Stage 0 Cancer: What It Means And Why Early Awareness Is Key

Most people are aware of stages 1 through 4, describing size and spread, associated with breast cancer. But there is an earlier stage, called Stage 0, or carcinoma in situ. This is the earliest form of breast cancer: abnormal cells are found only in the lining of a duct in the breast but have not invaded surrounding tissue.

Stage 0 breast cancer represents 20% of all newly diagnosed breast cancers but may be missed because it occurs without symptoms. Its early, non-aggressive nature makes it extremely curable, particularly when found because of routine screening.

Dr. Kunjal Lila, Head of Department and Consultant in Surgical Pathology, Metropolis Healthcare Ltd. shares all you need to know:

The increasing burden in India Breast cancer is the leading

cancer in India among women. The Global Cancer Observatory (GLOBOCAN) shows that there were estimated cases of around 192,020 new cases and 98,337 deaths in 2022 alone. The lifetime risk of developing breast cancer is 1 in 28 women, which escalates to 1 in 22 in urban areas.

Types of stage 0 breast cancer
Three types of Stage 0 or in-situ breast lesions exist:
1. Ductal Carcinoma in Situ (DCIS) – Most prevalent, limited to breast ducts.
2. Lobular Carcinoma in Situ (LCIS) – Occurs in milk-producing lobules.
3. Paget’s Disease of the Nipple– Uncommon, affects the nipple and the area around it.

All of these are non-malignant and extremely curable if detected early.

Importance of screening and early detection
Since Stage 0 breast cancer often has no symptoms, it is usually detected through screening mammography. In some cases, there may be a lump or bloody nipple discharge, but these are not always present.

Routine screening is crucial
Women over 40: Annual or biennial mammograms.
High-risk women (from age 30): Earlier and more frequent screenings if they have a family history, prior chest radiation, or known genetic mutations.
If abnormality is detected, a biopsy is done. This permits a pathologist to check the cells and identify the grade of cancer low, intermediate, or high in order to assist in treatment.

Individualized Treatment Options
Treatment for Stage 0 breast cancer varies based on such factors as the grade, age, general health, and size of the lesion. Not all need to be treated immediately.
• Low-risk DCIS: Can be treated with a “wait-and-watch” strategy.
• Localized lesions: Undergoes lumpectomy (excision of the tumor with a margin of normal tissue).
• Extensive involvement: Could need mastectomy (excision of the whole breast).
• Post-surgical options: Could be radiation or hormonal therapy to suppress recurrence.

Prognosis and hope
The outlook for Stage 0 breast cancer is outstanding, with a five-year survival rate of 99% if the cancer has not extended outside the breast. Notably, chemotherapy is not required in the majority of Stage 0 cases, and treatment tends to be less intrusive than in more advanced stages.

While the word “cancer” is frightening and anxiety-provoking, Stage 0 breast cancer presents an opportunity window, an opportunity to step in early, forego harsh treatments, and live a healthy, vibrant life. Routine screenings, awareness, and discussion with medical professionals are essential in detecting this early stage and maximizing results.