What is ductal carcinoma in situ?
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 to invade other parts of the breast.
DCIS is usually found during a mammogram done as part of breast cancer screening or when there is another concern with a woman’s breast. Because of increased screening with mammograms, the rate at which DCIS is diagnosed has increased dramatically in recent years.
While DCIS isn’t life-threatening, it does require treatment to prevent the condition from becoming invasive. Most women with DCIS are effectively treated with breast-conserving surgery and radiation.
How common is ductal carcinoma in situ?
DCIS accounts for 1 of every 5 new breast cancer diagnoses. Please discuss with your doctor for further information.
What are the symptoms of ductal carcinoma in situ?
DCIS doesn’t cause any signs or symptoms in most cases. However, DCIS can sometimes cause signs and symptoms, such as:
- A breast lump
- Bloody nipple discharge
DCIS is usually found on a mammogram and appears as small clusters of calcifications that have irregular shapes and sizes.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes ductal carcinoma in situ?
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.
Researchers don’t know exactly what triggers the abnormal cell growth that leads to DCIS. It’s likely that a number of factors may play a part, including genes passed to you from your parents, your environment and your lifestyle.
What increases my risk for ductal carcinoma in situ?
There are many risk factors for ductal carcinoma in situ, such as:
- Increasing age
- Personal history of benign breast disease, such as atypical hyperplasia
- Family history of breast cancer
- First pregnancy after age 30
- Taking combination estrogen-progestin hormone replacement therapy for more than three to five years after menopause
- Genetic mutations that increase the risk of breast cancer, such as in the breast cancer genes BRCA1 and BRCA2
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is ductal carcinoma in situ diagnosed?
This type of cancer doesn’t usually cause a lump in the breast that can be felt. Symptoms of DCIS include breast pain and a bloody discharge from the nipple. About 80% of cases are found by mammograms. On the mammogram, it appears as a shadowy area.
If your mammogram suggests that you may have DCIS, your doctor should order a biopsy to analyze the cells and confirm the diagnosis. Biopsies for DCIS are typically done using needles to remove tissue samples from the breast.
If you have DCIS, your doctor may order more tests to gather information about your cancer. These tests may include an ultrasound or MRI. Based on the results of various tests, your doctor will be able to tell the size of your tumor and how much of your breast is affected by cancer.
How is ductal carcinoma in situ treated?
No two patients are the same. Your doctor will customize your treatment plan based on your test results and medical history. Among other things, your doctor will consider:
- Tumor location
- Tumor size
- Aggressiveness of the cancer cells
- Your family history of breast cancer
- Results of tests for a gene mutation that would increase the risk of breast cancer
Most women with DCIS don’t have the breast removed with a mastectomy. Instead, they have breast-conserving surgery.
Most common is a lumpectomy followed by radiation. In a lumpectomy, the surgeon removes the cancer and a small area of healthy tissue around it. The tissue is taken to make sure all the cancer cells have been removed. Lymph nodes under the arm don’t need to be removed as they are with other types of breast cancer.
After lumpectomy, radiation significantly reduces the likelihood that the cancer will come back. If cancer does return, it’s called recurrence. Radiation can be given to the entire breast, or it can be taken internally to target certain areas of the breast.
Some women with an extremely low likelihood of cancer recurrence may have a lumpectomy only. This may be an option for older women with small tumors whose surgery showed large amounts of healthy tissue on all sides of the cancer. Discuss the risks of not having radiation with your doctor before deciding against it.
You and your doctors may decide that a mastectomy to remove the breast is the best course of treatment if you have any of the following:
- A strong family history of breast cancer
- A gene mutation that increases the risk of breast cancer
- Very large areas of DCIS
- DCIS lesions located in multiple areas throughout your breast
- Inability to tolerate radiation therapy
You and your treatment team may also consider the use of hormone therapy. It may reduce the risk of invasive breast cancer not only in the breast with cancer, but in the opposite breast as well. This risk reduction continues even after you stop taking the medication.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage ductal carcinoma in situ?
The following lifestyles and home remedies might help you cope with ductal carcinoma in situ :
- 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 National Cancer Institute, to find out more. This may help you feel more confident as you make choices about your care.
- Get support when needed. Don’t be afraid to ask for help or to turn to a trusted friend when you need to share your feelings and concerns. Talk with a counselor or medical social worker if you need a more objective listener. Join a support group — in your community or online — of women going through a situation similar to yours.
- Control what you can about your health. Make healthy changes to your lifestyle, so you can feel your best. Choose a healthy diet that focuses on fruits, vegetables and whole grains. Try to be active for 30 minutes most days of the week. Get enough sleep each night so that you wake feeling rested. Find ways to cope with stress in your life.
If you have any questions, please consult with your doctor to better understand the best solution for you.
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