Ductal Carcinoma in Situ

Ductal Carcinoma in Situ, also known as DCIS, is a pathological abnormality that is commonly found after a breast biopsy has been performed. Currently, DCIS is on the rise with 63,410 newly diagnosed cases estimated in 2017 (ACS Cancer Facts & Figures 2017). Often misunderstood, DCIS is not an invasive breast cancer. It is considered stage O in alignment with the National Comprehensive Cancer Network (NCCN) guidelines. When Ductal Carcinoma in Situ is identified in a tissue sample, it is graded on a low, medium and high scale. Also, the cells will be identified as cribriform spaces, micropapillae, solid or papillary. Diagnosis of DCIS has steadily risen over the years. Health care professionals specu-late that this is due to many factors. These include improved radiology screening and advancement in technolo-gy, higher patient education levels, and an increase in mammogram screening.

DCIS can be very complicated because treatment regimens are not al-ways clear-cut. Treatment can vary from surgical excision with negative margins, radiation therapy, or mastectomy with chemoprevention. Patients often report anxiety, as their providers do not always have a definitive treatment plan. This can lead to confusion on what the ‘right’ deci-sion is for the patient. Each case of DCIS can be very different, therefore making the decision on how to treat even more complex.

Research is ever evolving and there is much work to do about DCIS. Some current trends include adjusting radiation position to limit exposure to organs such as the heart and lungs, creating a healthy immune system to respond to changes in the cells’ activity, and vaccination. Patients should always make healthy lifestyle choices to help lower their risk of developing DCIS or invasive cancer. These can include maintaining a healthy weight, limiting alcohol, and daily exercise. Women at normal risk should continue to have yearly routine mammograms, or at intervals recommended by their health care provider.