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Information on Ductal Carcinoma in Situ

written by: Finn Orfano • edited by: Diana Cooper • updated: 10/20/2010

Ductal cell carcinoma in situ is a type of non-invasive breast cancer that develops in the milk ducts. This article discusses the symptoms, causes, risks, diagnosis and treatment options.

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    Signs and Symptoms

    Ductal cell carcinoma in situ (DCIS) is the most common type of non-invasive breast cancer. The cancer originates in the milk ducts and hasn’t spread to tissues beyond these ducts (hence ‘non-invasive’). The condition is not life-threatening, but may increase the risk of developing an invasive type of breast cancer.

    Generally, no symptoms are noticed by the affected individuals. A small percentage of people can have a small lump in the breast or discharge coming from the nipple. But mostly, cases are diagnosed by mammography.

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    Causes and Risks

    There is no certainty about what causes ductal cell carcinoma in situ. However, some indications have provided scientists with a couple of general ideas:

    • Genes: The risk increases in families with a history of breast cancer, which might suggest that there are genes that are capable of influencing the development of DCIS.
    • Diet: The role of diet is still quite unclear, but some recent studies have suggested that the risk of developing DCIS may increase as a result of too much alcohol. Conversely, the risk seems to decrease when a healthy lifestyle (low-fat diet, regular exercise, enough sleep and a low stress level) is implemented.

    Since DCIS is confined to the milk ducts, it is not a life-threatening condition, but if left untreated, it increases the risk of developing an invasive, malignant type of breast cancer.

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    Diagnosis

    As mentioned before, most cases of DCIS are detected through a mammography, or by the detection of a small lump. If there is reason to be suspicious, meaning a lump is noticed or the mammography shows some signs of DCIS, a biopsy is performed. After the small piece of breast tissue is removed, it is analyzed by a pathologist, who determines:

    • The type and grade of DCIS: How the cells look and how fast they’re growing.
    • The hormone-receptor status: Sometimes the cancer cells posses receptors for estrogen or progesterone. If this is the case, the cancer’s growth is fueled by these hormones.

    After diagnosis is confirmed, the treatment can commence.

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    Treatment

    There are four standard treatment options for DCIS that can be discerned.

    • Lumpectomy: This is also called breast-conserving surgery, since only the affected area is excised.
    • Lumpectomy followed by radiation therapy.
    • Mastectomy: In some cases, the total removal of the affected breast is recommended.
    • Hormonal therapy: This is implemented when hormone receptors are identified on the cancer cells. It slows down the development of the cancer. This is often used in combination with one of the aforementioned treatments.

    Generally, chemotherapy is not required for DCIS, since it is non-invasive. This means that sending anti-cancer medication through the body is not necessary because the cells will not have metastasized.

    In conclusion, the earlier it is diagnosed, the better, so do not underestimate the importance of regular mammographies.

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    References

    • Breastcancer.org: http://www.breastcancer.org/symptoms/types/dcis/
    • Cancer Prevention Institute of California, DCIS: http://www.dcis.info/
    • Cancer Research UK: http://www.cancerhelp.org.uk/type/breast-cancer/about/types/dcis-ductal-carcinoma-in-situ
    • National Breast and Ovarian Cancer Center: http://www.nbocc.org.au/breast-cancer/about-breast-cancer/what-is-ductal-carcinoma-in-situ-dcis