ductal carcinoma in situ

What is Ductal Carcinoma In Situ (DCIS)?

Ductal carcinoma in situ (DCIS) is a type of very early breast cancer where cancer cells line the milk ducts within one or both breasts. Milk ducts are tubes that carry milk from the lobules to the nipple.

Characteristics of DCIS:

• The cancer cells have not spread into the surrounding breast tissue.
• It is considered a non-invasive or pre-invasive breast cancer.
• The abnormal cells are found in the lining of a breast duct, but they have not spread outside the duct to other tissues in the breast.

Key Features:

• DCIS is an early stage of breast cancer, often referred to as stage 0.
• It means that some of the cells lining the breast ducts have started to turn into cancer cells.
• The cancer cells are confined inside a milk duct in the breast and haven't spread into the surrounding tissue.

In Summary:

DCIS is an early form of breast cancer where cancer cells line the milk ducts, but they have not spread beyond that area. It is considered non-invasive or pre-invasive, meaning it has not invaded other tissues in the breast.

References:

• [1] Ductal carcinoma in situ (DCIS) is a type of very early breast cancer where cancer cells line your milk ducts within one or both breasts.
• [2] Milk ducts are tubes that carry milk from the lobules to the nipple.
• [3] A condition in which abnormal cells are found in the lining of a breast duct.
• [4] The abnormal cells have not spread outside the duct to other tissues in the breast.
• [5] Ductal carcinoma in situ (DCIS) is an early breast cancer. It means that some of the cells lining the breast ducts have started to turn into cancer cells.
• [6] Ductal carcinoma in situ (DCIS) means the cells that line the milk ducts of the breast have become cancer, but they have not spread into surrounding breast tissue.
• [7] DCIS, by definition, is cancer that starts in the cells lining the milk ducts (carcinoma) and remains in the area where it originates (in situ).
• [8] Jul 18, 2024 — DCIS (ductal carcinoma in situ), also known as stage 0 breast cancer, is non-invasive breast cancer that starts in the milk ducts.

Ductal Carcinoma In Situ (DCIS) Signs and Symptoms

Ductal carcinoma in situ (DCIS) is an early form of breast cancer that typically does not cause noticeable symptoms. However, some people may experience certain signs or symptoms, which are often subtle and can be mistaken for other conditions.

Common Signs and Symptoms:

• A lump or mass in the breast or armpit [1]
• Nipple tenderness or itching [2]
• Breast pain or discomfort [3]
• Nipple discharge (rarely) [4]

Important Notes:

• DCIS is often found by mammogram, where it appears as small white clusters (calcifications) in the breast tissue [8].
• In most cases, DCIS does not have specific symptoms like a lump or breast pain [5].
• Quality of life is an essential aspect of breast cancer care, and early detection can significantly improve outcomes [6].

Early Detection and Treatment

While DCIS may not cause noticeable symptoms, it's crucial to detect and treat the condition early. Mammograms are an effective tool for identifying DCIS in its early stages.

References:

[1] - 3 [2] - 2 [3] - 3 [4] - 2 [5] - 5 [6] - 5 [7] - 8

Diagnostic Tests for Ductal Carcinoma In Situ (DCIS)

Ductal carcinoma in situ (DCIS) can be diagnosed through various tests, which are essential for confirming the presence of this early form of breast cancer. Here are some of the diagnostic tests used to diagnose DCIS:

• Mammogram: A mammogram is an X-ray image of the breast that can detect abnormalities, including DCIS. It's often used as a screening tool to identify potential issues before they become more serious (1).
• Biopsy: If a suspicious area is detected on a mammogram or other imaging tests, a doctor will perform a biopsy to remove some breast tissue for further examination (2). This involves removing a small sample of tissue through a needle under local anesthesia.
• Core Needle Biopsy: A core needle biopsy is a type of biopsy that involves removing a sliver of tissue through a needle. This tissue is then sent to the lab for analysis to confirm a DCIS diagnosis (9).
• Diagnostic Mammogram: If a radiologist sees something abnormal on a screening mammogram, they may order a diagnostic mammogram to get a more detailed image of the breast (5).

