Materiały źródłowe

• #1 Ductal carcinoma in situ (DCIS) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dcis/symptoms-causes/syc-20371889

  Ductal carcinoma in situ is a very early form of breast cancer. In ductal carcinoma in situ, the cancer cells are confined inside a milk duct in the breast. The cancer cells haven’t spread into the breast tissue. Ductal carcinoma in situ is often shortened to DCIS. It’s sometimes called noninvasive, preinvasive or stage 0 breast cancer. […] DCIS is usually found during a mammogram done as part of breast cancer screening or to investigate a breast lump. DCIS has a low risk of spreading and becoming life-threatening. However, it does require an evaluation and a consideration of treatment options. […] Treatment for DCIS often involves surgery. Other treatments may combine surgery with radiation therapy or hormone therapy. […] DCIS is usually found on a mammogram. It appears as tiny flecks of calcium in the breast tissue. These are calcium deposits, often referred to as calcifications.

• #2 Ductal Carcinoma in Situ (DCIS): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17869-ductal-carcinoma-in-situ-dcis

  Ductal carcinoma in situ (DCIS) is cancer in your breasts milk ducts. It isnt aggressive and it typically doesnt spread. This early form of breast cancer is usually curable with appropriate treatment, which often includes lumpectomy and radiation therapy. DCIS is highly treatable, and the outlook is excellent. […] Healthcare providers may call DCIS noninvasive or pre-invasive breast cancer. This means that the cancer cells havent spread beyond the walls of your milk ducts. Ductal carcinoma in situ doesnt typically metastasize, or spread to other organs in your body, as aggressive or invasive cancers do. […] Healthcare providers detect over 90% of DCIS cases during mammograms. If you receive suspicious mammogram results, theyll do a biopsy. […] Ductal carcinoma in situ is a highly treatable and curable stage 0 breast cancer.

• #3 Ductal Carcinoma In Situ (DCIS) | BCRF

  https://www.bcrf.org/about-breast-cancer/dcis-ductal-carcinoma-in-situ/

  Breast cancer is the most common cancer in women living in the U.S. Of all breast cancer diagnoses in the country, 20-25 percent are ductal carcinoma in situ (DCIS). An estimated 59,080 new cases of DCIS will be diagnosed in women this year. […] Though it can be very stressful and alarming, DCIS is not life-threatening; practically all patients with stage 0 breast cancer can be cured. […] Currently, there is not a way to determine which DCIS cases will become invasive breast cancer and which will not, so DCIS is almost always treated. […] Ductal carcinoma in situ (DCIS) is the earliest stage of breast cancer, which is why it’s sometimes referred to as stage 0 breast cancer. […] DCIS remains in the milk duct and does not spread through the duct walls into the surrounding breast tissue.

• #4 Imaging for the Diagnosis and Management of Ductal Carcinoma In Situ

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5161079/

  Diagnosis of ductal carcinoma in situ (DCIS) has increased dramatically in parallel with the increased use of screening mammography. […] There are specific mammographic findings, most associated with shapes (amorphous, fine and coarse pleomorphic, and fine linear) and distributions (linear and segmental) of calcifications that permit a reasonable sensitivity for detection of DCIS without an unreasonable decrease in specificity, especially in view of the dramatic decrease in breast cancer mortality associated with early detection. […] Ductal carcinoma in situ (DCIS) is a distinct lesion of the breast that is a precursor to development of invasive carcinoma. […] The histology diagnosis of DCIS increased with routine use of mammography, while the mortality from breast cancer, as verified by many worldwide screening trials, has decreased by at least 30%, in great part due to early nonclinical detection, almost entirely related to mammography.

• #5 Invasive Ductal Carcinoma (IDC) and Ductal Carcinoma in Situ (DCIS) Breast Cancer

  https://www.webmd.com/breast-cancer/ductal-carcinoma-invasive-in-situ

  What Is Ductal Carcinoma in Situ (DCIS)? Ductal carcinoma in situ (DCIS), also known as intraductal carcinoma, accounts for 1 of every 5 new breast cancer diagnoses. It’s an uncontrolled growth of cells within the breast ducts. Its noninvasive, meaning it hasn’t grown into the breast tissue outside of the ducts. The phrase „in situ” means „in its original place.” […] DCIS is the earliest stage at which breast cancer can be diagnosed. It’s known as stage 0 breast cancer. The vast majority of people diagnosed with it can be cured. […] DCIS usually has no symptoms. Most of the time, it’s found by a mammogram and appears as small white clusters (calcifications) in odd shapes and sizes. DCIS can sometimes cause these symptoms: A breast lump, Bloody nipple discharge, Itchy skin. […] About 80% of cases are found by mammograms. On the mammogram, it appears as a shadowy area.

• #6 Case: Ductal Carcinoma In Situ – Radiology | UCLA Health

  https://www.uclahealth.org/departments/radiology/education/breast-imaging-teaching-resources/cases/case-ductal-carcinoma-situ

  Ductal carcinoma in situ (DCIS) is considered a noninvasive, precursor lesion to invasive breast cancer. The basic pathologic definition of DCIS is the presence of malignant epithelial cells within the mammary ducts and without invasion into or passed the basement membrane. […] The incidence of DCIS has increased with the advent of screening mammography. Prior to the establishment of screening mammography, DCIS accounted for only 5% of breast cancers; this number has risen to nearly 30% due to screening mammography. This speaks to the value of screening mammography as more cases are diagnosed during the precursor stage to invasive malignancy. […] The imaging features of DCIS are nonspecific; however, there are several features which may be seen on mammography, ultrasound, and magnetic resonance imaging (MRI) which should result in suspicion for DCIS.

