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Medical condition
Breast cancer in situ
Other names
Intraductal carcinoma
Ducts of the mammary gland, the location of ductal carcinoma
Specialty
Oncology
Histopathologic image from ductal cell carcinoma in situ (DCIS) of breast (hematoxylin and eosin stain)
Ductal carcinoma in situ (DCIS), also known as intraductal carcinoma, is a pre-cancerous or non-invasive cancerous lesion of the breast.[1][2] DCIS is classified as Stage 0.[3] It rarely produces symptoms or a breast lump that can be felt, typically being detected through screening mammography.[4][5] It has been diagnosed in a significant percentage of men (see male breast cancer).[6]
In DCIS, abnormal cells are found in the lining of one or more milk ducts in the breast. In situ means "in place" and refers to the fact that the abnormal cells have not moved out of the mammary duct and into any of the surrounding tissues in the breast ("pre-cancerous" indicates that it has not yet become an invasive cancer). In some cases, DCIS may become invasive and spread to other tissues, but there is no way of determining which lesions will remain stable without treatment, and which will go on to become invasive.[7] DCIS encompasses a wide spectrum of diseases ranging from low-grade lesions that are not life-threatening to high-grade (i.e. potentially highly aggressive) lesions.
DCIS has been classified according to the architectural pattern of the cells (solid, cribriform, papillary, and micropapillary), tumor grade (high, intermediate, and low grade), or the presence or absence of comedo histology;[8] or, in the case of the apocrine cell-based in situ carcinoma, apocrine ductal carcinoma in situ, it may be classified according to the cell type forming the lesion.[9] DCIS can be detected on mammograms by examining tiny specks of calcium known as microcalcifications. Since suspicious groups of microcalcifications can appear even in the absence of DCIS, a biopsy may be necessary for diagnosis.
About 20–30% of those who do not receive treatment develop breast cancer.[10][11] DCIS is the most common type of pre-cancer in women. There is some disagreement on its status as cancer; some bodies include DCIS when calculating breast cancer statistics, while others do not.[12][13]
^Sinn, HP; Kreipe, H (May 2013). "A Brief Overview of the WHO Classification of Breast Tumors, 4th Edition, Focusing on Issues and Updates from the 3rd Edition". Breast Care. 8 (2): 149–154. doi:10.1159/000350774. PMC 3683948. PMID 24415964.
^Hindle, William H. (1999). Breast Care: A Clinical Guidebook for Women’s Primary Health Care Providers. New York: Springer. p. 129. ISBN 978-0-387-98348-6.
^DePolo, Jamie (13 October 2023). "Breast Cancer Stages: Stage 0 breast cancer". Breastcancer.org.
^Welch HG, Woloshin S, Schwartz LM (February 2008). "The sea of uncertainty surrounding ductal carcinoma in situ--the price of screening mammography". J. Natl. Cancer Inst. 100 (4): 228–9. doi:10.1093/jnci/djn013. PMID 18270336.
^Morris, Elizabeth A.; Liberman, Laura, eds. (2005). Breast MRI: Diagnosis and Intervention. New York: Springer. p. 164. ISBN 978-0-387-21997-4.
^Nofal MN, Yousef AJ (December 2019). "The diagnosis of male breast cancer". The Netherlands Journal of Medicine. 77 (10): 356–359. PMID 31880271.
^Mannu, GS; Wang, Z; Broggio, J; Charman, J; Cheung, S; Kearins, O; Dodwell, D; Darby, SC (27 May 2020). "Invasive breast cancer and breast cancer mortality after ductal carcinoma in situ in women attending for breast screening in England, 1988-2014: population based observational cohort study". BMJ (Clinical Research Ed.). 369: m1570. doi:10.1136/bmj.m1570. PMC 7251423. PMID 32461218.
^Virnig BA, Shamliyan T, Tuttle TM, Kane RL, Wilt TJ (September 2009). "Diagnosis and management of ductal carcinoma in situ (DCIS)". Evidence Report/Technology Assessment. AHRQ Publication No.09-E018. (185): 1–549. PMC 4781639. PMID 20629475.
^Quinn CM, D'Arcy C, Wells C (January 2022). "Apocrine lesions of the breast". Virchows Archiv. 480 (1): 177–189. doi:10.1007/s00428-021-03185-4. PMC 8983539. PMID 34537861.
^Rubin, Raphael; Strayer, David S., eds. (2008). Rubin's Pathology: Clinicopathologic Foundations of Medicine (5th ed.). Philadelphia: Lippincott Williams and Wilkins. p. 848. ISBN 978-0-7817-9516-6.
^Early Breast Cancer Trialists' Collaborative Group (EBCTCG); Correa, C.; McGale, P.; Taylor, C.; Wang, Y.; Clarke, M.; Davies, C.; Peto, R.; Bijker, N. (2010). "Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast". Journal of the National Cancer Institute. Monographs. 2010 (41): 162–177. doi:10.1093/jncimonographs/lgq039. ISSN 1745-6614. PMC 5161078. PMID 20956824.
^"Breast Cancer Treatment (PDQ®)". NCI. 11 April 2014. Retrieved 19 June 2014.
^"Breast Cancer Treatment (PDQ®)". NCI. January 1980. Retrieved 19 June 2014.
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