Breast Cancer Definition of Ductal Carcinoma In Situ Terms What is Ductal Carcinoma What characterizes DCIS? Ductal: Relating In Situ (DCIS)? DCIS is characterized by pre-can- to the breast’s milk Ductal Carcinoma In Situ is the cerous or early-stage cell abnor- ducts, the parts of the earliest possible and most treat- malities in the breast ducts. On a breast through which able diagnosis of breast cancer. mammogram, DCIS appears as milk fl ows. Some experts consider it to be areas of calcifi cation. “pre-malignant.” The most com- Carcinoma: A type mon form of non-invasive breast How does the pathologist of cancerous, or ma- cancer, DCIS accounts for about make a diagnosis? lignant, tumor. 25 percent of all breast cancers. The pathologist examines biopsy Sometimes, DCIS is seen in as- specimens, In Situ: In its original sociation with an invasive form of along with place. breast cancer. other tests if The diagnosis of DCIS is in- necessary. If Non-invasive: Not spreading beyond the creasing because more women are mammogra- inside of the breast receiving regular mammograms phy shows duct. – and because of advancements in suspicious mammography technology, which fi ndings, a Calcifi cation: Cal- can now fi nd small areas of calci- biopsy may cium deposits in the fi cation in the breast. If untreated, be recom- breast can be associ- about 30 percent of women with mended. A ated with Ductal Car- DCIS will develop invasive breast biopsy is the Ductal Carcinoma cinoma In Situ. Clus- cancer within 10 years of the ini- most widely used method for In Situ is the earliest ters of these deposits tial making a fi rm diagnosis of breast possible and most may indicate cancer. diagnosis. cancer. During a biopsy proce- treatable form of dure, a primary care physician breast cancer. Malignant: Cancer- Who is most likely to have removes cells or tissues from the ous and capable of DCIS? suspicious area for the pathologist spreading. Because of how DCIS is de- to examine more closely in the tected, it can be found in women laboratory. In Pathologist: A physi- earlier than age 45, which is the some cases a cian who examines age breast cancer becomes more biopsy may tissues and fl uids common. However, as a woman be performed to diagnose disease ages, breast cancer risk does not with surgery. in order to assist in decline; therefore, DCIS can be To make a making treatment de- fi rm diagnosis cisions. found at any age. About 20 per- cent of women with breast cancer of DCIS, the have a family history of the dis- pathologist ease. will investi- Other factors increasing the risk gate whether Normal breast cells. of having breast cancer include the malignan- having no children or the fi rst cy has invaded tissue surrounding child after age 30, early men- the ducts. A diagnosis of DCIS means the tumor remains only in Copyright © 2006 struation, and consuming three or College of American more alcoholic drinks its original place – “in situ.” Pathologists. For use and a day. reproduction by patients and CAP members only. First edition, Dec. 2006. What else does the All DCIS tumors are Stage “Tis,” which means pathologist look for? The biopsy sample is tested for the tumor is “in situ” and has not spread. The the presence of estrogen recep- tors. Women with DCIS contain- cure rate for stage “Tis” tumors is close to 100 ing this receptor are more likely percent if standard forms of treatment are fol- to respond positively to hormone therapy. Due to continual advanc- lowed. es in research, other tests may be used as well. Advancements in surgical What kinds of With all necessary tests com- techniques have enabled about questions should pleted, pathologists determine 70 percent of women to choose I ask my doctors? It’s important the cancer’s stage. All DCIS breast-conserving surgical treat- to learn as tumors are Stage “Tis,” which ments like lumpectomy rather Ask any question means the tumor is “in situ” and than mastectomy, where the you want. There are much as you has not spread. The cure rate for entire breast is removed. If you no questions you stage “Tis” tumors is close to 100 have DCIS, which is confi ned to should be reluctant can about percent if standard forms of treat- one area of one breast, you are to ask. Here are a your treatment ment are followed. likely to be a good candidate for few to consider: lumpectomy. If your breast cannot options and How do doctors determine be conserved, breast reconstruc- • Please describe what surgery or treatment tion surgery may be a possibility the type of cancer I to make the will be necessary? after you recover from your initial have and what treat- decision that’s The pathologist consults with operation to remove ment options are your primary care physician the cancer. available. right after reviewing the test results. Radiation therapy is often used Together, using their combined after lumpectomy and sometimes • What are the for you. experience and knowledge, they after mastectomy to rid the body chances for full determine treatment options most of any microscopic remnants of remission? appropriate for your condition. the cancer in the area where the original tumor was found and re- • What treatment What kinds of treatments moved. options do you rec- are available for DCIS? ommend? Why do DCIS is treated through surgery, For more information, go to you believe these are which is sometimes supplemented www.cancer.org (American Can- the best by radiation therapy. It’s impor- cer Society) or www.y-me.org. treatments? tant to learn as much as you can about your treatment options and • What are the pros to make the decision that’s right and cons of these for you. Because having DCIS is treatment options? not an emergency situation, you can take your time making your • What are the choices. side effects? • Should I receive a second opinion? • Is your medical team experienced in treating the type of cancer I have? • Can you provide me with information about the physicians .