How is Stage 0 Breast Cancer Treated

stage 0 breast cancer treatment

Stage 0 Breast cancer treatment is necessary as it is the earliest stage of breast cancer. Immediate treatment at the pre-cancerous stage stops the progress to later stages.

When abnormal cells are present in the lining of your milk ducts, you have stage 0 breast cancer, also known as ductal carcinoma in situ (DCIS). However, those cells have not penetrated the duct’s outer wall to colonize nearby tissue, your circulation, or your lymph nodes.

DCIS, which is non-invasive and referred to as a “pre-cancer,” however, has the capacity to spread.

Ductal carcinoma in situ comprises 20% of all newly diagnosed breast cancers according to a 2018 review. [ref]

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Hormone Therapy for Stage 0 Breast Cancer

The presence of estrogen receptors (ER) or progesterone receptors (PR) indicates that your tumor is utilizing these hormones to develop and perhaps spread.

Premenopausal women’s ovaries are where estrogen and progesterone are mostly produced. However, as they are also made in other tissues, postmenopausal men and women also generate some estrogen and progesterone.

However, certain breast cancers may be encouraged to spread by these hormones.

Surgery and radiation treatments specifically target the tumor location or lymph nodes, among other body parts. They are regarded as localized therapies since they concentrate on very certain regions.

Contrarily, hormone therapies are regarded as systemic treatments since they focus on hormones all over the body.

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Selective estrogen receptor modulators

(SERMs) are used in the hormone therapy of stage 0 breast cancer. The following are some commonly used SERMs:

Tamoxifen (Soltamox):

The anti-estrogen medication most frequently used is tamoxifen (Nolvadex, Tamofen). Both premenopausal and postmenopausal women utilize it. Tamoxifen is administered orally (by mouth) as a pill.

The hormone treatment pill Tamoxifen is most frequently used to reduce the likelihood that DCIS or LCIS would progress to invasive breast cancer.

Tamoxifen modestly raises the risk of deep vein thrombosis (DVT), stroke, and uterine cancer. Before prescribing this medication to women who have a strong personal or family history of these disorders, doctors will carefully assess the risks against the advantages of doing so.

Usually, using tamoxifen has more advantages than disadvantages. Both Fulvestrant (Faslodex) and Toremifene (Fareston) are used for advanced stages of breast cancer.

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Radiation Therapy for Stage 0 Breast Cancer

After a lumpectomy or mastectomy, radiation treatment for stage 0 breast cancer may be administered. For a few weeks, treatments are given five days a week.

High-energy waves are used in radiation therapy as a cancer treatment to harm or kill cancer cells.

By altering the DNA within them, the waves prevent cancer cells from proliferating and producing new cancer cells. However, occasionally it can harm cells that are not malignant.

High-energy waves used in radiation treatment are directed onto the afflicted region, which is frequently where a tumor existed or was removed after surgery. This method kills any cancer cells that may still be present.

In contrast to conventional cancer therapies like chemotherapy, which may harm cells across your whole body, this sort of treatment allows doctors to specifically target certain areas of your body.

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If the area of DCIS is particularly big, if the breast contains many independent regions of DCIS in various quadrants (multicentric), or if BCS cannot entirely eliminate the DCIS, a simple mastectomy (removal of the entire breast) may be required for stage 0 breast cancer treatment.

Many doctors will do an SLNB (​​Sentinel Lymph Node Biopsy) in addition to a mastectomy if one is required for any of the reasons mentioned since there is a larger likelihood that invasive cancer will be discovered.

The clinician may have to do a full axillary lymph node dissection (ALND) in place of SLNB if an aggressive cancerous region is discovered in the tissue removed following a mastectomy. [ref]

In most cases, DCIS-related mastectomy patients do not require radiation therapy and can choose immediate or delayed breast reconstruction.

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Breast-conserving surgery (BCS):

The surgeon performs breast-conserving surgery (BCS), in which the tumor and a tiny portion of healthy breast tissue surrounding it are removed.

With BCS, lymph node surgery is typically unnecessary. If an invasive cancerous region is discovered, it could be treated after the first operation.

The size of the tumor and the rate of cancer growth influence the likelihood that a DCIS region harbors invasive malignancy. A sentinel lymph node biopsy is often performed if lymph nodes are removed.

Radiation treatment is typically administered after BCS if it is performed. This lessens the possibility of cancer returning in the same breast (either as more DCIS or as invasive cancer).

Although BCS without radiation therapy is not a recommended course of treatment, it may be an option for elderly patients, patients with other serious medical conditions, or those who had tiny portions of low-grade DCIS excised with sufficient cancer-free surgical margins.

Breast-conserving surgery (BCS) and mastectomy are two common treatment options for women with early-stage breast cancer, such as DCIS.

The primary benefit of BCS is that a woman retains most of her breasts. Some female patients may be concerned that undergoing less invasive surgery may increase their likelihood of cancer returning.

However, studies that have been tracking thousands of women for more than 20 years reveal that when BCS is combined with radiotherapy in women with early-stage cancer, survival is equal to having a mastectomy.

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Pharmaceuticals used in chemotherapy belong to a subclass of drugs known as cytotoxic agents. They are made to destroy cancer cells.

Compared to healthy cells, cancer cells multiply more quickly. Fast-growing cells are slowed down by these medications, but slower-growing cells are often unaffected.

It is believed that chemotherapy is only required if cancer has invaded adjacent areas. Since in stage 0 breast cancer, the tumor is localized and has not invaded other regions yet, chemotherapy is not needed.

What do you think?

Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

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