What is DCIS (Ductal Carcinoma in Situ)?

The development of abnormal cells in the milk duct present in the breast leads to a medical situation referred as DCIS (ductal carcinoma in situ). DCIS (ductal carcinoma in situ) can be considered as the initial stage of breast cancer. DCIS (ductal carcinoma in situ) is noninvasive in nature which means that the disorder did not spread out or affected other parts of the body. The presence of abnormal cells in breast can be detected during screening for breast cancer (mammogram) or in case of any discomfort in breast. With mammogram it has now become easy to detect occurrence of DCIS (ductal carcinoma in situ) more often in the last few years. Although DCIS (ductal carcinoma in situ) is not life threatening but it must be treated immediately to prevent it from becoming serious. So far radiation therapy and breast conserving surgery are best treatments options available for DCIS (ductal carcinoma in situ).

What is DCIS (Ductal Carcinoma in Situ)?

What is a DCIS (Ductal Carcinoma in Situ) Diagnosis?

The presence of occurrence of DCIS (ductal carcinoma in situ) in breast can be detected during screening for breast cancer (mammogram) or in case of any discomfort in breast. With mammogram it has now become easy to detect occurrence of DCIS (ductal carcinoma in situ) more often in the last few years.

What Does it Mean When ‘Breast Cancer is in Situ’?

“Carcinoma in situ” is a term used for Stage 0 cancer. Carcinoma stands for cancer and “in situ” stands for “in the original place.” There can be following three cases of “in situ carcinoma” in breast tissue:

  • LCIS or Lobular Carcinoma in Situ.
  • Paget disease of the nipple.
  • DCIS or Ductal Carcinoma in Situ.

What is Stage 0 DCIS (Ductal Carcinoma in Situ)?

DCIS (ductal carcinoma in situ) or stage 0 of breast cancer is one and the same and is one of the cases of non-invasive cancer in which the development of abnormal cells is restricted to only the lining of the breast milk duct and has not invaded the adjacent portions of the ducts. However it must be treated immediately to avoid it from becoming invasive or threatening.

Causes of DCIS (Ductal Carcinoma in Situ)

The root cause of DCIS (ductal carcinoma in situ) is still not known. All we know is that the development of abnormal cells is due to the mutation which causes these abnormal cells but the phenomenon is restricted to only to the region of breast duct. Researchers are still trying to find reasons for mutation and some experts think that various factors like genetics, lifestyle etc… may have something to do with mutation.

Signs and Symptoms of DCIS (Ductal Carcinoma in Situ)

The occurrence of signs and symptoms is very rare in DCIS (ductal carcinoma in situ) and includes one or more of the following:

  • Lump in the breast.
  • Discharge of blood through nipple.

In case of DCIS (ductal carcinoma in situ) the breast shows small clusters of calcifications of varying shapes and sizes during mammogram.

When to See a Doctor for DCIS (Ductal Carcinoma in Situ)

It is strongly recommended to seek doctor’s advice in case of any abnormality of discomfort in breast including lump, presence of puckered region or thickened region in breast, discharge of blood through nipple etc…

Refer to your doctor for the right time and frequency of screening for breast cancer suitable in your case. Usually experts recommend routine scanning for breast cancer after the age of 40 years.

  • Prepare a complete report comprising your medical issues including any minor or irregular problems in breast. If you have taken any radiation therapy then make sure to mention it too.
  • The occurrence of any case of breast cancer in family especially first degree relatives including sister or mother must be reported.
  • Prepare a complete list of any medicines, supplements, vitamins etc that you have been taking as it can have a role to play in DCIS (ductal carcinoma in situ). It must also include any hormone replacement therapy if undertaken.
  • It is always better to have someone from your family or close friends to accompany you during a doctor’s visit as the patent can be too tensed to effectively explain his condition or even grasp everything that doctor is saying.
  • Prepare the list of questions that you wish to ask to the doctor during the visit as it is very normal to forget about something you had in mind during the visit to the doctor.

