Ductal Carcinoma In Situ (DCIS)
DCIS is a non-invasive form of breast cancer in which abnormal cells are confined to the milk ducts. While it is not an invasive cancer, it can increase future risk and is commonly treated with surgery to prevent progression.
At The Medical Group of New Jersey, we tailor DCIS treatment to your imaging findings, pathology, and personal goals, balancing effective cancer prevention with breast preservation whenever possible.
Symptom Onset & Initial Evaluation
Ductal carcinoma in situ (DCIS) is a very early form of breast cancer in which abnormal cells are confined to the milk ducts and have not invaded surrounding breast tissue. In most cases, DCIS does not cause noticeable symptoms and is discovered during routine screening mammography, often before a patient is aware of any breast changes.
Occasionally, patients may experience symptoms that lead to further evaluation, such as:
- Nipple discharge
- A palpable breast lump, although this is less common
When DCIS is suspected, your breast surgeon will review your mammogram results, medical history, and any relevant risk factors. A focused breast and lymph node examination is also performed to evaluate the area of concern and determine whether additional imaging or diagnostic testing is needed.
Diagnosis
Once an abnormality is identified on imaging, additional testing is performed to confirm the diagnosis and characteristics of the lesion.
Diagnostic evaluation typically includes:
- Diagnostic mammography, which provides detailed breast images and often reveals clusters of microcalcifications associated with DCIS
- Stereotactic or image-guided core needle biopsy is used to obtain small tissue samples from the abnormal area
- Pathology evaluation, which confirms the presence of DCIS and identifies important features such as tumor grade and hormone receptor status
These results help guide treatment planning and determine the most appropriate surgical approach.
Treatment & Ongoing Management
Treatment for DCIS focuses on removing the abnormal cells and reducing the risk of recurrence or progression to invasive breast cancer. The treatment plan is individualized based on the extent of the DCIS, imaging findings, and patient preferences.
Common treatment approaches include:
- Lumpectomy, a breast-conserving surgery that removes the area of DCIS along with a margin of surrounding healthy tissue
- Radiation therapy, which is often recommended after lumpectomy to lower the risk of recurrence
- Hormone therapy, such as tamoxifen or aromatase inhibitors, for hormone receptor–positive DCIS, as recommended by oncology specialists
In some situations, such as when DCIS is extensive or present in multiple areas of the breast, a mastectomy may be recommended.
Follow-Up Care
After treatment, ongoing follow-up care helps ensure long-term breast health and allows early detection of any future changes.
Follow-up plans commonly include:
- Post-operative visits to monitor healing after surgery
- Regular surveillance imaging, typically with mammography
- Long-term risk-reduction planning, which may include lifestyle guidance and preventive care strategies
With appropriate treatment and follow-up, the prognosis for patients with DCIS is generally excellent.