Ductal Carcinoma In Situ

What is ductal carcinoma in situ?

Ductal carcinoma in situ (DCIS) is breast cancer that has originated in the milk ducts-in situ in Latin means "in its original place". DCIS is not life-threatening, but it does increase your risk of developing an invasive breast cancer. The American Cancer Society reports there are more than 60,000 DCIS diagnoses annually, making DCIS the most common non-invasive type of breast cancer.

What are the signs and symptoms of DCIS?

DCIS generally does not present any symptoms, but there may be a noticeable lump or discharge from the nipple. Since there are not typically signs of DCIS, most cases are diagnosed through routine mammograms that women are recommended to have annually.

What are the causes and risk factors of DCIS?

The risk for developing DCIS increases with age. Since DCIS is rare in women under 40, preventive annual mammograms tend to start around the age of 40 for women. Prolonged exposure to estrogen and progesterone can also increase your risk. This risk factor is seen in women who have started their period very early, entered menopause late, or had children late in life. A family history of breast cancer can also increase your risk for developing DCIS. Baptist offers genetic counseling, if you or family members are concerned about your family history. Consuming more than the recommended amount of alcohol, as well as being obese, can increase your risk for developing DCIS.

How is DCIS diagnosed?

Baptist physicians use a variety of different procedures to diagnose DCIS, including mammography, physical examination of the breast, and biopsy. Physicians will generally use fine needle aspiration biopsy or core needle biopsy, depending on the sample cells needed to diagnose your cancer. If these biopsies prove to be inconclusive, your physician may use an incisional biopsy (removal of a small portion of the lump) or excisional biopsy (removal of entire lump of suspicious breast tissue).

Grade of DCIS

DCIS is considered stage 0, which is the earliest stage of cancer possible. Using the sample of abnormal cells collected from a biopsy, a pathologist will compare these cells to healthy breast tissue to better understand the grade of DCIS you have. There are three grades: low, moderate, and high. These grades will influence the treatment plan you and your physician agree on.

Hormone Receptor Status

While testing the breast tissue sample, the pathologist will test for hormone receptor status. Although testing DCIS for hormone receptors is considered a newer step in the diagnostic process, it is an important step for determining treatment plans. If the cancerous cells are receptive to estrogen and/or progesterone, this means the hormones are fueling the cancer's growth and you will likely need hormone therapy as part of your treatment plan.

How is DCIS treated at Baptist?

Each DCIS patient is unique, and their treatment plan will be personalized for their specific lifestyle, needs and any medical limitations. Common DCIS treatments include:

  • Lumpectomy
  • Lumpectomy and radiation therapy (this is the most common treatment)
  • Mastectomy
  • Hormone therapy*

Since DCIS is non-invasive, chemotherapy is generally not used in treatment plans, since other cells are not affected by the cancer.

*Hormone therapy is typically recommended if the patient's DCIS is positive for hormone receptors.