Ductal carcinoma in situ (DCIS) is the earliest stage of breast cancer in which cancerous cells develop along the milk duct of the breast. While generally considered noninvasive, DCIS can turn into invasive cancer in about 20%-50% of cases.
Early diagnosis and treatment are crucial since DCIS can become invasive and spread if not treated.
How is DCIS detected and diagnosed?
Ductal carcinoma in situ (DCIS) does not cause particular symptoms, and most cases are diagnosed by routine mammograms before any symptoms appear.
On mammography, DCIS will almost always appear as new calcium deposits, although this is not always the case. Sometimes, a distorting of the breast tissue on the scan may indicate DCIS. As the cancer cells enter the milk duct, you may begin to experience itching and ulceration (formation of a sore).
DCIS can affect men as well. Since men do not undergo routine screening mammograms, DCIS may not be detected until bloody discharge or a lump in the nipple is noticed. Breast lumps in both men and women can be a sign of invasive cancer and must be evaluated immediately by a medical professional.
If calcifications are noticed on the mammogram, more tests will be ordered, one of which may be a breast biopsy. During a biopsy, samples of cells and tissues are removed for analysis under a microscope to determine whether they show signs of cancer.
A stereotactic core needle biopsy may be used to detect DCIS. This is a nonsurgical technique that may be done as an outpatient procedure. After administering an anesthetic to numb the breast area, cells from the area of concern are collected using a needle while mammography is used to guide the procedure.
When does DCIS turn into invasive cancer?
In some cases, ductal carcinoma in situ (DCIS) can spread to other tissues. Because of this, nearly all women who have been diagnosed with DCIS receive some treatment for the condition. This is because there is the possibility that a small percentage of the lesions could become invasive.
After the cancer has been surgically removed along with DCIS, there is a remote chance that invasive cancer may be discovered during the final pathology investigation. When this occurs, the diagnosis will be revised. More surgery and therapies may be required.
What are treatment options for DCIS?
If you are diagnosed with ductal carcinoma in situ (DCIS), you may have the option of undergoing either breast-conserving surgery (BCS) or a straightforward mastectomy. However, if DCIS has turned invasive and spread across the breast, a mastectomy may be the best course of treatment.
Clinical trials are underway to determine whether the alternative of observation rather than surgery is viable for certain women.
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American Cancer Society. Ductal Carcinoma In Situ (DCIS). https://amp.cancer.org/cancer/breast-cancer/about/types-of-breast-cancer/dcis.html
Sun B. Ductal Carcinoma in Situ (DCIS). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/breast-cancer/ductal-carcinoma-in-situ?amp=true
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