Abstract Ductal carcinoma in situ (DCIS) now represents 20–25% of all ‘breast cancers’ consequent upon detection by population-based breast cancer screening programmes. Currently, all DCIS lesions are treated, and treatment comprises either mastectomy or breast-conserving surgery supplemented with radiotherapy.
Is DCIS really cancer?
DCIS is considered a pre-cancer because sometimes it can become an invasive cancer. This means that over time, DCIS may spread out of the ducts into nearby tissue, and could metastasize. Currently, there’s no good way to predict which will become invasive cancer and which won’t. Therefore, almost all women with DCIS will be treated.
How serious is invasive ductal carcinoma?
Invasive ductal carcinoma describes the type of tumor in about 80 percent of people with breast cancer. The five-year survival rate is quite high -- almost 100 percent when the tumor is caught and treated early. Once the cancer has metastasized to distant organs like the bones or liver, the five-year survival rate drops by almost three fourths.
Why is DCIS not cancer?
DCIS is stage 0: It has not spread outside a breast duct (where virtually all breast cancer begins) into the surrounding breast tissue. For this reason, DCIS is often referred to as a precancer. If left untreated, some DCIS lesions go on to become invasive cancers, while others remain a harmless precancer and never leave the duct.
Is DCIS considered cancer?
Ductal carcinoma in situ (DCIS)—or stage 0 breast cancer —is considered a non-invasive or pre-invasive cancer diagnosis, the American Cancer Society says. The cancer still needs to be treated, however, to ensure that it doesn't turn into invasive cancer.
What is the best treatment for ductal carcinoma in situ?
Radiation therapy Treatment of DCIS has a high likelihood of success, in most instances removing the tumor and preventing any recurrence. In most people, treatment options for DCIS include: Breast-conserving surgery (lumpectomy) and radiation therapy. Breast-removing surgery (mastectomy)
What stage cancer is ductal carcinoma in situ?
DCIS is also called intraductal carcinoma or stage 0 breast cancer. DCIS is a non-invasive or pre-invasive breast cancer. This means the cells that line the ducts have changed to cancer cells but they have not spread through the walls of the ducts into the nearby breast tissue.
How serious is ductal carcinoma in situ?
DCIS is non-invasive because it hasn't spread beyond the milk ducts into other healthy tissue. DCIS isn't life-threatening, but if you're diagnosed with DCIS, you have a higher-than-average risk of developing invasive breast cancer later in life.
What is the treatment for DCIS stage 0?
Surgery is the main treatment for DCIS. Most women are offered breast-conserving surgery. If there are several areas of DCIS in the breast, doctors may do a mastectomy to make sure that all of the cancer is removed.
Do I need a mastectomy for DCIS?
Most women with DCIS or breast cancer can choose to have breast-sparing surgery, usually followed by radiation therapy. Most women with DCIS or breast cancer can choose to have a mastectomy. You have small breasts and a large area of DCIS or cancer. You have DCIS or cancer in more than one part of your breast.
Is ductal carcinoma in situ really cancer?
Ductal carcinoma in situ (DCIS) is a condition that affects the cells of the milk ducts in the breast. The cells lining the milk ducts turn malignant (cancerous) but stay in place (in situ). DCIS is an early form of breast cancer.
How fast does ductal carcinoma in situ grow?
It assumes that all breast carcinomas begin as DCIS and take 9 years to go from a single cell to an invasive lesion for the slowest growing lesions, 6 years for intermediate growing DCIS lesions, and 3 years for fast-growing DCIS lesions.
What is the survival rate for ductal carcinoma in situ?
Although DCIS doesn't pose any risk, it can turn invasive and spread to other tissues at any time. The five-year survival rate of ductal carcinoma in situ (DCIS), also known as stage 0 breast cancer, is over 98 percent.
What causes ductal carcinoma in situ?
DCIS forms when genetic mutations occur in the DNA of breast duct cells. The genetic mutations cause the cells to appear abnormal, but the cells don't yet have the ability to break out of the breast duct. Researchers don't know exactly what triggers the abnormal cell growth that leads to DCIS.
How many radiation treatments are needed for DCIS?
A typical course of radiation treatment for DCIS involves 16 sessions given over three weeks.
Can DCIS spread after biopsy?
Because DCIS is not an invasive cancer and cannot spread to other parts of the body, whole body treatments, like chemotherapy, are not indicated for this stage of disease.
Is DCIS 100 curable?
Many women — perhaps assuming all breast cancers are dangerous — may believe that removing the healthy breast after a diagnosis of DCIS improves their chances of survival. But DCIS is nearly 100 percent curable.
