导管原位癌(DCIS)是一种影响乳腺乳管细胞的疾病. 衬在乳管上的细胞变成恶性的，但仍停留在原位。. DCIS is an early form of breast cancer. 它不是侵入性的——恶性细胞不会穿过导管壁生长或扩散到淋巴结或血流.

Bonnie Sun, M.D., of Johns Hopkins’ breast center, provides perspective:

Ductal Carcinoma In Situ (DCIS) — What You Need to Know

• DCIS accounts for about 20% of breast cancers.
• 这种情况通常不会引起症状，但可以在乳房x光检查中显示出来, typically as microcalcification clusters.
• DCIS可以通过手术治疗，有时也可以通过放疗和药物治疗. Chemotherapy is not needed.
• 通过及时的诊断和治疗，患者可以期待良好的结果.

What are DCIS symptoms?

导管原位癌没有特定的症状，如肿块或乳房疼痛. “大多数病例在出现任何症状之前都是通过乳房x光检查诊断出来的，”孙医生说. 乳腺原位癌在乳房x光检查中最常见的表现是新的钙质沉积, but not always — sometimes, 乳房组织在扫描上的扭曲可能是DCIS的征兆.

Once the cancerous cells start to invade the milk duct, you might notice itching or ulceration (formation of a sore).

Sun notes that DCIS can occur in men, and since they do not get regular screening mammograms as a rule, the problem can show up as a bloody nipple discharge or lump.

女性或男性的乳房肿块可能是侵袭性癌症，应该马上去看医生.

How is DCIS diagnosed?

If a doctor sees the calcifications on your mammogram, he or she will recommend more tests, which could include a breast biopsy. During the biopsy, 医生或其他医疗保健提供者从你的身体中提取细胞或组织样本. The cells are examined by a pathologist — a doctor who checks for signs of disease in body tissues. 病理学家在显微镜下观察细胞，看是否有癌细胞存在.

一种特殊的活检称为立体定向核心针活检可以诊断DCIS. This is a nonsurgical, outpatient procedure. After giving you medicine to numb the breast area, 医生或技术人员使用由乳房x线照相术引导的针从有关区域收集细胞.

Lessening the wait time can reduce stress

Waiting for results can be stressful, 先进的乳房中心牢记这一点，尽量缩短检查和结果之间的时间.

“At Johns Hopkins, 我们对DCIS可能的诊断给患者带来的焦虑非常敏感,” Sun says. “如果看你乳房x光片的放射科医生怀疑你患有DCIS, 他或她会尽快安排你做立体定向活检.” Biopsy results are usually returned in about a week.

What is the treatment for DCIS?

Lumpectomy with radiation. The standard treatment is breast-preserving surgery (a lumpectomy)配合放射治疗，大多数推荐十大正规网赌平台的治疗结果都很成功. Cancers can be larger than expected, so about 20% of the time, 患者需要再次进行乳房肿瘤切除术——另一种手术——来切除所有的癌症. Typically, 剩下的乳房将接受放射治疗以降低局部复发的风险. 乳房肿瘤切除加放疗是治疗DCIS较好的替代方法.

Mastectomy. 一些患者在同一乳房的一个以上象限有导管原位癌(多中心乳腺疾病)。. 有时，DCIS相对于患者的乳房尺寸非常大. In these situations, a mastectomy (或不立即重建)需要治疗更广泛的恶性细胞. Radiation therapy is not needed for DCIS treated with mastectomy.

Chemotherapy. 由于DCIS是非侵入性的，因此不需要化疗.

Hormonal (endocrine) therapy. 激素(内分泌)治疗可能适用于那些导管原位癌是激素受体阳性.

What should I expect after a DCIS diagnosis?

The outlook after DCIS diagnosis, Sun says, is encouraging. “通过持续、严格的监测，DCIS的预后非常好，”她解释说. “你的医生会建议定期进行筛查，以防止原乳房复发, and to monitor the other breast for any signs of malignancy.

“我们期望通过适当的治疗彻底解决这个问题. 这是一种局部疾病，手术治疗就足够了. 化疗不是必需的，在某些情况下，激素药物和放疗也不是必需的.”

Will DCIS return or spread?

• 由于DCIS是一种非侵入性癌症，它不会全身扩散(转移)。.
• 对于接受乳房肿瘤切除术和放疗的患者，局部复发的风险在5%到15%之间.
• 对于接受乳房切除术的患者，局部复发的风险小于2%. 术后接受激素治疗的患者复发风险进一步降低一半.
• 乳腺癌可能在患者的另一个乳房发展，但只有大约5%的病例. If this happens, the cancer in the second breast is not considered a recurrence, but a new primary breast cancer. It can also be a different type of breast cancer.

Surgery can reveal additional cancer

在手术切除DCIS后的最终病理检查中发现浸润性癌的可能性很小. When that happens,” Sun says, 诊断可能会升级，可能需要额外的手术和其他治疗. 我们会根据不同情况量身定制最佳治疗方案. 这很重要，因为每个肿瘤和每个推荐十大正规网赌平台都是不同的.”

She notes that at Johns Hopkins Medicine, 与她一起工作的病理学家在识别任何可能存在的侵袭性癌症方面尤其熟练. “在综合乳房中心接受DCIS治疗可以确保你得到最好的治疗,” Sun says.

Moving On After DCIS

Sun强调，生活质量是乳腺癌治疗的一个非常重要的方面. “Since many of our patients are successfully treated, we have many years of life to consider,” she says. “通过授权和教育我们的推荐十大正规网赌平台，共同制定治疗计划, our aim is to minimize any regrets about treatment decisions. 我们希望我们的推荐十大正规网赌平台在乳腺癌治疗结束后感到健康和快乐.”

How do I prevent DCIS?

“Get your mammograms on time,” says Sun. “Mammograms themselves do not prevent DCIS, but can catch it early. Early detection can mean a better outcome with less treatment.”