Ductal Carcinoma in situ (DCIS)

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 non-invasive, meaning it hasn't spread out of the milk duct and has a low risk of becoming invasive. DCIS is usually found during a mammogram done as part of breast cancer screening or to investigate a breast lump.

Ductal carcinoma in situ (DCIS) is non-invasive breast cancer. Ductal means that the cancer starts inside the milk ducts, carcinoma refers to any cancer that begins in the skin or other tissues (including breast tissue) that cover or line the internal organs, and in situ means "in its original place." DCIS is called "non-invasive" because it hasn’t spread beyond the milk duct into any normal surrounding breast tissue. DCIS isn’t life-threatening, but having DCIS can increase the risk of developing an invasive breast cancer later on.

When you have had DCIS, you are at higher risk for the cancer coming back or for developing a new breast cancer than a person who has never had breast cancer before. Most recurrences happen within the 5 to 10 years after initial diagnosis. The chances of a recurrence are under 30%. While DCIS isn't an emergency, it does require an evaluation and a consideration of treatment options. Treatment may include breast-conserving surgery combined with radiation or surgery to remove all of the breast tissue. A clinical trial studying active monitoring as an alternative to surgery may be another option.

DCIS doesn't typically have any signs or symptoms. However, DCIS can sometimes cause signs 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.

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. Factors that may play a part include your lifestyle, your environment and genes passed to you from your parents.

Risk factors

Factors that may increase your risk of DCIS include:

• Increasing age
• Personal history of benign breast disease, such as atypical hyperplasia
• Family history of breast cancer
• Never having been pregnant
• Having your first baby after age 30
• Having your first period before age 12
• Beginning menopause after age 55

Genetic mutations that increase the risk of breast cancer, such as those in the breast cancer genes BRCA1 and BRCA2

Treatment

Ductal carcinoma in situ (DCIS) means the cells that line the milk ducts of the breast have become cancer, but they have not spread into surrounding breast tissue. DCIS is considered non-invasive or pre-invasive breast cancer. DCIS can’t spread outside the breast, but it still needs to be treated because it can sometimes go on to become invasive breast cancer (which can spread). In most cases, a woman with DCIS can choose between Breast-Conserving Surgery (BCS) and simple mastectomy. But sometimes a mastectomy might be a better option.

Journal of Women’s Health and Reproductive Medicine is an interdisciplinary journal that explores clinical, medical, social and economic aspects of female reproductive health and medication worldwide.

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Journal of Women’s Health and Reproductive Medicine
Email: womenshealth@emedscholar.com