Talk:Carcinoma in situ

Medicine: Hematology-oncology Mid‑importance

	Medicine portal This article is within the scope of WikiProject Medicine, which recommends that medicine-related articles follow the Manual of Style for medicine-related articles and that biomedical information in any article use high-quality medical sources. Please visit the project page for details or ask questions at Wikipedia talk:WikiProject Medicine.MedicineWikipedia:WikiProject MedicineTemplate:WikiProject Medicinemedicine articles
Mid	This article has been rated as Mid-importance on the project's importance scale.
	This article is supported by the Hematology-oncology task force.

Ideal sources for Wikipedia's health content are defined in the guideline Wikipedia:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Carcinoma in situ.

PubMed provides review articles from the past five years (limit to free review articles)
The TRIP database provides clinical publications about evidence-based medicine.
Other potential sources include: Centre for Reviews and Dissemination and CDC

Bronchoalveolar carcinoma

Is it accurate to say that this is CIS? Some BACs secrete lots of mucus, but the majority will happily cause death without excessive mucus secretion.Jellytussle 00:55, 11 January 2006 (UTC)[reply]

Jellytussle, I see we will argue all over Wikipedia!

BAC is not classified as CIS in the big textbooks. By definition, however, it lacks stromal invasion and, therefore, satisfies all pathological diagnostic criteria for CIS, and some clinical criteria too (it does not form true, distant metastases). But unlike other CIS, it kills. This is probably why it is classified as malignant by clinician. This is due to the unique architecture and function of the lung: it blocks gas exchange either by filling the alveoli with mucus or simply coating their lining, thus thickening the distance between red cells and air (reducing diffusion capacity). Thus, it is malignant, not invasive.

As you can see, we are again arguing about definitions of words. I'll admit defeat about the word "cancer". As an oncologist, however, you should know not to argue about tumour classification with a pathologist.Emmanuelm 20:36, 11 January 2006 (UTC)[reply]

I never argue with pathologists ;-)Jellytussle 21:13, 11 January 2006 (UTC)[reply]

This argument about BAC has re-surfaced below, in the section "Citations needed -- really?" Emmanuelm 14:31, 30 October 2007 (UTC)[reply]

Treatment is easy?

How can it be stated that treatment of dysplasia and CIS is usually simple? It's a bold generalization without substance. Hovea 00:52, 26 October 2007 (UTC)[reply]

Good point. I moved all references to treatment in a new section to illustrate the range of difficulties. As you can see, the treatment of most CIS is easier and more certain than treatment of invasive carcinoma. Of course, to the patient, the excision of a colon polyp by endoscopy is a real ordeal, not exactly easy. Everything is relative. Emmanuelm

Citations needed -- really?

The request for citation is appropriate for controversial subjects. However, when the subject is technical (e.g. medical), most of the article is common knowledge, as stated in dozens of textbooks. To quote these books would be a useless waste of time. Wikipedians are good at correcting wrong statements. One may raise questions in the Talk page but please do not ask for references. I hope I have not angered too many Wiki gods. Emmanuelm —Preceding comment was added at 14:31, 27 October 2007 (UTC)[reply]

I agree with the gist of your argument. But the claim that "Bronchioloalveolar carcinoma of the lung is the only form of CIS that can kill"... it's thought-provoking and I was interested in a reference. I'm also a pathologist and I hadn't heard it before. Hovea 09:51, 28 October 2007 (UTC)[reply]

Thought provoking, I like the sound of this. So, go ahead, think! And edit the text if you can find a mistake. Emmanuelm 12:46, 28 October 2007 (UTC)[reply]

So there are no references? Hovea 23:54, 15 November 2007 (UTC)[reply]

Again, why am I the only one doing the thinking? Anyhow, eMedicine has nothing on BAC. UpToDate seems to have a good chapter on BAC but a subscription is needed to read the interesting part. Same thing with this Medscape article and this 2002 NEJM article on the subject, both stating plainly that BAC is CIS. I could find no "reliable source" saying that BAC is the only CIS that kills. Bottom line : lepidic growth = carcinoma in situ. No one denies that BAC can kill and no one can come up with another example of CIS that does. Therefore, I am right until proven otherwise. Sheeesh! Emmanuelm 15:41, 16 November 2007 (UTC)[reply]

Bronchioalveolar carcinoma: carcinoma in situ or invasive carcinoma? Here we go again

According to the AFIP fascicle, "hematogenous, lymphatic and pleural invasion may all be seen in BAC" (3rd series, fascicle 13, p. 233). How do you reconcile that with carcinoma in-situ? Hovea 03:57, 30 October 2007 (UTC)[reply]

Attention! Battle of tumor classifications ahead!

According to the WHO classifications of the tumors of the lung (2004, ISBN 92 832 2418 3), "a BAC pattern shows growth of neoplastic cells along pre-existing alveolar structures (lepidic growth) whithout evidence of stromal, vascular or pleural invasion". Therefore, the tumours that the AFIP calls "BAC with lymphatic invasion" are called "invasive adenocarcinoma" by the WHO.

The morphological definition above, so-called "lepidic growth", is completely identical to the classical pathological definition of CIS. Irrationally and unfortunately, the term CIS is not used in this context, and the WHO classifies BAC as a subtype of adenocarcinoma.

Note that many invasive adenocarcinomas of the lung are small invasive tumours surrounded by a large amount of BAC. One can therefore imagine that the invasive focus could be missed. The same argument is used in the breast when DCIS is associated with nodal metastases. Emmanuelm 14:42, 30 October 2007 (UTC)[reply]

Contradiction

The article claims that "CIS will usually not form a tumor" and that "The risk of transforming into cancer is high". Do these to statements not contradict each other? Although many tumours are not cancerous, most cancers involve a tumour, don't they? Will Bradshaw (talk) 22:53, 4 May 2013 (UTC)[reply]

the statement does not necessarily contradicts itself. it might means that CIS might turn cancerous and spread without forming a tumor. however, more citation is needed to assume either way. --MuanN (talk) 12:48, 14 August 2019 (UTC)[reply]