DCIS (ductal carcinoma in situ) is the most common form of non-invasive breast cancer and is considered stage 0 cancer. While DCIS isn’t considered life threatening, it does increase the risk of developing invasive breast cancer later in life.
DCIS usually is found when a biopsy is done on a suspicious area found by a mammogram. As old cancer cells die off and pile up, tiny specks of calcium (called "calcifications" or "microcalcifications") form within the broken-down cells. The mammogram will show the cancer cells inside the ducts as a cluster of these microcalcifications, which appear either as white specks or as a shadow. Most of the time, you don’t feel DCIS as a lump. If the biopsy results find DCIS, doctors want to remove the whole area of concern to make sure the DCIS has been removed completely. It’s most important to know if there’s any evidence of invasive cancer.
DCIS usually is treated with surgery to remove the cancer -- in most cases a lumpectomy, even though DCIS doesn’t usually form a lump. After lumpectomy, many women have radiation therapy to the rest of the breast. Radiation reduces the risk of an invasive cancer and also helps reduce the risk of DCIS coming back (recurrence). If the DCIS is hormone-receptor-positive (most are), hormonal therapy also may be recommended after lumpectomy.
Experts agree radiation does reduce the risk of DCIS recurrence. Still, some earlier studies have found a link between whole breast radiation and a higher risk of heart and lung problems, especially if the DCIS is in the left breast. More recent studies suggest that modern radiation techniques are less likely to cause heart problems than radiation therapy techniques used 20 or more years ago.
To provide more information, researchers wanted to know if women who had been treated for DCIS with surgery and radiation had higher death rates from any cause than women who hadn’t been treated for DCIS.
The results suggest that women treated for DCIS actually live longer than women who haven’t been diagnosed with DCIS.
The study, “Low cause-specific mortality in women treated for ductal carcinoma in situ of the breast,” was presented at the European Cancer Congress on Jan. 27, 2017.
In the study, done in the Netherlands, the researchers compared death rates for 10 years after treatment among 9,799 women treated for DCIS with surgery and radiation therapy to death rates among the general female population.
Overall, women treated for DCIS had a 10% lower risk of dying from any cause compared to women with no history of the disease. The women who had been diagnosed with DCIS did have a higher risk of dying from breast cancer, but a lower risk of dying from most other conditions and other cancers.
"Being diagnosed with DCIS can be extremely distressing, and research indicates that many women overestimate the risks involved and are confused about treatment," said Lotte Elshof, M.D., of the Netherlands Cancer Institute, who presented the research. "This study should provide reassurance that a diagnosis of DCIS does not raise the risk of dying."
The researchers speculated that women who had been treated for DCIS lived longer because they may be more health conscious and had other healthy habits.
If you’ve been diagnosed with DCIS, the goal is to provide you with the best treatment for your unique situation. This takes into account:
- your family history of breast cancer and other diseases
- your personal health history
- any other breast cancer risk factors you may have
- your preferences
- the characteristics of the DCIS
- any genomic test results
Together, you and your doctor will develop a treatment plan that makes the most sense for you. For more information, visit the Breastcancer.org DCIS pages.