Ductal Carcinoma in Situ (DCIS)

Overview

Carcinoma in situ  is a type of cancer that occurs when the cancerous cells have not spread beyond the original site of the cancer (non-invasive cancer). Ductal carcinoma in situ – or DCIS – occurs in a milk duct in the breast. Carcinoma in situ is also known as stage 0 disease.

Ductal carcinoma in situ causes

Ductal carcinoma in situ is caused by mutations (changes) to the DNA of cells of the milk duct in the breast.

Ductal carcinoma in situ risk factors

The following factors may increase your risk for developing ductal carcinoma in situ:

• Being older
• Having a family history of cancer
• Having a personal history of cancer
• Having genetic mutations related to breast cancer, including BRCA1 or BRCA2
• Having your first baby when you were older than 30
• Never having been pregnant
• Starting menopause after age 55
• Starting your menstrual period before you were 12

Ductal carcinoma in situ symptoms

Many people with ductal carcinoma in situ won’t experience any symptoms. When they do occur, they can include:

• A lump in the breast that can be felt with the fingers
• Bloody discharge from the nipple
• Fatigue
• Unexplained weight loss

Ductal carcinoma in situ diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

• Physical exam – your doctor will perform a complete physical exam, including asking questions about your health history, symptoms and related risk factors.
• Computerized tomography (CT) scan – this type of imaging test provides a 3-D image of the inside of the body that your doctor can use to determine if there is any cancer present.
• Biopsy – in this test, your doctor removes a biopsy (small tissue sample) from the suspicious area. This sample is sent to the laboratory, where a specialist closely checks the biopsy for abnormalities.
• Magnetic resonance imaging (MRI) – this type of imaging test uses high-powered magnets to create detailed images of the inside of your body. Your doctor can closely examine these images to look for any areas that could indicate cancer.

Ductal carcinoma in situ treatment

Depending on your personal health history, the extent of your ductal carcinoma in situ and other factors, your oncologist may recommend one or more of the following treatment options:

• Surgery – in most cases, your doctor will recommend a surgical procedure to remove the cancerous area. Types of surgery include lumpectomy (removal of the cancerous cells and a margin of healthy tissue) and mastectomy (removal of an entire breast). Your surgeon will work to preserve as much surrounding healthy tissue as possible. In some cases, you may opt to undergo reconstructive surgery following surgery to treat breast cancer.
• Chemotherapy – you may need to undergo chemotherapy to destroy any cancerous cells that couldn’t be removed surgically. During this treatment, medication is used to destroy cancerous cells. Chemotherapy can be taken via an oral (by mouth) pill or intravenously (through a vein).
• Hormone therapy – if you have hormone receptor-positive breast cancer, your oncologist may recommend you undergo hormone therapy for estrogen and progesterone.
• Radiation therapy – this treatment uses high-powered energy beams to destroy cancerous cells. You may need to undergo radiation therapy to destroy any cancerous cells that couldn’t be removed surgically.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.