What is the treatment for DCIS?
In most people, treatment options for DCIS include: Breast-conserving surgery (lumpectomy) and radiation therapy. Breast-removing surgery (mastectomy) In some cases, treatment options may include: Lumpectomy only.
What is DCIS on a mammogram?
DCIS is most often discovered during a mammogram used to screen for breast cancer. If your mammogram shows suspicious areas such as bright white specks (microcalcifications) that are in a cluster and have irregular shapes or sizes, your radiologist likely will recommend additional breast imaging. You may have a diagnostic mammogram, which takes ...
What is radiation therapy after lumpectomy?
Radiation therapy after lumpectomy reduces the chance that DCIS will come back (recur) or that it will progress to invasive cancer.
What is a calcification on a mammogram?
Calcifications are small calcium deposits in the breast that show up as white spots on a mammogram. Large, round or well-defined calcifications (shown left) are more likely to be noncancerous (benign). Tight clusters of tiny, irregularly shaped calcifications (shown right) may indicate cancer.
What is lumpectomy surgery?
A lumpectomy involves removing the cancer and some of the healthy tissue that surrounds it. This illustration shows one possible incision that can be used for this procedure, though your surgeon will determine the approach that's best for your particular situation.
What is clinical trial?
Clinical trials are studying new strategies for managing DCIS, such as close monitoring rather than surgery after diagnosis. Whether you're eligible to participate in a clinical trial depends on your specific situation. Talk with your doctor about your options.
Can alternative medicine cure DCIS?
Alternative medicine. No alternative medicine treatments have been found to cure DCIS or to reduce the risk of being diagnosed with an invasive breast cancer. Instead, complementary and alternative medicine treatments may help you cope with your diagnosis and the side effects of your treatment, such as distress.
How to treat invasive ductal carcinoma?
Invasive Ductal Carcinoma Treatment. Most women with IDC have surgery to remove the cancer. The treatment options are usually: Lumpectomy: The surgeon only removes the tumor and a bit of the tissue around it to help make sure all the cancer cells have been removed. You might hear it called breast-conserving surgery.
What are the different types of ductal carcinoma?
There are two types: 1 Invasive ductal carcinoma (IDC) 2 Ductal carcinoma in situ (DCIS), also called intraductal carcinoma
What is the name of the cancer that starts in the milk ducts?
Ductal carcinoma is a common type of breast cancer that starts in cells that line the milk ducts, which carry breast milk to the nipple. The symptoms, diagnosis, and treatments for each are different.
What is intraductal carcinoma?
Ductal Carcinoma in Situ (DCIS), also known as intraductal carcinoma, accounts for one of every five new breast cancer diagnoses. It's an uncontrolled growth of cells within the breast ducts. It’s noninvasive, meaning it hasn’t grown into the breast tissue outside of the ducts.
How many women with DCIS get invasive cancer?
Research shows that the risk of getting invasive cancer is low if you’ve been treated for DCIS. If it isn’t treated, 30% to 50% of women with DCIS will get invasive cancer. The invasive cancer usually develops in the same breast and in the same area as where the DCIS happened. Continued.
How big is a breast cancer tumor?
It’s larger than 0.2 mm but less than 2 mm in size. There’s either no sign of a tumor in the breast or there is, but it’s 20 mm or smaller (T0 or T1, N1, M0). There’s no sign of a tumor in the breast. The cancer has spread to between 1 and 3 underarm lymph nodes, but not to any distant body parts (T0, N1, M0).
What is stage IV breast cancer?
Stage IV (metastatic): The tumor can be any size and has spread to other organs, like your bones, lungs, brain, liver, distant lymph nodes, or chest wall (any T, any N, M1). Between 5% and 6% of the time, metastatic cancer is discovered upon first diagnosis. Your doctor may call this de novo metastatic breast cancer.
What is a DCIS?
Ductal carcinoma in situ (DCIS) is the presence of abnormal cells inside a milk duct in the breast. DCIS is considered the earliest form of breast cancer. DCIS is noninvasive, meaning it hasn't spread out of the milk duct and has a low risk of becoming invasive. DCIS is usually found during a mammogram done as part of breast cancer screening ...
What causes DCIS in breast?
It's not clear what causes DCIS. DCIS forms when genetic mutations occur in the DNA of breast duct cells. The genetic mutations cause the cells to appear abnormal, but the cells don't yet have the ability to break out of the breast duct.
What are the risks of breast cancer?