• #7 Imaging for the Diagnosis and Management of Ductal Carcinoma In Situ

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5161079/

  The detection of DCIS involves knowledge of the anatomy of the terminal ductal lobular unit (TDLU) and the types and distributions of calcifications occurring in the terminal duct portion of the TDLU, which significantly raise the potential for the presence of DCIS. […] The specific forms of calcifications related to DCIS are amorphous, coarse and fine pleomorphic, and fine linear. […] The amorphous forms are small (2300 m) and hazy in appearance. […] Their association with malignancy, especially DCIS, is as high as 20%. […] The linear and segmental distributions of calcifications are surrogate markers for disease distributed in the duct or ducts of TDLUs. […] The detection of DCIS is a mammographic and almost always not a clinical event. […] Approximately 25%30% of DCIS may never progress to invasive malignancy.

• #8 Ductal carcinoma in situ (DCIS) | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20371874/

  Ductal carcinoma in situ, also called DCIS, is most often discovered during a mammogram used to screen for breast cancer. A mammogram is an X-ray of the breast tissue. If your mammogram shows something concerning, you will likely have additional breast imaging and a biopsy. […] If an area of concern was found during a screening mammogram, you may then have a diagnostic mammogram. A diagnostic mammogram takes views at higher magnification from more angles than a mammogram used for screening. This examination evaluates both breasts. […] A biopsy is a procedure to remove a sample of tissue for testing in a lab. For DCIS, a healthcare professional removes the sample of breast tissue using a special needle. The needle used is a hollow tube. The healthcare professional puts the needle through the skin on the breast and into the area of concern. The health professional draws out some of the breast tissue. This procedure is called a core needle biopsy.

• #9 DCIS breast cancer (Ductal carcinoma in situ) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/breast-cancer/ductal-carcinoma-in-situ-dcis

  DCIS is usually found through changes seen on a mammogram as part of the NHS breast screening programme. This means DCIS is now diagnosed much more often than it used to be. In the UK, 1 in 5 breast cancers found by screening are DCIS (20%). […] If a mammogram shows changes, you will be referred to a breast clinic for further tests. The clinic staff will explain why you have been invited back and which tests you need. You may be able to have the tests on the same day. But sometimes you have to come back for further tests. […] Your cancer doctor needs certain information about the DCIS to help plan the best treatment for you. […] The main treatment is surgery to remove the DCIS. Not all DCIS will develop into invasive breast cancer. The aim of treatment is to remove it and reduce the risk of it developing into invasive cancer.

• #10 Ductal carcinoma in situ (DCIS) | Breast Cancer Now

  https://breastcancernow.org/about-breast-cancer/diagnosis/types-of-breast-cancer/ductal-carcinoma-in-situ-dcis/

  DCIS is diagnosed using a range of tests. These may include: A breast examination, A mammogram (breast x-ray), An ultrasound scan, A core biopsy (using a hollow needle to take a sample of tissue, under local anaesthetic, to be looked at under a microscope several tissue samples may be taken at the same time), A vacuum assisted biopsy (a hollow probe connected to a vacuum is used to take a sample of tissue, under local anaesthetic, to be looked at under a microscope) […] If you have calcifications, further mammograms will be done to see the calcifications in more detail. Sometimes an ultrasound will also be done. […] The biopsy samples will be x-rayed to check if they contain calcifications before being sent to the laboratory to be examined under a microscope. […] DCIS is graded based on what the cells look like under the microscope. They will be given a grade according to how different they are to normal breast cells and how quickly they are growing.

• #11 Invasive Ductal Carcinoma (IDC) and Ductal Carcinoma in Situ (DCIS) Breast Cancer

  https://www.webmd.com/breast-cancer/ductal-carcinoma-invasive-in-situ

  If your mammogram suggests that you may have DCIS, your doctor should order a biopsy to analyze the cells and confirm the diagnosis. Biopsies for DCIS are typically done using needles to remove tissue samples from the breast. […] If you have DCIS, your doctor may do more tests to gather information about your cancer. These tests may include an ultrasound or MRI. Based on the results of various tests, your doctor will be able to tell the size of your tumor and how much of your breast is affected by the cancer.

• #12 Ductal Carcinoma in Situ: Evolving Strategies to Optimal Diagnosis and Management

  https://www.medscape.org/viewarticle/568027

  Ductal carcinoma in situ is the most common form of noninvasive breast cancer, constituting about 85%-90% of the total, with survival rates close to 100%. Nevertheless, its diagnosis and management remain controversial. What is the best way to make the diagnosis? […] About 90% of DCIS lesions are calcified, so a mammogram will pick up most of these lesions. The distribution of calcification, however, does not always correlate with the extent of the lesion. Excising only calcified areas can lead to recurrence. Just relying on calcification to indicate the extent of the tumor underestimates the true extent of DCIS. […] Magnetic resonance imaging (MRI) is more sensitive and is becoming the standard modality for diagnosing DCIS. The main theme of this presentation, in fact, was that MRI examination of the breast is becoming the gold standard. High-contrast, high-resolution MRI provides enough detail to accurately define the margins of the lesion, thereby leading to safer operations and lowering the probability of recurrence. Most studies show nearly 100% sensitivity for detecting DCIS lesions, although the specificity is lower.

