Simply put, ductal carcinoma in situ is the earliest form of breast cancer where the abnormal cells form a growing in the milk duct of the breast by multiplying though it has not yet spread to any other part of the breast. This condition is also known as intraductal carcinoma and is considered to be a non invasive pre-cancer or stage 0 breast cancer.
The term ‘intraductal’ means that the abnormal cells are located in the milk ducts of the breast. The term ‘in situ’ means in place and refers to the fact that the abnormal growth has not yet moved from the breast to the surrounding tissue.
Ductal carcinoma in situ is not a cancer according to many experts
While some experts think of DCIS as stage zero breast cancer while others have opined that it is not a cancer at all.
This is a condition that is not harmful in itself, but one that raises the risk of actual or invasive breast cancer occurring.
In fact some of the experts who apportioned the name ductal carcinoma in situ have been known to regret the inclusion of the term ‘carcinoma’ in the name, since it can be falsely alarming and even misleading.
Only an estimated 2% of those with DCIS undergo metastases that result in harmful cancers.
How is DCIS detected?
Many of the time, this condition is asymptomatic, however when there are any symptoms of ductal carcinoma in situ, they may be a breast lump and / or nipple discharge. In fact a lump that can be felt is rarely observed. Usually this condition is only detected by way of a mammogram and sometimes not even then.
A mammogram can reveal the micro calcifications that indicate that there is some abnormality in the breast – these show up as very small white specks or clusters in the mammogram, which are irregularly shaped.
Treatment for DCIS
A majority of women with ductal carcinoma in situ do not go on develop breast cancer, and this is true even without any treatment being given.
However the treatment is given in order to remove all risk or chances of a breast cancer occurring and to remove any and all abnormal elements in the duct either by excision or radiation or both so that the risk of recurrence is reduced.
The surgical options for treating DCIS are either lumpectomy (removal of a part of the breast) or mastectomy (removal of the entire breast) and the rate of survival for both options are over 96%.
There are biomarkers that are able to predict which women with ductal carcinoma in situ are more likely to go on to develop invasive breast cancer.
Many women choose not to undergo surgery or they may have medical conditions that preclude this option. When lumpectomy is performed, this is usually followed by radiation therapy which helps to halve the risk of a woman going on to develop breast cancer in that area.
A mastectomy rather than breast conservation surgery may be used if ductal carcinoma in situ is multifocal or found at more than one site or if it is of a high grade or large size. If for some reason radiation is not an option, or the woman is below the age of 40, mastectomy may be preferred.