The breast is made up of glandular tissue (lobules that produce milk and milk ducts that carry milk to the nipple), fatty tissue, and supportive connective tissue. Most breast cancers start in the glandular tissue. When cancers are confined within the lobules or milk ducts, they are called non-invasive (in situ) breast cancer.

Non-invasive breast cancer stays within the milk ducts of the breast and has not grown into or invaded normal tissues within or beyond the breast.

Sometimes called ductal carcinoma in situ ("in the same place") or pre-cancer, about 1 in 5 new breast cancers are non-invasive breast cancers and are considered stage 0.

Nearly all women with this stage of breast cancer can be cured. Similar to invasive breast cancer, ductal carcinoma in situ requires surgical removal and sometimes additional treatments such as radiation therapy and medicines that reduce/block estrogen activity.

Tests

Mammograms 
Mammograms are the fastest, most accurate way of detecting an abnormal growth in your breast. With tomosynthesis, or 3-D mammography, radiology technologists can get breast images from multiple angles, enhancing the accuracy of a reading and reducing the potential need for repeat scans.

Breast Ultrasound and MRI (Magnetic Resonance Imaging)
Your doctor may request a noninvasive imaging exam, such as breast ultrasound or breast MRI, if you have dense breasts and you’re at a higher risk of breast cancer — especially for those with a 20 percent or higher lifetime risk for breast cancer.

Ductoscopy
More than 80 percent of breast cancer growths arise in milk ducts. If your symptoms include a watery, blood-tinged discharge from the nipple, your surgeon will use ductoscopy to find the lesion to sample or remove it. It uses a fiber-optic scope less than a millimeter thick inserted into the milk duct at the nipple to send images to a computer monitor.

Biopsies
A biopsy is a small sample of the suspicious breast tissue that’s removed and tested. Biopsies can be performed in several ways, depending on the circumstances: fine needle aspiration (minimally invasive biopsy), image-guided core needle biopsy, cyst aspiration, ductoscopy (milk ducts) and surgical biopsy (excisional or incisional biopsy).

Estrogen and Progesterone Receptor Test
This test looks for estrogen and progesterone (hormone) receptors in your cancer tissue. If your breast cancer cells have estrogen and progesterone receptors, the cancer may grow more quickly. The test tells your doctor whether treatment to block estrogen and progesterone will be effective.

Human Epidermal Growth Factor Type 2 (HER2/Neu) Receptor Test
This test measures how many HER2/neu breast cancer genes there are and how much HER2/neu protein is made in a sample of breast tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer may grow or spread more quickly.

Treatments

Surgery
Depending on the diagnosis, surgery can be done as a stand-alone procedure or in conjunction with other prescribed therapies. Sylvester’s surgical oncologists are highly specialized in surgical options for breast cancer.

Breast-Conserving Surgery
These types of procedures remove the cancerous tissue, but not the breast itself. Surgeries such as lumpectomies and partial mastectomies are examples of breast-conserving surgeries. Your doctor will discuss your options and help you decide what's right for you.

Lumpectomy
This procedure removes a tumor (lump) and a small amount of normal tissue around it. Sylvester cancer surgeons pioneered the technique for oncoplastic lumpectomy and now teach other surgeons around the country. During a lumpectomy, your surgeon removes the tumor and a small area of surrounding tissue. Your doctor sculpts the remaining breast tissue to give your breast a natural appearance, with touch-ups to the other breast to make them match.

Lumpectomy With Breast Reduction
For women with large breasts, the surgical oncologist and plastic surgeon can do breast-reduction surgery, starting with the cancerous breast to make sure the removed tissue contains the lump and a clean — or safe — margin around the lump. The plastic surgeon reduces the other breast to match.

Partial Mastectomy
This surgery, also called a segmental mastectomy, removes a larger part of the breast than a lumpectomy.

Skin and Nipple-Sparing Mastectomy
When appropriate and possible, this procedure preserves the skin and nipple to minimize scarring and improve your surgeon's ability to reconstruct your breasts.

Mastectomy
A mastectomy removes the entire breast that's affected by cancer. The surgeon may remove one or more of the lymph nodes under your arm during surgery, or as a separate procedure later, to see if cancer has spread.

Sentinel Lymph Node Biopsy
Doctors use this minor surgery to determine if cancer has spread beyond a primary tumor into your lymphatic system. A sentinel lymph node is the first place cancer cells may move to when they begin to spread. During the biopsy, your doctor injects a special dye (tracer) to locate the nodes and remove them to look for cancer cells. If they're free of cancer, it means it's unlikely that cancer has spread and it's not necessary to remove more lymph nodes.

Sylvester offers a novel treatment that prevents taking more lymph nodes, even if the sentinel node is suspicious. Before surgery, an ultrasound scan of the armpit can highlight which lymph nodes are involved (they will appear enlarged or swollen). When chemotherapy is used before surgery (neoadjuvant chemotherapy), it can convert a previously positive lymph node to negative when biopsied, which means more lymph nodes don't need to be removed.

Venous Lymph Node Transfer and Lymphatic Grafting
If you have lymphedema from a previous surgery, Sylvester’s expert surgeons can prevent or provide relief from the debilitating condition caused when cancerous lymph nodes in the armpit must be removed during surgery, disrupting the normal flow of lymphatic fluid out of the arm. With nowhere to go, the fluid backs up in the tissues of the limb, causing painful swelling. In vascularized lymph node transfer, lymph nodes and their blood supply are transferred into regions where lymph nodes have been dissected to restore normal drainage.

Radiation Therapy
Your radiation oncologist will discuss if radiation therapy is appropriate for your cancer and which type of radiation delivery best suits your case. Types include internal radiation therapy such as brachytherapy (radioactive “seeds” implanted in the tumor); partial breast radiation therapy (higher doses pinpointed for a shorter time to accelerate therapy); and targeted external-beam radiation therapy.

Hormone Therapy
If your breast cancer cells have estrogen and progesterone receptors, the cancer may grow more quickly. Hormone therapy to block estrogen and progesterone may be effective at preventing cancer recurrence.

Why Choose Sylvester Comprehensive Cancer Center?

Sylvester is an NCI-designated cancer center. The National Cancer Institute has reaffirmed us as South Florida’s only NCI-designated cancer center. We have been recognized for our scientific leadership, our commitment to training the next generation of cancer researchers and providers, as well as our engagement with the communities that we serve. For patients, this designation translates into greater access to leading-edge treatment options, including clinical trials that prioritize your specific cancer.

Renowned Braman Family Breast Cancer Institute at Sylvester. We offer treatments customized to your individual needs at one of the nation's best breast cancer diagnosis and care programs.

Breast Imaging Center of Excellence designation by the American College of Radiology. Thanks to imaging excellence, you receive a more precise diagnosis, which then guides a more effective treatment plan.