• #13 Ductal Carcinoma In Situ : Diagnosis and Treatment

  https://www.cioncancerclinics.com/blog/article/what-is-ductal-carcinoma-in-situ-dcis

  When cancer cells develop in the milk duct, it is called Ductal Carcinoma In Situ (DCIS) or Stage 0 breast cancer. In situ means the cancer has not metastasized and stays in its place. However, sometimes it can become invasive and spread to nearby tissues. […] The procedure during the diagnosis includes 1. Physical examination of the breast 2. Genetic counseling for people with family history 3. Pathologic review 4. Magnetic resonance imaging (MRI) of the breast with IV contrast: MRI performed preoperatively can help find the extent of the disease. After locating the cancerous tissue, a needle is used to excise the sample from the body. […] In an MRI, there is a possibility of a false positive (Indicating the cancer is present when it’s not) Therefore, surgery should not be entirely dependent on the result of Magnetic resonance imaging (MRI).

• #14 Ductal carcinoma in situ (DCIS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dcis/diagnosis-treatment/drc-20371895

  Ductal carcinoma in situ, also called DCIS, is most often discovered during a mammogram used to screen for breast cancer. A mammogram is an X-ray of the breast tissue. If your mammogram shows something concerning, you will likely have additional breast imaging and a biopsy. […] A biopsy is a procedure to remove a sample of tissue for testing in a lab. For DCIS, a healthcare professional removes the sample of breast tissue using a special needle. The needle used is a hollow tube. The healthcare professional puts the needle through the skin on the breast and into the area of concern. The health professional draws out some of the breast tissue. This procedure is called a core needle biopsy. […] Ductal carcinoma in situ can often be cured. Treatment for this very early form of breast cancer often involves surgery to remove the cancer. Ductal carcinoma in situ, also called DCIS, also may be treated with radiation therapy and medicines.

• #15

  https://www.cancervic.org.au/cancer-information/screening/breasts-health/ductal-carcinoma-in-situ

  DCIS can often be seen as a particular pattern of tiny calcifications on the mammogram. Although the shape and size of the calcification may suggest DCIS to the radiologist, the diagnosis will need to be confirmed by further investigation. The doctor will usually recommend a core needle biopsy, which involves removal of a sliver of tissue through a needle under local anaesthetic. This tissue is then sent to a pathologist. The diagnosis may also be made by surgical (open) biopsy. A surgical biopsy is done in a hospital, but you usually won’t have to stay overnight. […] Treatment for DCIS depends on each woman’s situation. More often than in the past, doctors are able to offer conservative treatment. This means the surgeon will only remove the area of DCIS, along with a small border of unaffected tissue. Occasionally, further treatment by radiation will be suggested. Radiation therapy can have side effects, and you should find out about these before starting a course of treatment.

• #16 Ductal carcinoma in situ (DCIS) | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20371874/

  Ductal carcinoma in situ, also called DCIS, is most often discovered during a mammogram used to screen for breast cancer. A mammogram is an X-ray of the breast tissue. If your mammogram shows something concerning, you will likely have additional breast imaging and a biopsy. […] If an area of concern was found during a screening mammogram, you may then have a diagnostic mammogram. A diagnostic mammogram takes views at higher magnification from more angles than a mammogram used for screening. This examination evaluates both breasts. […] A biopsy is a procedure to remove a sample of tissue for testing in a lab. For DCIS, a healthcare professional removes the sample of breast tissue using a special needle. The needle used is a hollow tube. The healthcare professional puts the needle through the skin on the breast and into the area of concern. The health professional draws out some of the breast tissue. This procedure is called a core needle biopsy.

• #17

  https://www.aurorahealthcare.org/services/cancer/breast-cancer/ductal-carcinoma-in-situ

  Ductal carcinoma in situ (DCIS) is an early and non-invasive form of breast cancer found in your milk ducts. Its commonly treated with surgery and radiation therapy to prevent it from progressing into invasive cancer. […] Diagnosing DCIS poses a challenge due to its nature of not showing any symptoms. Often, it’s found during routine breast examinations or mammograms. When abnormalities are found on a mammogram, a DCIS diagnosis is confirmed through a stereotactic breast biopsy. […] During a stereotactic breast biopsy, a small tissue sample is removed with a hollow needle from the area where the abnormal cells were identified on the mammogram. A pathologist will look at the tissue to confirm a diagnosis of DCIS.

• #18 Ductal carcinoma in situ (DCIS) | Breast Cancer Now

  https://breastcancernow.org/about-breast-cancer/diagnosis/types-of-breast-cancer/ductal-carcinoma-in-situ-dcis/

  DCIS is diagnosed using a range of tests. These may include: A breast examination, A mammogram (breast x-ray), An ultrasound scan, A core biopsy (using a hollow needle to take a sample of tissue, under local anaesthetic, to be looked at under a microscope several tissue samples may be taken at the same time), A vacuum assisted biopsy (a hollow probe connected to a vacuum is used to take a sample of tissue, under local anaesthetic, to be looked at under a microscope) […] If you have calcifications, further mammograms will be done to see the calcifications in more detail. Sometimes an ultrasound will also be done. […] The biopsy samples will be x-rayed to check if they contain calcifications before being sent to the laboratory to be examined under a microscope. […] DCIS is graded based on what the cells look like under the microscope. They will be given a grade according to how different they are to normal breast cells and how quickly they are growing.

