Ductal Carcinoma in Situ

Ductal carcinoma in situ (DCIS) is the earliest stage of breast cancer. DCIS is noninvasive breast cancer.

DCIS starts in the tubes (ducts) of the breast that carry milk. DCIS does not spread outside these tubes. This type of cancer stays in the area it first began (in situ). This means the risk of the cancer spreading to lymph nodes and to other parts of the body is much lower.

DCIS is not life-threatening. But it can increase a patient's risk of getting breast cancer (invasive) that spreads to other areas.

Symptoms

DCIS doesn't cause any symptoms in most people. In rare cases, the you may notice:

  • A breast lump
  • Bloody nipple or discharge


Causes and Risk Factors

Certain genetic mutations are linked to an increased risk of DCIS. These mutations are known as breast cancer genes BRCA1 and BRCA2.

Here are other risk factors that increase your risk of breast cancer:

  • Age
  • A history of benign breast disease
  • A family history of breast cancer
  • First pregnancy after age 30
  • Obesity
  • Using estrogen-progestin hormone replacement therapy for more than five years after menopause

Diagnosis

DCIS is most often found during a routine mammogram as a group of calcifications. If the medical team finds DCIS during the mammogram, a biopsy will be performed.

During a biopsy, a small piece of the abnormal tissue will be removed using a needle. The doctor may use stereotactic images, such as mammography, to guide the needle to the area. A specialist, known as a pathologist, will study the tissue to see if it is cancer.

Treatments

Treatment often has a high rate of success in getting rid of the DCIS and stopping the disease from returning. Treatment will depend on each patient’s personal circumstances.

The most common treatment is a lumpectomy. This removes the affected tissue while preserving as much of the natural breast as possible. This is generally followed by radiation therapy.

A mastectomy may be needed in some cases if there is a large amount of DCIS. This removes all of the breast tissue. There are different forms of mastectomy surgeries, such as:

  • Nipple-sparing
  • Skin-sparing
  • For most patients, a lumpectomy with radiation therapy can be just as effective as a mastectomy. A mastectomy may be needed if:
  • The area of DCIS is large
  • The DCIS affects multiple spots
  • The patient can’t use radiation therapy