Confirming DCIS Diagnosis

A DCIS diagnosis is ultimately confirmed by biopsy, where tissue is removed and sent to the lab for analysis. The structural features of DCIS can vary, but a biopsy helps determine if cancer cells are present in the milk ducts (8).

These diagnostic tests play a crucial role in identifying DCIS at an early stage, allowing for timely treatment and improving patient outcomes.

References:

1. [1] - A mammogram is an X-ray image of the breast that can detect abnormalities, including DCIS.
2. [2] - If a suspicious area is detected on a mammogram or other imaging tests, a doctor will perform a biopsy to remove some breast tissue for further examination.
3. [5] - When a radiologist sees something abnormal, they order a diagnostic mammogram to get a more detailed image of the breast.
4. [8] - A DCIS diagnosis is ultimately confirmed by biopsy; tissue is removed and sent to the lab for analysis.
5. [9] - A core needle biopsy involves removing a sliver of tissue through a needle under local anesthesia.

Treatment Options for DCIS

While surgery is often the primary treatment for ductal carcinoma in situ (DCIS), drug therapy can also play a role in managing this condition.

• Hormone Therapy: Hormone therapy, specifically tamoxifen or aromatase inhibitors, may be prescribed to women with estrogen receptor-positive DCIS. This type of therapy can help reduce the risk of recurrence by blocking the effects of estrogen on breast cells [1][2].
• Adjuvant Endocrine Therapy: In some cases, hormone therapy may be recommended as an additional treatment after surgery to further reduce the risk of recurrence [3].

Radiation Therapy and Hormone Therapy

In addition to surgery, radiation therapy is often used in conjunction with hormone therapy to treat DCIS. This combination can help ensure that any remaining cancer cells are eliminated, reducing the risk of recurrence [4][5].

It's essential to note that not all women with DCIS will require drug treatment. The decision to use hormone therapy or other medications will depend on individual factors, such as the size and location of the tumor, as well as the woman's overall health.

References:

[1] Most women with DCIS can be cured with surgery, sometimes followed by radiation therapy and/or hormone therapy. [2] Ductal carcinoma in situ (DCIS) is usually treated with surgery, radiation therapy and hormone therapy. [3] Therapeutic approaches include surgery, radiation therapy, and adjuvant endocrine therapy. [4] In most cases, a woman with DCIS can choose between breast-conserving surgery (BCS) and simple mastectomy. Radiation is usually given after BCS. [5] by LC Collins · Cited by 14 — Therapeutic approaches include surgery, radiation therapy, and adjuvant endocrine therapy.

The differential diagnosis of ductal carcinoma in situ (DCIS) includes several conditions that can mimic its characteristics. Some of these conditions are:

• Atypical ductal hyperplasia (ADH): This is a condition where the cells lining the milk ducts appear abnormal but have not yet invaded the surrounding tissue [1][3]. It is often considered a precursor to DCIS and can be challenging to distinguish from it.
• Usual ductal hyperplasia: This is a benign condition characterized by an overgrowth of cells in the milk ducts, which can sometimes resemble DCIS [4].
• Lobular carcinoma in situ (LCIS): This is a rare condition where abnormal cells are found in the lobules of the breast, but it is not considered a precursor to invasive cancer like DCIS is [4].
• Microinvasive carcinoma: In some cases, DCIS can progress to microinvasive carcinoma, which is an early stage of invasive breast cancer [4].

It's worth noting that the differential diagnosis of DCIS also includes other intraductal epithelial proliferations and lobular in situ neoplasia [5]. A definitive diagnosis of DCIS is typically made through biopsy and histopathological examination.

References: [1] SE Pinder · 2010 · Cited by 169 [3] by MK Komforti · 2019 · Cited by 3 [4] by LC Collins [5] by SE Pinder · 2010 · Cited by 169