• #19 Ductal carcinoma in situ (DCIS): pathological features, differential diagnosis, prognostic factors and specimen evaluation | Modern Pathology

  https://www.nature.com/articles/modpathol201040

  Ductal carcinoma in situ (DCIS) is a heterogeneous, unicentric precursor of invasive breast cancer, which is frequently identified through mammographic breast screening programs. […] The lesion can cause particular difficulties for specimen handling in the laboratory and typically requires even more diligent macroscopic assessment and sampling than invasive disease. […] Pitfalls and tips for macroscopic handling, microscopic diagnosis and assessment, including determination of prognostic factors, such as cytonuclear grade, presence or absence of necrosis, size of the lesion and distance to margins are described. […] All should be routinely included in histopathology reports of this disease; in order not to omit these clinically relevant details, synoptic reports, such as that produced by the College of American Pathologists are recommended.

• #20 Diagnosis of ductal carcinoma in situ | Cancer Australia

  https://www.canceraustralia.gov.au/cancer-types/breast-cancer/how-breast-cancer-diagnosed/diagnosis-ductal-carcinoma-situ

  Ductal carcinoma in situ (DCIS) is a non-invasive breast condition that can potentially develop into invasive breast cancer, and its pathology report provides crucial information for treatment decisions, including size, location, surgical margin status, grade, and hormone receptor status. […] Ductal carcinoma in situ (DCIS) is not breast cancer as we commonly understand it, because it has not spread outside the milk ducts into other parts of the breast, or to other parts of the body. Without treatment, DCIS may develop into invasive breast cancer, which can spread outside the ducts and possibly to other parts of the body. […] The DCIS pathology report contains important information about a woman’s DCIS that is used to decide on treatment recommendations. […] The pathology report usually includes the following information: Size and locationThe report shows the size of the DCIS and where it is in the breast. This will affect what treatments are recommended, including the type of surgery.

• #21 Diagnosis of ductal carcinoma in situ | Cancer Australia

  https://www.canceraustralia.gov.au/cancer-types/breast-cancer/how-breast-cancer-diagnosed/diagnosis-ductal-carcinoma-situ

  Surgical marginDuring a surgical biopsy or breast conserving surgery, the surgeon removes the DCIS and an area of healthy looking tissue around the DCIS. The healthy looking tissue is called the surgical margin. If there are no DCIS cells in the surgical margin, it’s likely that all the DCIS has been removed. In this case, the surgical margin is said to be ‘clear’. If the surgical margin is not considered to be ‘clear’, more surgery may be required to ensure that all of the DCIS is removed. […] Grade of DCISThe grade of the DCIS shows how fast the abnormal cells are growing. DCIS grade is numbered from 1 to 3. A low grade (Grade 1) means that the DCIS is growing slowly. A high grade (Grade 3) means that the cancer is growing more quickly. […] Hormone receptorsThe report may show whether the DCIS cells are positive or negative for hormone receptors. This will affect whether hormonal therapies are recommended.

• #22 Ductal Carcinoma In Situ (DCIS) | BCRF

  https://www.bcrf.org/about-breast-cancer/dcis-ductal-carcinoma-in-situ/

  DCIS diagnosis has increased significantly since routine screening mammograms became widespread. […] A DCIS diagnosis is ultimately confirmed by biopsy; tissue is removed and sent to the lab for analysis. […] Typically, DCIS is categorized by what’s called nuclear grade, which measures the characteristics of the nuclei of the cells like size and shape compared to the nuclei of normal breast cells. […] A DCIS diagnosis is categorized as low-grade (grade I), intermediate grade (grade II), or high-grade (grade III). […] DCIS treatment has a high success rate, in most cases removing the tumor and preventing recurrence. […] The prognosis is excellent—98 percent survival after 10 years. […] If left untreated, some cases of DCIS will transform into invasive breast cancer, but it is uncertain how many.

• #23 Ductal Carcinoma In Situ (DCIS) Treatment | Susan G. Komen®

  https://www.komen.org/breast-cancer/treatment/by-diagnosis/dcis/

  A lumpectomy for DCIS is often followed by radiation therapy to lower the risk of DCIS recurrence (a return of DCIS) in the treated breast and invasive breast cancer in the treated breast. […] Most cases of DCIS are hormone receptor-positive. People with hormone receptor-positive DCIS may benefit from hormone therapy (tamoxifen or an aromatase inhibitor). […] After treatment for DCIS, theres a small risk of DCIS recurrence (a return of DCIS) and invasive breast cancer. […] Higher grade DCIS appears more likely than lower grade DCIS to recur as DCIS or invasive breast cancer after treatment.

• #24 Ductal carcinoma in situ (DCIS): pathological features, differential diagnosis, prognostic factors and specimen evaluation | Modern Pathology

  https://www.nature.com/articles/modpathol201040

  Nevertheless, even if such gaps are present in an individual case, the size of DCIS reported should be the overall size of the disease process, rather than reporting individually the size of each focus. […] Despite the additional effort that is required to obtain better reproducibility of grading of DCIS, as noted above one advantage of classifying DCIS according to cytonuclear grade is that there is less commonly a variation within an individual lesion. […] Grade of DCIS in surgical excisions relates to risk of local recurrence and to be relatively reproducible; the histological grade of DCIS in core biopsy specimens is also clinically relevant with regard to the likelihood of there being radiologically unsuspected invasion. […] If, for example, a patient has more than 40 flecks of calcification on mammogram and core biopsy demonstrates high-grade DCIS, the risk of a radiologically occult invasive focus is 48%.

