Search
ductal carcinoma, breast
See breast cancer.
Epidemiology: most frequent histologic type (70%)
Genetics:
- see breast cancer
- overexpression of NEK8
- specifically implicated genes:
- KAT, KIAA0100, BCL9L, TP73, CTNND1, TNK2
Radiology:
- PET scan not indicated in asymptomatic women (see breast cancer)
Management:
1) ductal carcinoma in situ
a) surgical excision with negative margins by histopathology
b) adjuvant radiation therapy cuts recurrence rate in half
c) adjuvant aromatase inhibitor for postmenopausal women [1]
d) adjuvant tamoxifen for 5 years for premenopausal women [1]
e) axillary node dissection is not indicated
- incidence of lymph node metastases is 2-3%
2) invasive ductal carcinoma
a) modified radical mastectomy (most common surgery)
b) breast-conserving therapy
1] lumpectomy
2] partial (segmental) mastectomy or quadrantectomy
3] radiation therapy
c) sentinel lymph node biopsy
d) tamoxifen vs aromatase inhibitor for estrogen receptor- positive tumor after lumpectomy & radiation therapy to reduce risk of local recurrence &/or 2nd primary
3) see breast cancer
Interactions
disease interactions
Specific
tubular carcinoma of the breast
General
breast cancer
ductal adenocarcinoma
Database Correlations
OMIM correlations
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, 16.
American College of Physicians, Philadelphia 1998, 2012
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 666
- Smith BD et al,
Effectiveness of radiation therapy in older women with ductal
carcinoma in situ.
J Natl Cancer Inst 2006, 98:1302
PMID: 16985249
- Fisher B, Dignam J, Wolmark N et al
Tamoxifen in treatment of intraductal breast cancer: National
Surgical Adjuvant Breast and Bowel Project B-24 randomised
controlled trial.
Lancet. 1999 Jun 12;353(9169):1993-2000.
PMID: 10376613