DCIS (Ductal Carcinoma in Situ)

DCIS is a noninvasive condition referring to abnormal cells in the lining of the breast duct that have not spread to other tissues. It is possible for DCIS to become invasive cancer and spread to other parts of the body, so treatment can reduce the likelihood of recurrence. DCIS is considered Stage 0, since it is noninvasive.

How is DCIS diagnosed?

DCIS can be diagnosed starting with a physical examination, though more often a lump may not be present with DCIS. The abnormal cells can also be detected with a mammogram, which shows the calcifications from old cancer cells dying off and piling up. If a patient has an abnormal mammogram, the doctor will perform a biopsy in which tissue is extracted and examined.

How is DCIS treated?

DCIS may be treated with breast-conserving surgery, which is often followed by radiation therapy. With breast-conserving surgery, only the DCIS and some normal tissue around it is removed, and this type of surgery often does not alter the appearance of the breast significantly. Breast-conserving surgery may also be called a lumpectomy, a partial mastectomy, breast-sparing surgery, or segmental mastectomy.

DCIS can also be treated with single or double mastectomy, another type of surgery in which the whole breast is removed.

The goal of radiation therapy is to keep the DCIS from returning to the same breast, and research has shown that the risk of recurrence is substantially reduced by radiation therapy in some patients. Your radiation oncologist will take into account age, size of tumor, other medical problems and degree of differentiation in the cells (microscopic appearance) before making a recommendation.. For patients with DCIS, radiation therapy would follow surgery. Radiation therapy can cause changes in the skin and increases the risk of developing secondary cancers in the future.

Patients may also have a recommendation for hormonal therapy. The goal is to decrease the likelihood of developing either further DCIS in or an invasive cancer.

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