Boy Meets World star Danielle Fishel has been diagnosed with an early form of breast cancer called ductal carcinoma in situ (DCIS).
The 43-year-old mother of two shared the news with her podcast cohosts, Rider Strong and Will Friedle, in the latest episode of her show “Pod Meets World,” released on Monday, August 19.
“It is very, very, very early. It’s technically stage 0,” said Fishel. “I was diagnosed with high grade DCIS. … And I’m going to be fine, I’m having surgery to remove it.”
Fishel added that she is also having “some follow-up treatment,” and explained to listeners that her working schedule for the podcast might be put on hold while she has her upcoming treatment.
“The only reason I caught this cancer when it is still stage 0 is because the day I got my text message that my yearly mammogram had come up, I made the appointment,” Fishel said in the podcast.
How can someone have stage 0 cancer, and does it require the same types of treatment as breast cancer in more advanced stages? Here’s what you need to know about DCIS.
What Is Ductal Carcinoma In Situ (DCIS)?
Some people may call it precancer, but it’s more accurate to say it’s preinvasive breast cancer, says Jean Bao, MD, an assistant professor at Stanford Medical School and general surgeon at Stanford Health Care in California, who specializes in breast surgical oncology.
“So basically, these are cancer cells that are still trapped within the milk ducts and have not spread into the breast tissue. Because of that, the cancer cannot metastasize [spread],” says Dr. Bao.
This is in contrast to invasive breast cancer, where the cancer cells have broken through the duct, when it has the potential to spread to lymph nodes or somewhere else in the body, she explains.
Why Is It Called Stage 0 Breast Cancer?
Experts use the phrase Stage 0 breast cancer because it is noninvasive, says Elizabeth Berger, MD, a breast surgical oncologist at Yale Cancer Center and Smilow Cancer Hospital in New Haven, Connecticut.
“The abnormal cells are still confined within the ducts and thus truly it doesn’t have the ‘invasive cancer’ diagnosis,” says Dr. Berger.
In Stages 1, 2, and 3, cancer has spread into the nearby tissues. In Stage 4, cancer has spread to distant parts of the body.
How Is DCIS Usually Detected?
DCIS typically shows up on mammograms as white calcium deposits, or calcifications, says Berger. Sometimes DCIS can be detected by ultrasound or breast MRI.
Are There Any Risk Factors for DCIS?
The risk factors for DCIS are the same as any other type of breast cancer, says Bao.
They include the following:
- Age; and chances increase as you age, especially after age 30
- A family history of breast cancer
- Starting your period before age 12
- Having a baby after age 30
- Never being pregnant or breastfeeding
- Starting menopause after age 55
- A personal history of breast cancer or atypical hyperplasia (having abnormal cells in your milk ducts).
- Having dense breast tissue
- Having previous radiation therapy directed at your breasts or chest
- Having gene mutations associated with increased cancer risk, such as BRCA1 and BRCA2
What Are the Treatment Options for DCIS?
Doctors use a process called grading to help decide the best treatment option for DCIS. There are three grades: low-grade or grade 1, moderate-grade or grade 2, and high grade or grade 3. If the cells are aggressive, fast growing, and more likely to come back, those are higher grade. The size of the DCIS (measured at the tumor’s widest point) is also considered.
“The surgical decision for women with DCIS depends upon the size and extent of the diseased area in the breast. If the area is large and requires a lot of tissue to be removed, then often a woman will require a mastectomy,” says Berger. A mastectomy is surgery to remove the breast.
If the area is smaller, then a woman can have a lumpectomy for DCIS, she says. Also known as breast-sparing surgery, a lumpectomy removes the DCIS plus a small rim of healthy tissue around it, called the margin.
In some cases, the lumpectomy would be followed by radiation to help ensure no cancer cells are left. Also, if the DCIS is hormone receptor–positive, hormone therapy may be recommended, says Bao.
There is a lot of research going on to see if DCIS may be managed without surgery, says Bao.
“We don’t have the data from these clinical trials yet, but that’s definitely a direction that we’re exploring,” she says.
What Is the Prognosis for Stage 0 Breast Cancer?
The prognosis for DCIS is very good, says Bao.
Don’t Neglect Mammograms
The new recommendations state that women should get screened for breast cancer biannually (every other year) starting at age 40, and continuing through age 74.