'Boy Meets World' star says she has Stage 0 breast cancer. What does that mean?

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Danielle Fishel, best known for playing Topanga Lawrence in the 1990s sitcom “Boy Meets World,” revealed her diagnosis of ductal carcinoma in situ, a noninvasive form of breast cancer.

DCIS, which affects more than 55,000 women per year in the United States, is curable. Fishel, who said her cancer was at Stage 0, urged other women to get their mammograms, or breast cancer screenings, to catch any issues early.

Here’s what to know.

What is Stage 0 cancer?

Cancer staging is the way doctors describe the size and spread of cancer in the body. Cancers are grouped into stages on a scale of 0 to 4, with 4 being the most advanced. Ductal carcinoma in situ — abnormal cells that line the milk ducts of the breast and are pre- or noninvasive — is typically considered a Stage 0 form of cancer.

Staging guides medical professionals in determining treatment options and assessing patients’ chances of survival. According to the American Cancer Society, “although each person’s cancer experience is unique, cancers with similar stages tend to have a similar outlook and are often treated in much the same way.”

What kind of cancer does Danielle Fishel have?

Fishel, 43, revealed in an episode of the podcast “Pod Meets World” aired on Monday that she was diagnosed with “high-grade DCIS with micro-invasion.”

The term “high-grade” means the cells are highly abnormal — which could mean they look more like cancer cells and less like normal cells under a microscope — and are more likely to recur. “Micro-invasion” means the cells have already begun to break down the membrane separating them from the breast tissue and to spread into the issue, but only minimally, said Mangesh Thorat, a breast surgeon and honorary reader at the Wolfson Institute of Population Health at Queen Mary University of London.

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Even when cells start to spread, there “is still no guarantee that they will be capable of developing and growing outside the duct,” said Clare Rebbeck, a senior research associate at Cancer Research UK at Cambridge University.

What is the survival rate for DCIS?

According to the American Cancer Society, “nearly all women” with DCIS can be cured with appropriate treatment and medical care.

According to the Cleveland Clinic, DCIS accounts for up to a quarter of all new cancer diagnoses each year. Modern medical imaging technology has made it possible to detect DCIS, whereas it would typically go undetected before and could in some cases turn into invasive and deadly forms of breast cancer. But routine mammograms can and do pick up tens of thousands of new cases per year.

However, DCIS can recur and turn into invasive breast cancer and therefore requires close monitoring and in many cases, treatment, said Nigel Bundred, an emeritus professor of surgical oncology at Manchester University.

How is DCIS treated?

“There is no standard DCIS,” and therefore no one-size-fits-all treatment, Rebbeck said. The most common is a surgery known as lumpectomy, which involves removing the abnormal cells and some healthy breast tissue that surrounds them. According to the Cleveland Clinic, “removing small amounts of nearby healthy tissue increases the chance no abnormal cells will be left behind.”

After surgery, patients can be offered radiation therapy, typically for three to four weeks, to “kill any remaining cancer cells” and “reduce the likelihood that the cancer will return,” the Cleveland Clinic said. In some more serious cases, patients may choose to have one or both their breasts removed, in a procedure known as mastectomy. Afterward, patients can be offered a five-year hormone therapy treatment to “prevent DCIS from recurring or a new type of cancer from forming,” the clinic said.

Fishel said she is “having surgery to remove” the abnormal cells and will receive “some follow-up treatment.” She did not specify what type of surgery or treatment she will receive.

There is some debate among experts about whether all patients diagnosed with DCIS should receive treatment. Some women can live with undiagnosed DCIS and not experience any major issues, Rebbeck said. Because treatments like surgeries, radiation and hormone therapy can be hard on the body, some doctors believe it’s best not to treat DCIS and instead monitor closely and only treat once the cells start to spread outside the ducts.

The most important thing when receiving a diagnosis for DCIS is not to panic, Rebbeck said. “Speak to your doctor and realize that actually, it is very early stages … and as it is, it’s not life-threatening,” she said. If a patient decides not to seek treatment, they should still be closely monitored to make sure the cells don’t become invasive, she said.

How can you screen for DCIS?

The U.S. Preventive Services Task Force recommends that women between the ages of 40 and 74 who are at average risk for breast cancer get a mammogram every two years. Until last year, the guidance had advised most women to start getting mammograms from age 50; the lowered age range reflected evidence that shows more women in their 40s are getting breast cancer.

Fishel said she chose to speak publicly about her diagnosis to encourage others to get screened regularly. “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,” she said.

“If it’s time for your appointment, if you’ve never had an appointment before, get in there,” she added. “If you have to find out that you have cancer, find out when it’s at Stage 0, if possible.”

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