• #25 Ductal Carcinoma in Situ (DCIS) Melbourne, VIC | Radiotherapy Melbourne, VIC

  https://www.melbournebreastcancersurgery.com.au/ductal-carcinoma-in-situ-dcis.html

  If you have calcifications, further mammograms will be done to see the calcifications in more detail. Sometimes an ultrasound will also be done. […] Pathology result showed ductal carcinoma in situ. […] There are various histological patterns of DCIS and more than one of these may be present in a single case. The most common are the comedo, solid, papillary, cribriform and micro-papillary types. […] DCIS is graded based on what the cells look like under the microscope. DCIS is graded as low, intermediate, or high grade. […] Ductal carcinoma in situ is considered a precursor of invasive breast cancer. There is a 30-50% risk of untreated DCIS progressing to invasive carcinoma in the ipsilateral breast 10-20 years after initial diagnosis. […] The aim of treating DCIS is to prevent invasive breast cancer from developing. If DCIS is not treated it may develop into invasive breast cancer, which can spread outside the ducts into the breast tissue and then possibly to other parts of the body.

• #26 Ductal carcinoma in situ (DCIS) | Breast Cancer Now

  https://breastcancernow.org/about-breast-cancer/diagnosis/types-of-breast-cancer/ductal-carcinoma-in-situ-dcis/

  If DCIS is not treated, the cancer cells may develop the ability to spread outside the ducts, into the surrounding breast tissue. This is known as invasive breast cancer. Invasive cancer has the potential to also spread to other parts of the body. […] The aim of treatment is to remove all the DCIS from within the breast to reduce the chance of it becoming an invasive cancer. […] Surgery is nearly always the first treatment for DCIS. […] If you have any questions or concerns about your diagnosis and treatment, talk to your treatment team. […] After surgery, you may need other treatments. These are called adjuvant treatments and can include radiotherapy and, in some cases, hormone therapy. […] Radiotherapy uses high energy x-rays to destroy cancer cells. If you’ve had breast-conserving surgery you may be offered radiotherapy. It is not usually necessary to have radiotherapy after a mastectomy for DCIS. […] Hormone therapies block or stop the effect of oestrogen on breast cancer cells. Different hormone therapy drugs do this in different ways. […] Tests may also be done to see if your breast cancer is progesterone receptor positive (PR+).

• #27 Ductal Carcinoma in Situ (DCIS)

  https://www.cancercenter.com/cancer-types/breast-cancer/types/common-breast-cancer-types/ductal-carcinoma-in-situ

  If DCIS is detected, the cancer cells are examined and assigned a grade that assesses how fast the cancer is growing and its likelihood of progressing or returning after treatment. […] A DCIS diagnosis may also include information on the cancers hormone-receptor status. Additional tests may be used to determine whether the cancer is estrogen-receptor positive or negativeimportant information that helps the medical team predict whether the cancer may be treated with hormone therapy.

• #28 Ductal Carcinoma In Situ (DCIS) Treatment | Susan G. Komen®

  https://www.komen.org/breast-cancer/treatment/by-diagnosis/dcis/

  A lumpectomy for DCIS is often followed by radiation therapy to lower the risk of DCIS recurrence (a return of DCIS) in the treated breast and invasive breast cancer in the treated breast. […] Most cases of DCIS are hormone receptor-positive. People with hormone receptor-positive DCIS may benefit from hormone therapy (tamoxifen or an aromatase inhibitor). […] After treatment for DCIS, theres a small risk of DCIS recurrence (a return of DCIS) and invasive breast cancer. […] Higher grade DCIS appears more likely than lower grade DCIS to recur as DCIS or invasive breast cancer after treatment.

• #29 Ductal Carcinoma In Situ (DCIS) Fact Sheet | Westmead BCI

  https://www.bci.org.au/breast-cancer-information/fact-sheets/ductal-carcinoma-situ-dcis/

  DCIS is usually diagnosed on a core needle biopsy before surgery. Sometimes, even when the core biopsy shows DCIS, areas of invasive breast cancer are seen when the whole area is removed by a surgeon and examined in detail by a pathologist. In around a quarter of cases, early invasive breast cancer (rather than only DCIS) is found in the final pathology. This is more likely if the area of DCIS is large or if it can be felt as a lump. The surgeon can discuss the likelihood of invasive breast cancer with you before the operation. […] There are several ways to treat DCIS. Each treatment has advantages and disadvantages. […] Wide excision alone may be suitable for some women with small areas of low risk DCIS. In most cases surgery is combined with a course of radiotherapy as it has been proven that radiotherapy significantly reduces the chances of DCIS or invasive cancer affecting the breast in the future.

• #30 Ductal carcinoma in situ (DCIS): pathological features, differential diagnosis, prognostic factors and specimen evaluation | Modern Pathology

  https://www.nature.com/articles/modpathol201040

  No biomarkers have been convincingly shown, and validated, to predict the behavior of DCIS till date. […] Ductal carcinoma in situ (DCIS) is a malignant, clonal proliferation of cells growing within the basement membrane-bound structures of the breast and with no evidence of invasion into surrounding stroma. […] Where mammographic breast screening is not performed, DCIS constitutes approximately 5% of breast cancers but within screening programs it comprises approximately 20-25% of these tumors. […] However, it is now generally accepted that DCIS is not one entity but rather a heterogeneous group of lesions clinically, radiologically, morphologically and genetically. […] This heterogeneity adds complexity to the pathologist’s role, in macroscopic specimen handling, and microscopic diagnosis and prognostic feature assessment.

