[Carcinoma in situ of the breast: 10 cases]

The authors have reviewed 10 cases of carcinoma in situ of the breast, which they were able to isolate from 180 invasive cancers of the breast that were operated on during the same period of time. (These rare lesions occasionally occur at the same time as an invasive cancer; then they increase the risk of local recurrences). When they occur by themselves in situ cancers of the breast tend to be duct cancers or lobular cancers. Duct lesions are more common. They do, in a significant proportion of cases, become invasive. The authors point out the value of more mammographies being taken to diagnose these duct carcinomas in the breast in order to work out the correct treatment. They think it is important to delay making a decision as to the surgical procedure to be adopted until the report on the histology of the specimen taken for biopsy has been received. For a long time total mastectomy was the only treatment: the results were too good... (some patients were overtreated). The present tendency is to limit the operation (to segmental excision) in cases where the lesion is limited. Mastectomy is reserved for cases that are spread out. Carrying out irradiation after widespread segmental excision increases the risks of local recurrences. Clearing the whole area has only to be considered when there are widespread forms of the condition. Lobular cancers in situ are marker lesions and have to be followed up very carefully indeed. The authors illustrate their article with some anatomopathological specimens and mammographies that they have come across.