Ductal Carcinoma In Situ (DCIS)
Ductal carcinoma in situ (DCIS) is non-invasive breast cancer that starts in the milk ducts. In situ means in its original place. 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.
According to the American Cancer Society, about 20% of new breast cancers are DCIS.
Symptoms of DCIS
DCIS generally has no symptoms. In some cases, DCIS may cause a lump or nipple discharge. But in most cases, DCIS is found by mammogram where it looks like small clusters of white spots.
Diagnosis of DCIS
Diagnosing DCIS involves a combination of procedures and almost always includes:
Other tests that may be used are:
DCIS is stage 0 breast cancer, the earliest stage possible.
Because all DCIS is stage 0, your doctor will also use the grade of the DCIS to decide on the best treatment options for you. The grade describes how much the cells look like healthy breast cells.
There are three grades of DCIS:
Low-grade or grade I DCIS cells look only a little bit different from healthy breast cells and grow slowly. Low-grade DCIS is less likely to come back (recur) than moderate- or high-grade DCIS.
Moderate-grade or grade II (also called intermediate-grade) DCIS cells look more different from health breast cells than low-grade DCIS and grow faster. Moderate-grade DCIS is more likely to come back than low-grade DCIS, but less likely to come back than high-grade DCIS.
High-grade or grade III DCIS cells look much different from healthy breast cells and tend to grow more quickly. High-grade DCIS has a higher risk of coming back than low- or moderate-grade DCIS. High-grade DCIS may be described as comedo or comedo necrosis, which means there are areas of dead cancer cells inside the DCIS.
Your doctor will likely do other tests to collect more information on the characteristics of the DCIS. These tests, as well as the results of your biopsy, make up the parts of your pathology report.
Information that may be part of your DCIS pathology report includes:
size of the DCIS
hormone receptor status
rate of cell growth (Ki-67 levels)
Treatment of DCIS
Standard treatments for DCIS are:
lumpectomy alone, if the DCIS is very small and low-grade
hormonal therapy, if the DCIS is hormone-receptor-positive
The Oncotype DX Breast DCIS Score Test can help you and your doctor decide if radiation would offer benefits after lumpectomy to remove the DCIS.
Survivorship care after DCIS treatment
Because of treatments they’ve received, many people who’ve been diagnosed with DCIS have a higher risk of developing other diseases as they age, including high blood pressure, heart disease, and osteoporosis. To make sure you’re regularly screened for these and other diseases, experts have developed the idea of survivorship care planning.
Survivorship care plans are written documents made up of two parts.
The first part is a treatment summary, a record of all the treatments you’ve received.
The second part is basically a roadmap of what you can expect in the years after treatment, including any late or long-term side effects you might have, and a schedule of how you’ll be monitored for these side effects and other health conditions. This part of the survivorship care plan usually includes:
the tests you’ll have
which doctors will order the tests
a schedule of when the tests will be done
healthy living recommendations
resources, if you need more information
Learn more at Before Treatment: Planning Ahead for Survivorship.
— Last updated on February 4, 2022, 5:35 PM