The breasts consist of glands that not only produce but release milk after the birth of a child. These glands are called lobules and have tubes that connect to each nipple are called ducts. The entire breast is made up of these lobules, ducts, in addition to the fatty, connective and lymphatic tissue. There is a clear liquid called lymph that is carried in lymphatic vessels that lead to small collections of tissue called lymph nodes. There are also lymphatic vessels the go to the lymph nodes under each arm called axillary lymph nodes.

Several types of tumors can occur in the breasts. Most are non cancerous and are related to fibrocystic changes. Since cysts are fluid filled sacs, fibrosis means that the tissue is connected. Benign tumors appear on the inside and are not life threatening.

One of the most common cancers to women is breast cancer and the other being skin cancer. Deaths have declined because of earlier detection and better treatment.

Ductal Breast Cancer is a cluster of cancer cells that begins in the milk passages but has not gone beyond the duct walls into the connecting tissue. It is generally called ductal carcinoma in situ or DCIS for short. The term of in situ refers to a tumor that has not gone outside the place where it developed. The true definition of DCIS is means that it is a non invasive form of breast cancer because it is maintained inside the milk ducts.

Even though DCIS is non invasive, if it is not treated it may very well develop into a real and true breast cancer and spread into the surrounding healthy area of the breast. Doctors cannot tell if DCIS will become an invasive cancer therefore early detection and treatment is extremely important. With this early detection and treatment the outlook is excellent.

Fortunately for most women, DCIS is often able to be detected by having a mammogram. It is able to be detected by this method before any symptoms have a chance to develop. Ductal Cancer most often shows up on the mammogram as a small cluster inside the breast. Because mammograms are more readily available to women today, the breast cancer is able to be detected much earlier.

One point of interest is that the incidence of DCIS has had a dramatic increase since the widespread screening by mammography was introduced. Almost 30 years ago there were about 5,000 cases of DCIS diagnosed in the United States. Because of the increased use of screening by mammography, about 50,000 cases are diagnosed almost every year.

The symptoms of DCIS are either a discharge from the nipple or as a mass that is under the skin. It usually occurs as two entirely different cell types where one may be invasive more quickly then the other will. The first progresses more slowly and consists of smaller, normal looking cells which are called solid. The second cell type progresses to the invasive stage early in its growth and generally consists of larger and more irregular shaped cells.

Ductal Breast Cancer accounts for 10 to 15% of all the new cases of breast cancer that are diagnosed in the US. 30 to 50% of all cancers detected by screening mammography are in women who are under the age of 50 years old while 15 to 25% are detected in women who are over the age of 50. DCIS is also attributed to approximately 7 to 10% of the breast biopsies performed.

One thing that is fortunate is that DCIS is an extremely curable disease with a 10 year survival rate about 97%. DCIS has been called the forerunner of non invasive breast cancer and therefore it is important the there be early diagnoses and of course, treatment to reduce the risk of developing invasive cancer.

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• lobular breast cancer