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DCIS and Tamoxifen
The drug tamoxifen has been used for over a quarter of a century to treat breast cancer. More
recently, tamoxifen has been used to treat early stage breast cancer after primary
treatment (lumpectomy or mastectomy). To grow and reproduce, breast cancer cells require the female
hormone estrogen. Tamoxifen is an "anti-estrogen" and works by competing with estrogen
to bind to estrogen receptors in breast cancer cells. Tamoxifen is formally known as a
selective estrogen receptor modulator (SERM). By blocking estrogen in the breast, tamoxifen
helps slow the growth and reproduction of breast cancer cells. Click here to
learn more about tamoxifen.
Breast
Reconstruction
Breast
reconstruction is an important topic for women to discuss with their doctors before
cancer treatment begins. Mastectomy (removal of the breast)
will cause physical alterations to the breast. Since DCIS is not an emergency
condition requiring immediate action, there is time to weigh reconstructive options and become more informed. A procedure to rebuild the
breast such as a TRAM Flap may be included at the
end of mastectomy. This typically adds a few days to the recovery period. Women may also
choose to have reconstructive surgery almost any time following recovery from mastectomy.
The standard options for breast
reconstruction include: skin expansion followed by the use of implants, or flap reconstruction. Skin expansion
involves the insertion of a balloon expander beneath the skin and chest muscles following
mastectomy. The surgeon will periodically inject a salt-water solution into the balloon to
fill the expander for the next several months. After the breast skin has been sufficiently
stretched, the balloon expander is removed and replaced by a permanent implant. Today,
some initial expanders serve as final implants. TRAM Flap breast reconstruction is
also common after a mastectomy. In TRAM Flap reconstruction, a flap of the lower abdominal
wall fat is transferred to the intended breast area with its own blood supply. Normally
the blood supply comes from the rectus muscle(s) attached at the lower edge of the rib
cage. A TRAM flap leaves a horizontal scar on the abdomen.
| Breast
Reconstruction Options Include: |
- Skin expansion: insertion of
balloon expander followed by silicone or saline implants
- TRAM Flap: abdominal wall fat
transferred to breast area
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Click here for more
information on mammography and imaging guidelines after breast cancer surgery: http://www.imaginis.com/breasthealth/after_surgery.asp
DCIS and
Breast Cancer Recurrence
Occasionally breast cancer can return
(recur) after primary treatment. Breast cancer most commonly recurs in the same area as
the original cancer had occurred. Women with ductal carcinoma in situ (DCIS) who are
treated with breast-conserving therapy (lumpectomy) are at a
slightly higher risk of experiencing a recurrence than those women who are treated with mastectomy (removal of the affected breast).
However, several studies have shown
that women treated with breast conserving therapy who have local recurrence of DCIS are
not at any significantly greater risk of dying from the disease than women treated with
mastectomy. DCIS is a common type of cancer that is confined to the milk ducts of the
breast. Click here to learn more about breast cancer
recurrence.
Additional
References and Resources |