Factors that may increase your risk of DCIS include: 1 Increasing age 2 Personal history of benign breast disease, such as atypical hyperplasia 3 Family history of breast cancer 4 Never having been pregnant 5 Having your first baby after age 30 6 Having your first period before age 12 7 Beginning menopause after age 55 8 Genetic mutations that increase the risk of breast cancer, such as those in the breast cancer genes BRCA1 and BRCA2
What to do if you have a lump under your breast?
Make an appointment with your doctor if you notice a change in your breasts, such as a lump, an area of puckered or otherwise unusual skin, a thickened region under the skin, or nipple discharge. Ask your doctor when you should consider breast cancer screening and how often it should be repeated.
Is DCIS an emergency?
While DCIS isn't an emergency, it does require an evaluation and a consideration of treatment options. Treatment may include breast-conserving surgery combined with radiation or surgery to remove all of the breast tissue. A clinical trial studying active monitoring as an alternative to surgery may be another option.
How is DCIS diagnosed?
If a doctor sees the calcifications on your mammogram, he or she will recommend more tests, which could include a breast biopsy. During the biopsy, a doctor or other health care provider takes samples of cells or tissues from your body. The cells are examined by a pathologist — a doctor who checks for signs of disease in body tissues.
What is the treatment for DCIS?
Lumpectomy with radiation. The standard treatment is breast-preserving surgery (a lumpectomy) with radiation therapy, which results in successful outcomes for most patients. Cancers can be larger than expected, so about 20% of the time, patients need a re-excision lumpectomy — another surgery — to remove all of the cancer.
What should I expect after a DCIS diagnosis?
The outlook after DCIS diagnosis, Sun says, is encouraging. “With continued, rigorous monitoring, the prognosis for DCIS is excellent,” she explains. “Your doctor will recommend a regular screening schedule to guard against recurrence in the original breast, and to monitor the other breast for any signs of malignancy.
What is the first treatment for DCIS?
Surgery is nearly always the first treatment for DCIS, and it is very effective. There are two types of surgery used for DCIS. The less-invasive option is a lumpectomy, in which a surgeon removes the area that’s abnormal as well as a little bit of the normal tissue around it. This is called a margin.
What is DCIS in breast?
Ductal carcinoma in situ (DCIS) is a common type of breast cancer , but many patients are confused about their treatment options for the disease. MSK surgeon Melissa Pilewskie explains that surgery is nearly always the recommended treatment, sometimes followed by radiation and possibly hormone therapy as well.
What is a high grade DCIS?
High-grade DCIS cells are the most abnormal and grow the fastest. Hormone-receptor status refers to whether the cancer cells have receptors for estrogen, progesterone, or both.
What is stage 0 breast cancer?
It has the word “carcinoma” in the name, and it is classified as stage 0 cancer. DCIS refers to abnormal cells that are confined to the milk ducts. These cells have not yet spread into the surrounding normal breast tissue and cannot spread elsewhere in the body. It’s more of a precancer, or preinvasive lesion.
How to detect DCIS?
Most DCIS is detected from a mammogram that shows abnormal calcifications (small deposits of calcium) in the breast. The doctor may need to conduct additional imaging tests, such as ultrasound or MRI. These are used to determine the full extent of the disease.
What is the hardest decision to make after lumpectomy?
Probably the hardest decision faced by women with DCIS is whether to have one of these additional treatments after a lumpectomy. A lot of factors must be considered, including the size and grade of the DCIS, how close the DCIS cells were to the final margin, and the age of the person at diagnosis.
Can a DCIS be lumped?
Most women with DCIS undergo a lumpectomy, possibly followed by additional treatments. In some cases, a mastectomy is recommended, especially if the DCIS covers a large area or appears in multiple spots throughout the breast. With either of these surgeries, the survival rate is excellent.
What is a Lumpectomy for DCIS?
Lumpectomy for DCIS is usually followed by whole breast radiation therapy to lower the risk of [ 6-13 ]: DCIS recurrence (a return of DCIS) in the treated breast. Invasive breast cancer in the treated breast.
Why is DCIS called in situ?
It’s called “in situ” (which means “in place”) because the cells have not left the milk ducts to invade nearby breast tissue. DCIS is also called intraductal (within the milk ducts) carcinoma. You may hear the terms “pre-invasive” or “pre-cancerous” to describe DCIS. DCIS is treated to try to prevent the development of invasive breast cancer.
How do pathologists determine the hormone receptor status of a DCIS tumor?
