Early diagnosis helps treat breast cancer on time. Awareness is essential in understanding when to seek medical help. Today, in our series on understanding breast cancer, we talk about one of the most common types of breast cancer – Ductal Carcinoma In Situ (DCIS).
What is Ductal Carcinoma In Situ (DCIS)?
Ductal Carcinoma In Situ is non-invasive breast cancer that occurs in the milk ducts of the breast. It’s in situ, which means it does not spread to other healthy tissues from its point of origin. DCIS is one of the most common types of breast cancer – according to national records, 1 in every five new breast cancer cases is a DCIS. Although DCIS isn’t life-threatening, it slightly increases the risk of having invasive breast cancer later on in your life.
DCIS is relatively easy to treat and has favorable rates of survival. With timely intervention and financial support, DCIS patients can achieve complete recovery and the chance at a fulfilling life.
Signs and Symptoms of DCIS
Typically, DCIS does not show any symptoms. The following, however, could be possible signs:
- You feel a lump when you press your breast
- Reddish, bloody discharge from the nipple
Mammography can usually detect ductal carcinoma in situ. In the scan, DCIS appears as irregular clusters of calcifications (hardened tissue).
Diagnosis of DCIS
There are a couple of ways to diagnose DCIS. Doctors usually use a combination of procedures as it is hard to confirm DCIS with a single test.
Physical examination: Physical examination is the first step of a breast cancer diagnosis. However, it is usually ineffective for DCIS, as a noticeable lump by physical examination is rare.
Mammography: Mammography is the most viable method of detection for DCIS. In the mammogram, ductal carcinoma in situ appears as specks of white or as shadows.
Biopsy: If a mammogram shows results that require further investigation, the doctor might prescribe a biopsy to collect samples. There are two methods to conduct a biopsy- via a needle or through small incisions.
- Fine needle aspiration biopsy leaves no scars, while core needle biopsy leaves a barely visible scar for a few weeks.
- An incisional biopsy removes a small piece of the affected tissue. An excisional biopsy removes the entire lump of breast tissue.
Depending upon the biopsy results, the doctor will tell you the type and grade of the DCIS and the hormone receptor status of the cancer cells.
Type and grade of DCIS
The type, grade, and hormone status of DCIS determine the treatment that suits you the most. So, what do type and grade mean for cancer?
Type and grade are information gathered by comparing the cancer cells with the healthy breast cells. There are three grades of DCIS: I, II, and III, which are called low, moderate, and high-grade DCIS, respectively. The lower the grade is, the more is the similarity between the cancer cells and healthy cells. Cancer grade also helps us understand how fast cancer is spreading.
Hormone receptor status tells us if there are hormone receptors in the cancer cells that react positively to estrogen or progesterone, i.e., the result tells us if estrogen or progesterone helps the cancer cells grow. If the status is positive, you may need to undertake a treatment that blocks the hormones.
Treatment for DCIS
DCIS treatment has a high success rate. Most of the time, the treatment completely removes the tumor and thus reduces the chances of recurrence. Early detection and prompt treatment make for a very successful recovery.
Lumpectomy, followed by radiation therapy: Also called breast-conserving treatment, lumpectomy is the most common treatment method for DCIS. Here, the surgeon removes the affected part of the breast and a thin area of healthy tissue surrounding it.
Mastectomy: Complete removal of the breast is called mastectomy. This treatment is recommended for recurrent cancers.
Post-surgical Hormonal therapy: If you test positive for hormone receptors, then hormonal treatment is the best option. It will block and lower the amount of estrogen in the body and stop the growth of the cancer cells.
Since DCIS is a non-invasive form of cancer, usually, there is no need for chemotherapy.
Follow-Up Care for DCIS
Follow-up care is essential for all surgical treatments. Experts recommend physical examinations every 6-12 months for five years and once a year after that. Regular mammograms and screening methods every year will also be likely in follow-up routines.
DCIS is considered non-life-threatening cancer and has high chances of complete recovery. With the proper medical attention at the right time, you can be free from DCIS and get your life back on track.