Ductal carcinoma in situ

The presence of abnormal cells within a milk duct in the breast is known as ductal carcinoma in situ (DCIS). The first stage of breast cancer is known as DCIS. DCIS has a low probability of becoming invasive because it hasn’t moved outside of the milk duct and is noninvasive.

In order to explore a breast lump or as part of breast cancer screening, DCIS is frequently discovered during a mammography. DCIS needs to be evaluated and treatment alternatives must be taken into account even though it isn’t an emergency. Surgery to remove all of the breast tissue or radiation therapy may be used as a kind of treatment. Another choice would be a clinical trial looking at active monitoring as an alternative to surgery.

DCIS cannot spread (metastasize) outside of the breast to other regions of the body since it hasn’t migrated into the breast tissue around it.

DCIS, however, can occasionally progress to aggressive malignancy. At that point, the cancer has left the duct and entered the adjacent tissue; from there, it may have migrated to other regions of the body.

Almost all women with DCIS will receive treatment because there is currently no reliable technique to determine which cases will develop into invasive cancer and which ones won’t.

Symptoms 

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.

Causes 

What causes DCIS is unclear. DCIS develops when breast duct cells’ DNA experiences genetic alterations. Although the cells have genetic alterations that make them appear aberrant, they are not yet able to escape the breast duct.

The precise cause of the aberrant cell development that causes DCIS is unknown. Your lifestyle, your surroundings, and the genes your parents passed down to you are some of the variables that might be at play.

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 of DCIS

A woman with DCIS typically has the option of either breast-conserving surgery (BCS) or a straightforward mastectomy. Usually, BCS is followed by radiation. If the DCIS is hormone-receptor positive, using tamoxifen or an aromatase inhibitor following surgery may potentially be an option.