A pathologist determines the hormone receptor status of the DCIS by testing the tissue removed during a biopsy. Hormone receptor-positive (estrogen receptor-positive/progesterone receptor-positive) DCIS tumors express hormone receptors. This means they have a lot of hormone receptors..
How to treat DCIS?
Surgery is the first step to treat DCIS. It removes the abnormal tissue from the breast. Depending on how far the DCIS has spread within the milk ducts, surgery can be mastectomy or lumpectomy. If DCIS is spread throughout the ducts, affecting a large part of the breast, a total (simple) mastectomy will be done.
Can a lumpectomy be done with DCIS?
If there’s little spread of DCIS within the ducts, a choice can be made between mastectomy or lumpectomy. With lumpectomy, the surgeon removes only the abnormal tissue in the breast and a small rim of normal tissue around it. The rest of the breast is left intact.
Can you get DCIS without radiation?
Because DCIS might progress to invasive breast cancer, almost all cases of DCIS are treated. Surgery (with or without radiation therapy) is recommended to treat DCIS. After surgery and radiation therapy, some people take hormone therapy. Learn more about treatments for DCIS. Learn about the risk of invasive breast cancer after treatment for DCIS.
Can DCIS progress to breast cancer?
DCIS is non-invasive, but without treatment, the abnormal cells could progress to invasive cancer over time. Left untreated, it’s estimated 20-50 percent of DCIS cases may progress to invasive breast cancer [ 1-5 ]. Health care providers cannot predict which cases of DCIS will progress to invasive breast cancer ...
What is in situ carcinoma?
What is in-situ carcinoma (or carcinoma in situ) of the breast? This term is used for the earliest stage of breast cancer, when it is confined to the layer of cells where it began. The normal breast is made of tiny tubes (ducts) that end in a group of sacs (lobules).
What is a low grade DCIS?
DCIS that is low grade, is nuclear grade 1, or has a low mitotic rate is less likely to come back after surgery. DCIS that is intermediate grade, is nuclear grade 2, or has an intermediate mitotic rate falls in between these two. Patients with higher grade DCIS may need additional treatment.
What is it called when a tumor breaks out?
Once the carcinoma cells have grown and broken out of the ducts or lobules, it is called invasive or infiltrating carcinoma. In an invasive carcinoma, the tumor cells can spread (metastasize) to other parts of your body.
Can DCIS come back after surgery?
Later, when the entire area of DCIS is removed (with surgery), an accurate measurement can be done. The larger the area of DCIS, the more likely it is to come back (recur) after surgery. Doctors use information about the size of the DCIS when recommending further treatments.
Can DCIS be left untreated?
Still, we don’t really understand it well. We don’t think that all DCIS would go on to become invasive cancer, but we can’t tell which DCIS would be safe to leave untreated.
Diagnosis
Treatment
- Treatment of DCIS has a high likelihood of success, in most instances removing the tumor and preventing any recurrence. In most people, treatment options for DCIS include: 1. Breast-conserving surgery (lumpectomy) and radiation therapy 2. Breast-removing surgery (mastectomy) In some cases, treatment options may include: 1. Lumpectomy only 2. Lumpec...
Clinical Trials
- Explore Mayo Clinic studiestesting new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Alternative Medicine
- No alternative medicine treatments have been found to cure DCIS or to reduce the risk of being diagnosed with an invasive breast cancer. Instead, complementary and alternative medicine treatments may help you cope with your diagnosis and the side effects of your treatment, such as distress. If you're distressed, you may have difficulty sleeping and find yourself constantly thinki…
Coping and Support
- A diagnosis of DCIS can be overwhelming and frightening. To better cope with your diagnosis, it may be helpful to: 1. Learn enough about DCIS to make decisions about your care. Ask your doctor questions about your diagnosis and your pathology results. Use this information to research your treatment options. Look to reputable sources of information, such as the Nationa…
Preparing For Your Appointment
- Make an appointment with your doctor if you notice a lump or any other unusual changes in your breasts. If you have already had a breast abnormality evaluated by one doctor and are making an appointment for a second opinion, bring your original diagnostic mammogram images and biopsy results to your new appointment. These should include your mammography images, ultrasound …
Overview
- Ductal carcinoma in situ (DCIS) is the presence of abnormal cells inside a milk duct in the breast. DCIS is considered the earliest form of breast cancer. DCIS is noninvasive, meaning it hasn't spread out of the milk duct and has a low risk of becoming invasive. DCIS is usually found during a mammogram done as part of breast cancer screening or to ...
Symptoms
Causes
Risk Factors
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