ductal carcinoma of the breast was pathologically confirmed. The control subjects were chosen from women who had come to our department for the purpose of breast cancer screening. The control subjects selected were proven to be free of breast cancer by a complete physical examination, ultrasonography, bilateral mammography, and biopsy when necessary. Women who had a previous history of cancer were also excluded. The controls were matched to the case patients on the basis of geographical area and age. All study subjects provided a 3- to 5-ml venous blood sample. All of the data collected were entered into a computerized database established by the Department of Breast Surgery of the Fudan University Shanghai Cancer Center.