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Breast cancer usually starts in glands (lobules) in the breast that produce milk or in the ducts that carry milk through your breast. You will have a breast biopsy to look for breast cancer. If your biopsy shows that cancer cells have not spread outside of these areas, the cancer is noninvasive.
There are two conditions of concern, based on where the abnormal cells are: lobular carcinoma in situ (LCIS) and ductal carcinoma in situ (DCIS). Doctors approach each one differently.
LCIS Treatment
LCIS is not a true breast cancer because it does not become invasive itself. However, it does raise your risk of developing breast cancer in either breast. If your doctor finds LCIS, you may benefit from these care options:
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Your doctor may suggest you have mammograms more often, possibly once a year.
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Your doctor may suggest you come in more often for breast exams.
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Your doctor may want to add a breast imaging study, called an MRI, to your breast exams.
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Your doctor may recommend hormone medicines to lower your risk of developing breast cancer. Estrogen stimulates estrogen receptor (ER)-positive cancer cells. Use of the hormone drugs tamoxifen or raloxifene may block this stimulation and lower your cancer risk. You take tamoxifen as a pill or liquid and raloxifene as a pill. Medicine used this way—to lower your risk of, or to prevent breast cancer—is called chemoprevention. It may last for about five years.
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If a biopsy shows an unusual type of LCIS called pleomorphic type, your doctor may suggest surgery to remove the cancer cells and some nearby breast tissue.
DCIS Treatment
Another name for DCIS is stage 0, ductal carcinoma. Treatment for DCIS often involves multiple approaches:
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Treatment usually starts with surgery. Your doctor may remove the cancer along with some breast tissue that's around it. That's called breast-conserving surgery. If your cancer is larger than usual or in more than one place within the ducts, your doctor may suggest a mastectomy. That's total breast removal. During surgery, your doctor may take out a lymph node closest to your cancer and test it to see if cancer cells have spread to it. That procedure is a sentinel node biopsy.
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If you have breast-conserving surgery, you may get radiation therapy afterwards. Treatment with radiation can make it less likely that your cancer will return. Radiation is usually not necessary after mastectomy.
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If your cancer is ER-positive, you may take the hormone therapy drug tamoxifen for five years.
The best treatment options for noninvasive breast cancer depend on your specific case. Work with your doctor so you understand each part of the treatment and how it can help.