• #31 Ductal carcinoma in situ (DCIS): pathological features, differential diagnosis, prognostic factors and specimen evaluation | Modern Pathology

  https://www.nature.com/articles/modpathol201040

  Thus, the presently recognized pathological prognostic factors for local recurrence of DCIS, nuclear grade, presence/absence of necrosis and architectural pattern(s), size/extent of DCIS and distance to excision margins/margin status should all be included in the pathology report. […] Use of a synoptic report is one technique that is widely used to ensure that all relevant features are included and allows for standardization of reporting of DCIS lesions.

• #32 Diagnosis of ductal carcinoma in situ | Cancer Australia

  https://www.canceraustralia.gov.au/cancer-types/breast-cancer/how-breast-cancer-diagnosed/diagnosis-ductal-carcinoma-situ

  Ductal carcinoma in situ (DCIS) is a non-invasive breast condition that can potentially develop into invasive breast cancer, and its pathology report provides crucial information for treatment decisions, including size, location, surgical margin status, grade, and hormone receptor status. […] Ductal carcinoma in situ (DCIS) is not breast cancer as we commonly understand it, because it has not spread outside the milk ducts into other parts of the breast, or to other parts of the body. Without treatment, DCIS may develop into invasive breast cancer, which can spread outside the ducts and possibly to other parts of the body. […] The DCIS pathology report contains important information about a woman’s DCIS that is used to decide on treatment recommendations. […] The pathology report usually includes the following information: Size and locationThe report shows the size of the DCIS and where it is in the breast. This will affect what treatments are recommended, including the type of surgery.

• #33 Oncotype DX DCIS Score® Test │ Precision Oncology

  https://precisiononcology.exactsciences.com/patients-and-caregivers/understanding-your-diagnosis/breast-cancer/breast-dcis-score

  After a diagnosis of non-invasive stage 0 breast cancer (called ductal carcinoma in situ [DCIS]), you and your doctor will need to determine the next steps in your treatment. The Oncotype DX Breast DCIS Score test provides a score that indicates the probability of whether your cancer will recur and if radiation therapy is right for you. […] The DCIS Score test uses genomics to give you and your doctor important risk information about how your individual tumor will likely behave. […] The 10-year risk of your tumor coming back in the same breast as another DCIS tumor […] The 10-year risk of your cancer coming back as invasive breast cancer […] Whether you may benefit from radiation therapy. […] It was the first clinically validated genomic test available for patients with DCIS. […] It can provide important insights into determining your treatment decisions.

• #34 Oncotype DX DCIS Score® Test │ Precision Oncology

  https://precisiononcology.exactsciences.com/patients-and-caregivers/understanding-your-diagnosis/breast-cancer/breast-dcis-score

  Your DCIS Score result predicts how likely your cancer is to return. Based on a very low score, you may feel comfortable avoiding aggressive surgery or radiation, or vice versa if your score is high. […] Without the DCIS Score test, doctors can only estimate how likely your cancer is to return by looking at factors such as margin width, tumor size, and tumor grade.

• #35 Breast Ductal Carcinoma in Situ – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK567766/

  Given the noninvasive nature of DCIS, metastases or death in women with DCIS who are treated are rare. If untreated, however, DCIS usually transforms into invasive cancer that may be deadly. […] A recent meta-analysis from 2019 identified 6 factors that were linked to a higher risk of recurrence of invasive breast cancer. These factors are DCIS found by a doctor during a physical exam, premenopausal, positive margins, high-grade DCIS, high levels of p16 protein, and African American ethnicity.

• #36 Pathology Outlines – DCIS

  https://www.pathologyoutlines.com/topic/breastmalignantdcis.html

  Risk of progression of untreated high grade DCIS to invasive carcinoma is not well characterized as most clinically detected high grade DCIS is excised surgically (N Engl J Med 2004;350:1430) […] A nomogram for predicting recurrence risk after breast conserving surgery based on clinical, pathologic and treatment variables has shown utility in providing individualized estimates of recurrence risk (J Clin Oncol 2010;28:3762) […] Positive surgical margins, high nuclear grade, large lesion size, comedo necrosis and young age (< 45 years) reported as the most important clinical pathologic predictors associated with local recurrence and prognosis (J Clin Oncol 1996;14:754, Int J Radiat Oncol Biol Phys 2001;50:991, Cancer 1999;85:616, J Clin Oncol 2006;24:3381, Cancer 2005;103:2481, Breast Cancer Res Treat 2008;109:405, Eur J Cancer 2007;43:291, Breast J 2005;11:242)

• #37 Ductal carcinoma in situ (DCIS): pathological features, differential diagnosis, prognostic factors and specimen evaluation | Modern Pathology

  https://www.nature.com/articles/modpathol201040

  Nevertheless, even if such gaps are present in an individual case, the size of DCIS reported should be the overall size of the disease process, rather than reporting individually the size of each focus. […] Despite the additional effort that is required to obtain better reproducibility of grading of DCIS, as noted above one advantage of classifying DCIS according to cytonuclear grade is that there is less commonly a variation within an individual lesion. […] Grade of DCIS in surgical excisions relates to risk of local recurrence and to be relatively reproducible; the histological grade of DCIS in core biopsy specimens is also clinically relevant with regard to the likelihood of there being radiologically unsuspected invasion. […] If, for example, a patient has more than 40 flecks of calcification on mammogram and core biopsy demonstrates high-grade DCIS, the risk of a radiologically occult invasive focus is 48%.

