导管原位癌 (DCIS)

概述

导管原位癌 (DCIS) 是指乳腺乳管内存在异常细胞。

DCIS 被认为是乳腺癌的最早期形式。DCIS 是非侵入性的，这意味着它尚未扩散到乳腺导管中，但存在演变为侵入性的低风险。

通常在乳房 X 光检查中发现 DCIS，这是乳腺癌筛查或调查乳房肿块的一部分。

尽管 DCIS 并非紧急情况，但确实需要进行评估并考虑采取治疗方案。治疗方案可能包括保乳手术、放射治疗或切除所有乳腺组织的手术。作为手术的替代方案，另一种方案是临床试验，研究主动监测。

症状

导管原位癌通常不会引起任何体征或症状。但导管原位癌有时可引起以下体征：

• 乳腺肿块
• 带血的乳头溢液

导管原位癌通常可在乳房 X 线检查中被发现，外观呈形状和大小不规则的小钙化簇。

何时就诊？

如果您发现乳房出现变化，比如有肿块、皮肤出现皱褶或其他异常情况、皮下区域增厚或乳头溢液，请预约医生进行检查。

询问您的医生您应该在什么时候考虑进行乳腺癌筛查，以及应该多长时间筛查一次。大多数小组建议考虑从 40 岁开始进行常规的乳腺癌筛查。与医生探讨适合您的方案。

病因

目前尚不清楚导致乳腺导管原位癌的病因。当乳腺导管细胞的 DNA 发生基因突变时，便会形成乳腺导管原位癌。基因突变会导致细胞出现异常，但此时这些细胞无能力从乳腺导管中发展出来。

研究人员还不清楚导致乳腺导管原位癌的异常细胞生长的确切原因。生活方式、所处环境和从父母遗传得到的基因都可能与此有关。

风险因素

会增加您患原位导管癌风险的因素包括：

• 年龄增长
• 个人有良性乳腺疾病史，如不典型增生等
• 有乳腺癌的家族史
• 从未怀孕
• 30 岁后生下第一个孩子
• 12 岁之前月经初潮
• 55 岁之后绝经
• 出现增加患乳腺癌风险的基因突变，如乳腺癌基因 BRCA1 和 BRCA2 的突变

预防

Making changes in your daily life may help lower your risk of ductal carcinoma in situ. This early form of breast cancer also is called DCIS. To lower your risk of breast cancer, try to:

Ask about breast cancer screening

Talk with your doctor or other healthcare professional about when to begin breast cancer screening. Ask about the benefits and risks of screening. Together, you can decide what breast cancer screening tests are right for you.

Become familiar with your breasts through breast self-exam for breast awareness

You may choose to become familiar with your breasts by occasionally inspecting them during a breast self-exam for breast awareness. If you find a new change, lumps or other unusual signs in your breasts, tell a healthcare professional right away.

Breast awareness can't prevent breast cancer. But it may help you to better understand the look and feel of your breasts. This might make it more likely that you'll notice if something changes.

Drink alcohol in moderation, if at all

If you choose to drink alcohol, limit the amount you drink to no more than one drink a day. For breast cancer prevention, there is no safe amount of alcohol. So if you're very concerned about your breast cancer risk, you may choose to not drink alcohol.

Exercise most days of the week

Aim for at least 30 minutes of exercise on most days of the week. If you haven't been active lately, ask your healthcare professional whether exercising is OK and start slowly.

Limit hormone therapy during menopause

Combination hormone therapy may increase the risk of breast cancer. Talk with a healthcare professional about the benefits and risks of hormone therapy.

Some people have symptoms during menopause that cause discomfort. These people may decide that the risks of hormone therapy are acceptable to get relief. To reduce the risk of breast cancer, use the lowest dose of hormone therapy possible for the shortest amount of time.

Maintain a healthy weight

If your weight is healthy, work to maintain that weight. If you need to lose weight, ask a healthcare professional about healthy ways to lower your weight. Eat fewer calories and slowly increase the amount you exercise.