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Stage 0 Noninvasive, Ductal Carcinoma in situ

• Definition of DCIS - The cancer is found only in the milk ducts of the breast

• Treatments for DCIS - Treatment of ductal carcinoma in situ (DCIS) may include the following:

  • Breast-conserving surgery with or without radiation therapy or hormone therapy
  • Total mastectomy with or without hormone therapy

• Outcome Data for DCIS

  • Two studies found that radiation after breast conserving surgery for DCIS reduced local recurrence and invasive carcinoma compared with no radiation after 4-8 years.

  • One study found that tamoxifen plus radiation following wide excision surgery reduced recurrence in women with estrogen receptor positive tumors.

• Prognosis for DCIS

DCIS is not regarded as life-threatening, having an overall ten-year survival rate higher than 98% of affected patients.

Stage 0 Lobular Carcinoma in situ

• Treatments for LCIS - Treatment of lobular carcinoma in situ (LCIS) may include the following:

  • Biopsy to diagnose the LCIS followed by observation (regular examinations and mammograms to find any changes as early as possible)
  • Tamoxifen to reduce the risk of developing breast cancer
  • Bilateral prophylactic mastectomy - This treatment choice is sometimes used in women who have a high risk of getting breast cancer. Most surgeons believe that this is a more aggressive treatment than is needed.

Stage I Breast Cancer

• Definition - Cancer cells have not spread beyond the breast and the tumor is no more than about 2 centimeters (cm), or about an inch, across.

• Treatments for Stage I Breast Cancer - Treatment of Stage I breast cancer may include the following:

  • Breast-conserving surgery to remove only the cancer and some surrounding breast tissue, followed by lymph node dissection and radiation therapy.
  • Modified radical mastectomy with or without breast reconstruction surgery

• Outcome Data for Stage I Breast Cancer

One systematic review found that adjuvant combination chemotherapy reduced recurrence and improved survival at 10 years, compared with no chemotherapy. The benefit seemed to be independent of node or menopause status, although the benefits were greater in women with node positive disease, and probably greater in young women.

• Prognosis for Stage I Breast Cancer

The 5-tear survival rate for Stage I cancer is nearly 100%

Stage II Breast Cancer

• Definition of Stage II - This stage is divided into two groups:

  • Stage IIA

    • the tumor in the breast is less than 2 cm across and the cancer has spread to the lymph nodes under the arm but not to other parts of the body; OR
    • the tumor is less than 5 cm but has not spread to the lymph nodes under the arm or to other parts of the body; OR
    • no tumor is visible in the breast, however, cancer cells have been detected in the lymph nodes under the arm but the cancer has not spread to other parts of the body

  • Stage IIB

    • the tumor is less than 5 cm but the cancer has spread to the lymph nodes under the arm but not to other parts of the body; OR
    • the tumor is large (more than 5 cm across), however, cancer cells have not been detected in the lymph nodes under the arm and there is no spread of the cancer to other parts of the body