NCCN Guidelines for Patients® | Stage 0 Breast Cancer - page 22

NCCN Guidelines for Patients
Stage 0 Breast Cancer, Version 1.2014
Genetic counseling | Treatment
Genetic counseling
About 10 out of 100 breast cancers are due to
changes in genes that are passed down from a parent
to a child. This is called hereditary breast cancer.
Using your medical and family history, your doctor will
assess how likely you are to have hereditary breast
cancer. If your likelihood is high, he or she will refer
you to a genetic counselor.
A genetic counselor is an expert in changes within
genes that are related to disease. The counselor
can tell you more about how likely you are to have
hereditary breast cancer. He or she may suggest
that you undergo genetic testing to look for changes
in genes that increase your chances of developing
breast cancer.
Hereditary breast cancer is most often caused by
mutations in the
genes. Normal
genes help to prevent tumor growth by fixing
damaged cells and helping cells grow normally.
Genetic testing can tell if you have a BRCA or another
mutation. Your test results may be used to guide
treatment planning.
Some abnormal changes in genes, called VUS
ariants of
ignificance), are not fully
understood by doctors. Your doctors may know of
research that aims to learn more. If interested, ask
your doctors about taking part in such research.
The cancer treatment that you will receive will partly
depend on your biopsy. You may have had a biopsy
that only removed some of the cancer. Such biopsies
include a FNA, a core needle biopsy, and a surgical
biopsy. After these biopsies, surgery to remove all of
the DCIS is needed.
An excisional biopsy is a minor surgery that removes
tissue for cancer testing. The goal of an excisional
biopsy isn’t to treat cancer, but instead is to determine
if cancer is or is not present. A second surgery is
likely needed after this biopsy to remove all the
cancer with cancer-free surgical margins.
There are two types of surgery (re-excisions) that are
recommended for DCIS treatment. Lumpectomy is
a breast surgery that removes any area with cancer
along with a surgical margin. It’s like an excisional
biopsy but removes more tissue. The other surgery
used to treat DCIS is a mastectomy. Depending on
the type, a mastectomy removes either a large part of
or the whole breast.
Before either surgery, you will be asked to stop
eating, drinking, and taking some medicines for a
short period of time. If you smoke, it is important to
stop. The three recommended treatments for DCIS
that include these surgeries are described next.
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