• #38 Ductal Carcinoma In Situ (DCIS) Fact Sheet | Westmead BCI

  https://www.bci.org.au/breast-cancer-information/fact-sheets/ductal-carcinoma-situ-dcis/

  DCIS is usually diagnosed on a core needle biopsy before surgery. Sometimes, even when the core biopsy shows DCIS, areas of invasive breast cancer are seen when the whole area is removed by a surgeon and examined in detail by a pathologist. In around a quarter of cases, early invasive breast cancer (rather than only DCIS) is found in the final pathology. This is more likely if the area of DCIS is large or if it can be felt as a lump. The surgeon can discuss the likelihood of invasive breast cancer with you before the operation. […] There are several ways to treat DCIS. Each treatment has advantages and disadvantages. […] Wide excision alone may be suitable for some women with small areas of low risk DCIS. In most cases surgery is combined with a course of radiotherapy as it has been proven that radiotherapy significantly reduces the chances of DCIS or invasive cancer affecting the breast in the future.

• #39 Ductal carcinoma in situ (DCIS) | Breast Cancer Now

  https://breastcancernow.org/about-breast-cancer/diagnosis/types-of-breast-cancer/ductal-carcinoma-in-situ-dcis/

  DCIS is diagnosed using a range of tests. These may include: A breast examination, A mammogram (breast x-ray), An ultrasound scan, A core biopsy (using a hollow needle to take a sample of tissue, under local anaesthetic, to be looked at under a microscope several tissue samples may be taken at the same time), A vacuum assisted biopsy (a hollow probe connected to a vacuum is used to take a sample of tissue, under local anaesthetic, to be looked at under a microscope) […] If you have calcifications, further mammograms will be done to see the calcifications in more detail. Sometimes an ultrasound will also be done. […] The biopsy samples will be x-rayed to check if they contain calcifications before being sent to the laboratory to be examined under a microscope. […] DCIS is graded based on what the cells look like under the microscope. They will be given a grade according to how different they are to normal breast cells and how quickly they are growing.

• #40 Understanding Ductal Carcinoma In Situ (DCIS) | NBCFNational Breast Cancer Foundation logoNational Breast Cancer Foundation logo

  https://nbcf.org.au/about-breast-cancer/diagnosis/ductal-carcinoma-in-situ/

  Ductal carcinoma in situ (DCIS) is considered the earliest form of breast cancer. A diagnosis of DCIS means that abnormal cells have been found within the milk ducts of the breast. At this stage, the cells have not broken through the walls of the milk ducts into the surrounding breast tissue. […] Ductal carcinoma in situ is generally diagnosed via the following methods: Mammogram, Ultrasound. The majority of cases of DCIS are diagnosed with a mammogram. The mammogram detects tiny specks of calcium known as calcifications which come from a build-up of older cancer cells and will appear as dark shadows or white specks. […] If the mammogram does appear suspicious your doctor may recommend a biopsy. This involves taking a small sample of cells or tissue from the area of concern in the breast, which is then examined by a pathologist. The pathologist will determine if there is cancer and identify the grade (how abnormal the cells look and how fast they are growing) of the DCIS, and the type, the hormone receptor status.

• #41 Ductal Carcinoma In Situ (DCIS) | BCRF

  https://www.bcrf.org/about-breast-cancer/dcis-ductal-carcinoma-in-situ/

  DCIS diagnosis has increased significantly since routine screening mammograms became widespread. […] A DCIS diagnosis is ultimately confirmed by biopsy; tissue is removed and sent to the lab for analysis. […] Typically, DCIS is categorized by what’s called nuclear grade, which measures the characteristics of the nuclei of the cells like size and shape compared to the nuclei of normal breast cells. […] A DCIS diagnosis is categorized as low-grade (grade I), intermediate grade (grade II), or high-grade (grade III). […] DCIS treatment has a high success rate, in most cases removing the tumor and preventing recurrence. […] The prognosis is excellent—98 percent survival after 10 years. […] If left untreated, some cases of DCIS will transform into invasive breast cancer, but it is uncertain how many.

• #42 Ductal carcinoma in situ (DCIS): Symptoms, screening, and more

  https://www.medicalnewstoday.com/articles/ductal-carcinoma-in-situ

  Healthcare professionals do not typically use chemotherapy to treat DCIS. […] Treatment of DCIS varies depending on how much cancer is in the breast and if the DCIS is aggressive. […] The survival rate of DCIS is high because people receive their breast cancer diagnosis early and begin treatment before the cancer progresses to a more invasive type. […] According to Cancer Research UK, it is rare for DCIS to return after a mastectomy. […] Breastcancer.org notes that those who undergo a lumpectomy without radiation have a 2530% chance of experiencing a recurrence. With radiation therapy, this is lowered to 15%. […] Because people with DCIS have a higher risk of developing invasive breast cancer in the future, they should remember to physically examine their breasts for lumps and speak with their doctor if they notice any changes in the breast, a lump, or discharge from the nipple. […] People should be aware that mammography screenings detect most DCIS cases as the condition is often symptomless. As a result, a person should be sure to have regular screenings.

