J K Singh 


             Breast Conditions & Treatment Mrs Jagdeep K Singh  CONSULTANT ONCOPLASTIC AND RECONSTRUCTIVE BREAST SURGEON   



These are common, can be concerning for patients but are generally harmless. Further information can be found by clicking on the relevant links: 

 Ductal Carcinoma In Situ (DCIS)  

Pre-cancerous changes or Ductal Carcinoma In Situ (DCIS) is a condition where the cells lining the milk duct have acquired many of the characteristics of cancer of but have not spread beyond the lining of the ducts. The changes can be classified as low grade, intermediate grade or high grade according to how different the cells appear compared to normal cells and how quickly they are growing. Around 6900 women are diagnosed with DCIS each year in the UK and most cases are picked up incidentally on mammograms, although some women may notice a lump or nipple discharge which may be blood stained. 
It is very treatable with surgery and has an excellent prognosis. Mrs Singh will talk through your surgical options with you depending on the size and part of the breast affected. Often, the area can be removed through a lumpectomy (breast conserving surgery) where the disease is removed and the breast is conserved. If the area is large and the breast cannot be conserved, a mastectomy (removal of the breast) is performed. Breast reconstruction can be performed either immediately at the time surgery or delayed until later. Radiotherapy may be recommended following surgery and more information about DCIS can be found here. 


Approximately 55,000 cases of breast cancer are diagnosed each year in the UK. Most cases are sporadic (i.e. there is no inherited faulty gene) and 1 in 7 women will develop breast cancer at some point in their lifetime. Only 5% of women with breast cancer have an inherited abnormal gene. 
In most instances, breast cancer is very treatable and with improved treatment, the number of women surviving breast cancer continues to increase over time. Overall, 85% of women will be alive after 5 years from their diagnosis. 
More information can be found via Cancer Research UK by clicking on the links below: 

Treatment Options 

Surgery is the mainstay of treatment for breast cancer and other therapies may be given to reduce the chance of the cancer returning or where the disease has spread to other parts of the body
You may be offered either a lumpectomy (breast conserving surgery) or a mastectomy (removal of the breast) or given a choice between the two depending on your unique circumstances.  
Surgery to the armpit (axilla) may be recommend at the same time and is likely to involve either removal of a few lymph glands to see if the disease has spread beyond the breast (sentinel lymph node biopsy) or removal of all of the lymph glands from under the arm (axillary node clearance) if it is known that the disease has spread to them. 
Treatment to block the effect of oestrogen for hormone dependent cancers. 
High energy x-ray treatment to either your breast, chest wall after a mastectomy or armpit. 
Often a combination of drugs given in cycles to destroy residual cancer cells. 
e.g. HER2-directed treatment for cancers that have too much HER2, a protein of the surface of the cancer cells that makes them grow. 


Breast reconstructive options are discussed with all women having a mastectomy. The aim of breast reconstruction is to restore a breast shape which is acceptable to you. Your reconstructed breast will look and feel different to your natural breast. Your breasts will not look identical, but hopefully the reconstruction will be similar in terms of size, shape and position to your remaining breast.  
The reconstruction can be performed either at the time of the cancer surgery (immediate reconstruction) or after the cancer surgery (delayed reconstruction). There are pros and cons of each and these will be discussed with you. 
Breast reconstruction can be performed using either implants or your own tissue (autologous). Sometime a device called an expander is put under the skin which allows the skin to be expanded slowly before it is exchanged for an implant or your own tissue. 
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