What is Ductal Carcinoma In Situ?

Ductal Carcinoma In Situ (DCIS) is a non-invasive type of breast cancer. The term “in situ” means “in place,” indicating that the cancer cells are confined within the milk ducts and have not spread to surrounding breast tissue. DCIS is sometimes referred to as Stage 0 breast cancer, and while it is not life-threatening, it does increase the risk of developing invasive breast cancer later on.

With proper treatment, DCIS is highly treatable, and many people have an excellent prognosis.

Who is at Risk?

Several factors may increase the risk of developing DCIS:

• Age – Most common in women over 50.

• Family History – Having a family history of breast cancer can increase risk.

• Genetic Factors – Some genetic mutations, such as BRCA1 and BRCA2, can raise the risk.

• Lifestyle Factors – Excessive alcohol consumption, obesity, and hormone replacement therapy after menopause are linked to higher risk.

Treatment Options for DCIS

DCIS treatment aims to remove or control the abnormal cells to prevent them from becoming invasive. Common treatment options include:

1. Surgery

• Lumpectomy – Removal of the DCIS and a small margin of surrounding tissue. Often followed by radiation to reduce the risk of recurrence.

• Mastectomy – Complete removal of the affected breast. Recommended in cases where DCIS is widespread or if there are multiple areas of DCIS. Reconstruction surgery may be an option after a mastectomy.

2. Radiation Therapy

• Often recommended after a lumpectomy to target any remaining abnormal cells. Radiation reduces the likelihood of recurrence in the same breast.

How is DCIS Diagnosed?

DCIS is often found during routine mammograms before any symptoms appear. The diagnosis process typically includes:

1. Mammogram – DCIS often appears as small clusters of calcium deposits (microcalcifications) on mammograms.

2. Ultrasound or MRI – These imaging techniques may be used for further evaluation.

3. Biopsy – A small tissue sample is taken from the area of concern to confirm the diagnosis. A pathologist will examine the cells to determine whether they are cancerous and confined to the milk ducts.

3. Hormone (Endocrine) Therapy

• If DCIS is hormone-receptor-positive, hormone therapy (e.g., tamoxifen or aromatase inhibitors) may be recommended after surgery. This treatment helps lower the risk of developing DCIS or invasive breast cancer in the future.

4. Active Surveillance (Watchful Waiting)

• In select cases, particularly for low-grade DCIS, doctors may recommend active surveillance, involving regular monitoring with mammograms and physical exams. This approach is still being studied and may not be suitable for everyone.

Managing Life with DCIS

Side Effects of Treatment: Treatment side effects vary depending on the type of treatment. Common side effects include fatigue, changes in breast appearance, skin irritation from radiation, and potential hot flashes or joint pain with hormone therapy. Your healthcare team can help manage these effects.

Follow-up Care: After treatment, routine follow-up care with regular mammograms and clinical breast exams is essential to monitor for any signs of recurrence. Follow-up appointments are usually scheduled every six to twelve months for the first few years.

Lifestyle Support: A healthy lifestyle that includes a balanced diet, regular exercise, and stress management can improve overall well-being. Avoiding smoking and limiting alcohol consumption can also be beneficial for breast health.

Support and Resources

Living with DCIS can feel overwhelming, but there are resources and support networks available:

• Support Groups – Connecting with others who have had similar experiences can provide valuable support.

• Cancer Support Services – Hospitals often offer counseling, physical therapy, and nutrition support.

• You will have a Breast Care Nurse as part of your journey through breast cancer treatment. Their role is to guide you through the maze of appointments and treatments, to be a source of emotional and physical support and your point of contact for questions and concerns now and in the future.