• #43 Breast Ductal Carcinoma in Situ – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK567766/

  Ductal carcinoma in situ (DCIS) of the breast represents neoplastic lesions, typically localized to the breast ducts with no evidence of invasion into the surrounding tissue. The diagnosis of DCIS has significantly increased in the recent past since the implementation of routine screening mammograms. […] Ductal carcinoma in situ (DCIS), or intraductal carcinoma, is a non-invasive breast cancer characterized by a proliferation of abnormal epithelial cells confined within the basement membrane. Disruption of the basement membrane layer would change the diagnosis from DCIS to invasive breast cancer. DCIS is considered to be a precursor for invasive breast cancer. […] Rates of diagnosis have been increasing with the use of screening mammography that detects pre-clinical microcalcifications. However, the diagnosis of DCIS does require a tissue biopsy. The treatment for DCIS is multidisciplinary and may include surgery, hormone therapy, and radiation therapy.

• #44 Ductal Carcinoma in Situ (DCIS) Melbourne, VIC | Radiotherapy Melbourne, VIC

  https://www.melbournebreastcancersurgery.com.au/ductal-carcinoma-in-situ-dcis.html

  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. Ductal Carcinoma in Situ (DCIS) is an early form of breast cancer and accounts for about 20% of all breast cancers. DCIS is diagnosed more often now than in the past. […] DCIS is considered non-invasive or pre-invasive breast cancer. DCIS cant spread outside the breast, but it still needs to be treated because it can sometimes go on to become invasive breast cancer (which can spread). […] DCIS usually has no symptoms. Most cases of DCIS are found during routine breast screening or if a mammogram (breast x-ray) is done for some other reason. […] Before commencement of screening mammography in Australia, DCIS made up only 2% of all newly diagnosed breast cancers. It usually presented with a palpable mass or was associated with another abnormality such as nipple discharge or Paget disease of the nipple, with or without a mass. It now represents around 20% of all newly diagnosed breast cancers detected by BreastScreen, Australia’s national screening program.

• #45 Ductal Carcinoma In Situ (DCIS) Fact Sheet | Westmead BCI

  https://www.bci.org.au/breast-cancer-information/fact-sheets/ductal-carcinoma-situ-dcis/

  Under general anaesthetic, the surgeon removes the whole breast and usually the nipple. This is sometimes the only treatment option for large areas of DCIS or cases where small clusters of DCIS are scattered through the breast. […] Hormone-blocking therapies such as tamoxifen and aromatase inhibitors are tablets that are often used in the treatment of invasive breast cancer. They can also reduce the chances of DCIS recurring in those women who have breast conservation rather than a mastectomy. However, with modern surgery and radiotherapy, the risk of recurrence is very low, and it is thought that the additional benefit from these tablets is small. Your doctor can talk to you about the potential benefits and risks in your situation. […] In DCIS, the cancer cells are contained in the milk ducts and do not invade into the breast tissue or spread to the lymph. It is therefore not usually necessary to remove the glands. However, if there is a large area of DCIS or lots of small clusters of DCIS, the chances of finding invasive cancer in the DCIS is higher and your surgeon may recommend sentinel node biopsy of the lymph glands. When mastectomy is recommended for DCIS, a sentinel node biopsy is frequently recommended. […] DCIS is not an emergency. You have time to consider your options carefully and to make a decision in your own time. Ask for a second opinion if you are unsure about what to do.

• #46 Ductal Carcinoma in Situ (DCIS) Program | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/treatment/breast-oncology/programs/ductal-carcinoma-in-situ

  Most DCIS likely takes a long time possibly years to develop into invasive cancer, and some DCIS will never develop into invasive cancer. Understanding which patients with DCIS are at low risk for developing invasive breast cancer and which patients are at high risk is an important goal of the DCIS program. It is generally safe for patients to take the time they need to evaluate all of their options and decide if and when surgery or other treatment is right for them. […] There are several treatment options to consider. You and your physician can discuss what’s appropriate for you based on your specific biopsy results and disease characteristics. We encourage everyone diagnosed with ductal carcinoma in situ to get a second opinion with us to help understand your options for treatment. All of the treatment options for DCIS are associated with excellent survival rates, including: Lumpectomy: A lumpectomy, also known as breast-conserving surgery, removes only the area of the breast tissue with DCIS and a small amount of healthy tissue around the DCIS to ensure complete removal (this is referred to as achieving a negative margin). Lumpectomy with radiation: After lumpectomy, radiation therapy to the remaining breast tissue may be recommended to reduce the risk of local recurrence (the chance that cancer will develop again in the same breast). Mastectomy: A mastectomy is the removal of all breast tissue. A mastectomy may be recommended if there is more than one area of DCIS in the breast or if your surgeon is concerned about your cosmetic outcome with a lumpectomy. Radiation therapy is generally not recommended after a mastectomy for DCIS. If you undergo mastectomy, your surgeon will also talk with you about your options for breast reconstruction. Endocrine (hormonal) therapy: Some DCIS cells are sensitive to estrogen, meaning they use estrogen to grow. This is called estrogen receptor (ER)-positive DCIS. If you have ER-positive DCIS, medication (in pill form) to block estrogen may be recommended to reduce the risk of recurrence in that breast after surgery and to decrease the risk of developing a breast cancer in the other breast. Endocrine therapy is typically taken for five years and may be recommended with or without radiation.

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