This information is intended to provide a general overview of Ductal Carcinoma in Situ (DCIS). It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for any health concerns or before making any decisions related to your health.
Ductal Carcinoma in Situ (DCIS) represents the earliest form of breast cancer. It originates from the cells lining the milk ducts within the breast. Crucially, DCIS is non-invasive, meaning the abnormal cells are entirely confined to the duct and have not spread into the surrounding breast tissue. For this reason, it is classified as Stage 0 breast cancer.
While some cases may progress to invasive breast cancer by spreading beyond the duct and into nearby tissue, others remain confined for many years, and predicting this progression is not currently possible. Due to advances in screening practices and technology, DCIS now accounts for approximately 20% of all breast cancer diagnoses.
The prognosis for patients with DCIS is excellent, and because it is found at cancer's earliest stage, it responds very well to treatment. The disease has an outstanding 10-year survival rate of more than 98%.
Molecular receptors are proteins found inside or on the surface of cells. In cancer, some receptors can bond with specific hormones or proteins in the body, which can fuel the cancer's growth. Women with DCIS may be tested for receptors for the hormones oestrogen and progesterone. If these tests are positive, the patient may be advised to undergo hormone therapy after their DCIS treatment is complete. This therapy is not used to treat DCIS itself, but rather to help prevent a new breast cancer from developing in the future.
Breast cancer symptoms can differ significantly from person to person. The most important step is to be familiar with the normal look and feel of your breasts so you can detect any changes. Many breast cancers, including DCIS, are discovered via routine screening mammograms before any physical symptoms are even noticed.
If you notice any of the following changes, it is important to discuss them with your doctor, as they may signal breast cancer or other health problems:
If you notice any changes in your breasts, experience potential symptoms, or have an abnormal result from a screening mammogram, your doctor will need to investigate further to make a definitive diagnosis.
Diagnosis may begin with a physical breast exam, where the doctor manually checks the breasts and armpit for lumps and abnormalities.
If breast cancer is suspected, imaging tests will be ordered. The first procedures are typically a mammogram (X-ray pictures) or an ultrasound (high-energy sound waves to create a sonogram). Occasionally, a Magnetic Resonance Imaging (MRI) scan or other specialist examinations may be used.
If imaging shows an unusual or suspicious mass or skin thickening, a definitive diagnosis requires a tissue sample. This procedure is called a biopsy. For breast cancer, patients usually undergo an image-guided core needle biopsy, often performed during the initial imaging exam. This helps doctors guide the needle precisely to the suspected cancerous tissue. If cancer is confirmed, additional imaging and biopsies may be needed to determine the exact scope of the disease and if it has spread to nearby lymph nodes.
Following a breast cancer diagnosis, the cancer cells are analysed to determine their molecular receptor subtype. Understanding the subtype is key to developing a comprehensive, personalised treatment plan. Patients may also be advised to undergo genetic counselling, especially if there is an elevated risk due to family history.
Breast cancer is primarily treated with surgery and is often combined with chemotherapy, radiation therapy, or both. Treatment plans are unique to each patient and may also include options such as targeted therapy and angiogenesis inhibitors.
Many patients undergo one of two main categories of surgery, and sometimes chemotherapy or targeted therapy is given before surgery to shrink the tumour and make the procedure easier.
The tumour and a small margin of surrounding normal tissue are removed. This procedure may be appropriate for early breast cancer cases and is usually followed by radiation therapy. Lumpectomies are often outpatient procedures with shorter recovery times.
The tumour and the entire breast are removed. There are several different types, including procedures that can spare the breast's skin and nipple/areola. In some cases, both breasts are removed (double mastectomy) to prevent the development of new breast cancer, typically for patients with a high genetic risk, such as a BRCA mutation.
In both procedures, the surgeon may also remove nearby lymph nodes to check for cancer cells, which helps determine the risk of the disease spreading and the need for further systemic therapy. The breast cancer surgeons and reconstructive surgeons at SSCHRC work together to plan procedures that aim for the most effective outcome with minimal scarring and good cosmetic symmetry.
Uses powerful drugs, given orally or intravenously, to directly kill cancer cells, control their growth, or relieve pain. It is often given before surgery to shrink the tumour.
These therapies stop or slow the growth of cancer by interfering with, or targeting, specific molecules (often proteins) that the cancer cells rely on to survive and multiply.
These drugs disrupt angiogenesis, the process tumours use to create new blood vessels, which increases their blood supply and allows them to grow rapidly.
It can be used before surgery to shrink large tumours or after surgery to kill any remaining cancer cells. After a lumpectomy, patients often receive several weeks of daily radiation therapy.
Treatments may include 3D conformal radiation therapy, Intensity-Modulated Radiation Therapy (IMRT), Volumetric Arc Therapy (VMAT), and Stereotactic Body Radiation Therapy (SBRT), which administers very high doses with precision.
The radiation oncologists at SSCHRC are dedicated specialists who collaborate to ensure every patient receives the most effective and precise dose of treatment.