INTRADUCTAL CARCINOMA

SYMPTOMS

Intraductal carcinoma, also known as ductal carcinoma in situ (DCIS), is a non-invasive form of breast cancer where abnormal cells are found in the lining of a breast duct but have not spread beyond it into surrounding breast tissue. Symptoms of intraductal carcinoma may include:

• Breast Changes: DCIS typically doesn’t cause any noticeable breast changes or physical symptoms, such as a lump or mass that can be felt.
• Nipple Discharge: Discharge from the nipple, which may be clear or bloody, can sometimes occur.
• Breast Pain or Tenderness: Some women with DCIS may experience breast pain or tenderness, although this is not a common symptom and can be caused by various other conditions as well.
• Inflammatory Signs: In rare cases, DCIS may cause inflammatory signs such as redness, warmth, or swelling of the breast. However, these symptoms are more commonly associated with invasive breast cancer rather than DCIS.

DIAGNOSIS

Diagnosing intraductal carcinoma involves a combination of imaging studies, biopsy, and histopathological examination. Diagnostic steps may include:

• Mammography: Screening mammography is the primary imaging modality for detecting DCIS, often presenting as microcalcifications within the breast ducts.
• Breast Ultrasound: Ultrasound may be used to further evaluate suspicious findings detected on mammography and guide needle biopsy procedures.
• Breast Biopsy: A core needle biopsy or vacuum-assisted biopsy is performed to obtain tissue samples from the suspicious area, which are then examined under a microscope for the presence of DCIS.
• Histopathological Examination: Histological analysis of biopsy samples helps confirm the diagnosis of DCIS and determine the histologic subtype, grade, hormone receptor status, and presence of biomarkers such as HER2/neu.

TREATMENT

Treatment of intraductal carcinoma aims to remove the cancerous cells and reduce the risk of recurrence or progression to invasive breast cancer. Treatment options may include:

• Surgery: Lumpectomy (breast-conserving surgery) or mastectomy (removal of the entire breast) may be performed to remove the DCIS and achieve negative surgical margins.
• Radiation Therapy: Adjuvant radiation therapy may be recommended after lumpectomy to reduce the risk of local recurrence, particularly in cases of high-grade DCIS or positive surgical margins.
• Hormonal Therapy: Hormone receptor-positive DCIS may be treated with adjuvant hormonal therapy, such as tamoxifen or aromatase inhibitors, to reduce the risk of recurrence.
• Targeted Therapy: DCIS that overexpresses the HER2/neu protein may benefit from targeted therapy with drugs such as trastuzumab (Herceptin) to reduce the risk of recurrence.