PRECANCEROUS CONDITIONS

Precancerous Conditions

Lobular Carcinoma In Situ (LCIS): The term “in situ lobular carcinoma” refers to cases where cancer cells are confined to the lobular epithelium and do not invade the base membrane. When they grow beyond the basal membrane, it is referred to as Invasive Lobular Carcinoma (ILC). The treatment of LCIS depends on various factors such as age, positive family history, other accompanying health problems, and even the occurrence of cancer in the contralateral breast. Treatment can range from simple regular monitoring to prophylactic bilateral mastectomy. The well-known intervention by Angelina Jolie falls under this category.

Ductal Carcinoma In Situ (DCIS): The term “In situ ductal carcinoma” refers to cases where cancer cells are confined to the ductal epithelium. There are subtypes of histological types, such as comedogenic, which present a particularly aggressive form. Mammography typically shows microcalcifications, which may have been detected in a previous mammogram. However, there are rare cases where the mammogram appears normal. Clinical examination is of paramount importance, especially for early cancer diagnosis. Our concern is whether it is possible to diagnose cancer at the precancerous in situ stages. The therapeutic management of DCIS depends on various factors such as size, family history, grade of malignancy, histological type (homeomorphic), diffuse multicentric appearance in more than one quadrant, etc. All these factors will ultimately determine the type of surgical intervention-reconstruction, as well as further treatments with chemotherapy, radiation therapy, hormone therapy, or immunotherapy. International guidelines determine the therapeutic management with the goal of curing the disease. At this stage, complete cure is much easier, and the likelihood of cancer recurrence is reduced. If someone happens to come into contact with cancer, we hope that it is in this early stage.

Paget’s Disease: It is an extremely rare condition, accounting for only 1% of all breast cancers. It clinically presents as an eczematous lesion affecting the nipple, which later spreads horizontally to the areola and the surrounding skin. When Paget’s disease is diagnosed, it is almost always accompanied by cancer in the breast parenchyma, with a large percentage located beneath the nipple. If diagnosed early, the development of cancer in the underlying mass can be prevented within the next 2-3 years. The therapeutic approach involves mastectomy, including the nipple-areolar complex, and sentinel lymph node biopsy (to assess possible lymph node metastasis), followed by immediate or delayed reconstruction.

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