Ductal Breast Cancer in Situ (DCIS)

Symptoms and Grades

Ductal Carcinoma in Situ (DCIS), also known as Intraductal Carcinoma, is a type of noninvasive or preinvasive cancer that starts in the cells of the ducts of the breasts and remains contained within the ducts. '

DCIS typically produces no symptoms. It is usually discovered on routine examination and appears as small clusters of irregular calcifications on a mammogram.

DCIS is generally considered to be Stage O of Invasive Ductal breast cancer since it is non-invasive.

All ductal breast carcinomas begin as DCIS. One in five DCIS lesions, if left untreated, will escape from the confines of the duct to become an invasive ductal cancer of the breast.

Some studies say that it can take 9 years to go from a single cell to an invasive lesion for the slowest growing lesions, 6 years for intermediate growing DCIS lesions, and 3 years for fast-growing DCIS lesions.

Symptoms of DCIS

No Symptoms: In most cases, DCIS produces no symptoms at all. It is diagnosed at routine mammography or physical examination.

Breast Lump: In some cases, a small lump may be felt under the nipple or areola of a normal breast . Like most breast cancers, these are also non-tender and firm lumps.

Nipple Discharge: Some women may have a nipple discharge which may be yellowish, greenish or reddish. Reddish implies the presence of blood while greenish or yellowish may indicate the presence of infection.

Pain: Pain is very uncommon. But in the presence of infection of the lump, there may be some amount of pain.

Rash or itching: A rash or itching on or around the nipple which does not respond to any medicine may occur due to irritation by the nipple discharge.

Symptoms of Ductal Breast Cancer in situ

Grades of DCIS

DCIS is graded after pathological examination of the breast tissue obtained by biopsy. Grading depends on the presence of abnormal cells in the ducts and the degree of abnormality of the cells as compared to normal cells. It also depends on the stage of growth of the abnormal cells. There are three grades:

Grade I or Low grade - Grade I or low-grade DCIS cells look very similar to normal cells. They have a low risk for developing into invasive ductal cancer in the next 5 years. Recurrence rate is also low. It is sometimes described as "non-comedo" DCIS. This means that there are not many dead cancer cells in the tumor. When a tumor grows quickly, some of its cells begin to die off. A lesser number of dead cells shows that the cancer is growing slowly.

Grade II or Moderate Grade - Moderate grade DCIS is also non-comedo tumor with less dead cells. It too grows slowly with less risks of developing into invasive ductal cancer. But the cells in Grade II are less mature than grade I and with less differentiation. Less differentiated cells can develop earlier into cancerous cells.

Grade III or High Grade - In the high-grade pattern, DCIS cells tend to grow more quickly and look much different from normal, healthy breast cells. People with high-grade DCIS have a higher risk of invasive cancer, either when the DCIS is diagnosed or at some point in the future. They also have an increased risk of the cancer coming back earlier - within the first 5 years rather than after 5 years.

Read More :

Risk factors of DCIS

Diagnosis of DCIS