What to Know About DCIS of the Breast

Its name stands for ductal carcinoma in situ. Although it is often grouped with early breast cancer, the defining feature is that the abnormal cells are confined by the duct wall. Treatment aims to remove or control these cells before an invasive cancer can develop.

DCIS is commonly detected on a mammogram rather than through a breast symptom. A biopsy provides the diagnosis by allowing a pathologist to examine tissue. The report may describe the grade, the pattern of the cells, hormone receptors, and whether tissue removed during surgery has clear margins.

Grade describes how different the cells look from normal duct cells and can help the care team judge their behaviour. It does not mean that the cells have already travelled elsewhere. DCIS itself remains within the ducts, although a surgical specimen can occasionally reveal a separate invasive area that was not visible in the smaller biopsy sample.

Review the imaging and biopsy results with a breast specialist. Management may involve breast-conserving surgery or mastectomy, depending on the area involved, its position, breast size, and whether clear margins appear achievable. Radiotherapy may be discussed after breast-conserving surgery, while hormone therapy may be considered when the cells carry hormone receptors.

Bring the pathology report and a current medicines list to the appointment. Ask whether more imaging is needed, what operation is being proposed, how the final specimen could change the plan, and what follow-up imaging will be arranged for the remaining breast tissue.

Arrange a clinical assessment for a new breast or underarm lump, bloody nipple discharge, nipple inversion that is new, skin dimpling, persistent one-sided breast change, or redness and swelling that do not settle. These changes have several possible causes, but they should be examined rather than watched indefinitely.

After a biopsy or operation, seek prompt advice for worsening redness, spreading warmth, pus, fever, increasing swelling, heavy bleeding, breathlessness, or pain that is not controlled by the medicines provided. Follow the surgical team's specific wound and emergency instructions.

Ask: Is the diagnosis entirely DCIS on the current sample? What grade and hormone-receptor findings are reported? How large and widespread does the affected area appear? Which surgery fits its location? Will radiotherapy or hormone therapy be discussed? What result would lead to another operation?