London Bridge Hospital
 
Home | Contact | Links      
 
 
Breast Cancer and Breast Screening
 
Breast Cancer and Breast Screening

Breast cancer is of course the most serious breast problem that we encounter. It is the most common type of cancer in the UK and will affect around 1 in 10 women at sometime during their life, although much more often this happens in old age. The good news about breast cancer however is that treatment is quite effective and that most women who develop breast cancer will be permanently cured following he correct treatment. Treatment is more effective if the breast cancer is caught in the early stages and this is the reason for undergoing breast screening (mammography). This is provided automatically by the National Health Service for all women between the ages of 50-70, but continues to effective after the age of 70 and is certainly available on request at your local screening centre if you wish to continue with it. Breast screening is also effective between the ages of 40-50, though mammograms need to be carried out more often (at the very least once every two years).

The commonest sign of breast cancer is a lump in the breast. This can be any size but is usually a felt as a separate lump within the breast tissue which is harder than the normal tissue around it. Very often a cancerous lump will be attached to the overlying surface tissue causing either puckering of the skin, which is most noticeable when raising the arms, or inversion of the nipple. Breast cancer can also cause nipple discharge which is frequently blood stained. Breast cancer lumps are practically never painful and generally are felt by accident whilst washing or during self breast examination. Rarely breast cancer causes a red discoloration of the overlying skin so this is another important symptom which should always be checked by your doctor.

       
         
         
Ductal Carcinoma-in situ (DCIS)

Ductal Carcinoma-in situ is the name given to pre-cancerous changes in the breast. This is the stage before breast cancer and very different from breast cancer. Under the microscope abnormal cells similar to cancer cells can be seen within the breast ducts, but these cells do not have the ability to invade the surrounding tissue or to live outside the breast duct. As a consequence DCIS can never spread to the lymph glands or away from the breast and for this reason is not life threatening in itself. If left untreated however, DCIS will often, though not always, turn into breast cancer with potentially more serious consequences.

Ductal Carcinoma-in situ is most often discovered when you have a mammogram. In particular it produces fine specks of calcium which show up on a mammogram. A needle biopsy is usually required to make the diagnosis for certain. It is unusual to have any symptoms as DCIS does not cause any pain and only rarely leads to lump or to nipple discharge.

Ductal Carcinoma-in situ is nearly always treated by surgery. It is essential to remove all of the affected tissue in a way that leaves none of the problem behind. Often this can involve the removal of only a small area of breast tissue but if the changes are very extensive a mastectomy can sometimes be required. In these cases breast reconstructive surgery can be safely carried out at the same time as the mastectomy.

Ductal Carcinoma-in situ is classified under the microscope according to its aggressive potential. High grade DCIS turns into breast cancer much more quickly and when it does turn into cancer it is of the more aggressive type. Low grade DCIS is the opposite taking many years to become cancerous and sometimes never going cancerous at all. If it does become cancerous the type of cancer that evolves is of equally low grade, growing very slowly and often not spreading. In cases of high grade DCIS we usually recommend the addition of radiotherapy to the breast to minimise the chances of further problems. Radiotherapy is occasionally also recommended in cases of intermediate grade DCIS, not of great benefit in low grade DCIS.

The success of the treatment for DCIS depends on the grade. There is very little chance that low grade DCIS will recur but approximately 1/4 of all cases of high grade DCIS develop further DCIS (50%) or invasive breast cancer (50% of recurrences are invasive breast cancer). The addition of radiotherapy reduces the chance of recurrence by a half, giving a recurrence rate of approximately 12-13% in cases of high grade DCIS. Women who have a mastectomy have only a very small chance of recurrence (1%) even if they have high grade DCIS.

 

Click here for more information on Breast Care Surgery at London Bridge Hospital


 
 
 
 
<< back  
 
London Bridge Hospital
27 Tooley Street
London, SE1 2PR
Tel: 020 7407 3100
Fax: 020 7407 3162
  Disclaimer | Contact Details | Privacy Statement | Site designed by Medical Pages | Site Map  
Find your Doctor, Find your Treatment at Medical Pages Health Portal. Click here