During your visit to doctor, be prepared to answer one of more of the following questions related to DCIS (ductal carcinoma in situ):

  • Are you having menopause?
  • Have you used or been using any supplements of medications for suppressing symptoms of menopause?
  • Have you undergone any surgeries or treatments like breast biopsies?
  • Do you have any existing breast condition like noncancerous?
  • Do you have any other medical condition?
  • Is there anyone in your family suffering from breast cancer?
  • Have you or someone in your family have ever undergone any BRCA gene mutations test?
  • Have you undergone any radiation therapy?
  • What do you take in your daily diet including alcohol or anything else?
  • Do you exercise often?

Risk Factors for DCIS (Ductal Carcinoma in Situ)

The most common risk factors associated with DCIS (ductal carcinoma in situ) are as follows:

  • Higher age group is a risk factor for DCIS (ductal carcinoma in situ).
  • Any instance of some benign breast disease including atypical hyperplasia is a risk factor for DCIS (ductal carcinoma in situ).
  • Someone in the family having breast cancer is also a factor of risk for DCIS (ductal carcinoma in situ).
  • Obesity.
  • Getting pregnant after 30 years of age.
  • Exposure to estrogen-progestin hormone replacement therapy for a long duration of 3 years or more after menopause.
  • Any type of mutation in the genes most commonly in the breast cancer genes BRCA1 and BRCA2.

Complications in DCIS (Ductal Carcinoma in Situ)

DCIS (ductal carcinoma in situ) is regarded as the type 0 breast cancer as it is early stage of the breast cancer. As it is a very early stage of cancer, there are reliable methods of treatment available that can ensure with very high probability that it will not becoming life threatening. However as we have already discussed that there are no medications but only surgical methods are available for the treatment of DCIS (ductal carcinoma in situ), the complications associated with DCIS (ductal carcinoma in situ) are pretty much similar to the complications of any surgical methods.

With proper treatment and surgical removal of affected cells, the chances of survival are almost 100% and even the chances of recurring or spreading to other parts is minimal. At the most in rare cases if proper follow up medications is not taken, it can reoccur or can affect the other breast but again it happens rarely.

Tests to Diagnose DCIS (Ductal Carcinoma in Situ)

  1. Breast Imaging Test to Diagnose DCIS (Ductal Carcinoma in Situ)

    The initial testing for DCIS (ductal carcinoma in situ) is mammogram which involves screening for breast cancer. If any clusters of calcifications with variables shapes and sizes are spotted then it is an indication of DCIS (ductal carcinoma in situ). Hence in such case your radiologist would recommend additional tests related to breast imaging.

    The advanced diagnosis tests involves more detailed screening at specific angles to get a better view of the micro calcifications to actually decide if the there are any worrying signs or not. If the experts feel the need of further evaluation then he would usually recommend ultrasound and breast biopsy.

  2. Removing Breast Tissue Samples for Testing in DCIS (Ductal Carcinoma in Situ)

    Breast biopsy is carried out for obtaining breast tissue sample for testing. Various methods for biopsy are:

    • Core Needle Biopsy for Diagnosing DCIS (Ductal Carcinoma in Situ). In core needle biopsy method for diagnosing DCIS (ductal carcinoma in situ), the surgeon or radiologist make use of a hollow needle to suck the samples of breast tissue that can be analyzed in the lab. It can also be carried out with ultrasound referred as ultrasound guided breast biopsy.
    • Diagnosing DCIS (Ductal Carcinoma In Situ) Using Stereotactic Biopsy. It is a pretty similar approach as the previous one but in this the images obtained from mammogram screening is used to locate the area from where tissue sample is to be drawn using hollow syringe.
    • Surgical Biopsy (wide local excision or lumpectomy) for DCIS (Ductal Carcinoma In Situ). In this method for diagnosing DCIS (ductal carcinoma in situ), it involves a minor surgery to obtain the tissue sample for better analysis. However it is carried out only if the above two methods suggest any sign of DCIS (Ductal Carcinoma in Situ).

    Once the samples are obtained, pathologist look for the details to find out the nature and aggressiveness of the abnormalities of the micro calcifications observed during mammogram.

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Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: July 25, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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