Disease: Ductal carcinoma in situ (DCIS)


    Ductal carcinoma in situ (DCIS) is the presence of abnormal cells inside a milk duct in the breast.

    DCIS is considered the earliest form of breast cancer. DCIS is noninvasive, meaning it hasn't spread out of the milk duct and has a low risk of becoming invasive.

    DCIS is usually found during a mammogram done as part of breast cancer screening or to investigate a breast lump.

    While DCIS isn't an emergency, it does require an evaluation and a consideration of treatment options. Treatment may include breast-conserving surgery combined with radiation or surgery to remove all of the breast tissue. A clinical trial studying active monitoring as an alternative to surgery may be another option.

    Source: http://www.mayoclinic.com


    DCIS doesn't typically have any signs or symptoms. However, DCIS can sometimes cause signs such as:

    • A breast lump
    • Bloody nipple discharge

    DCIS is usually found on a mammogram and appears as small clusters of calcifications that have irregular shapes and sizes.

    When to see a doctor

    Make an appointment with your doctor if you notice a change in your breasts, such as a lump, an area of puckered or otherwise unusual skin, a thickened region under the skin, or nipple discharge.

    Ask your doctor when you should consider breast cancer screening and how often it should be repeated. Most groups recommend considering routine breast cancer screening beginning in your 40s. Talk with your doctor about what's right for you.

    Source: http://www.mayoclinic.com


    It's not clear what causes DCIS. DCIS forms when genetic mutations occur in the DNA of breast duct cells. The genetic mutations cause the cells to appear abnormal, but the cells don't yet have the ability to break out of the breast duct.

    Researchers don't know exactly what triggers the abnormal cell growth that leads to DCIS. Factors that may play a part include your lifestyle, your environment and genes passed to you from your parents.

    Source: http://www.mayoclinic.com


    Breast imaging

    DCIS is most often discovered during a mammogram used to screen for breast cancer. If your mammogram shows suspicious areas such as bright white specks (microcalcifications) that are in a cluster and have irregular shapes or sizes, your radiologist likely will recommend additional breast imaging.

    You may have a diagnostic mammogram, which takes views at higher magnification from more angles. This examination evaluates both breasts and takes a closer look at the microcalcifications to be able to determine whether they are a cause for concern.

    If the area of concern needs further evaluation, the next step may be an ultrasound and a breast biopsy.

    Removing breast tissue samples for testing

    During a core needle biopsy, a radiologist or surgeon uses a hollow needle to remove tissue samples from the suspicious area, sometimes guided by ultrasound (ultrasound-guided breast biopsy) or by X-ray (stereotactic breast biopsy). The tissue samples are sent to a lab for analysis.

    In a lab, a doctor who specializes in analyzing blood and body tissue (pathologist) will examine the samples to determine whether abnormal cells are present and if so, how aggressive those abnormal cells appear to be.

    Source: http://www.mayoclinic.com

    Alternative medicine

    No alternative medicine treatments have been found to cure DCIS or to reduce the risk of being diagnosed with an invasive breast cancer.

    Instead, complementary and alternative medicine treatments may help you cope with your diagnosis and the side effects of your treatment, such as distress. If you're distressed, you may have difficulty sleeping and find yourself constantly thinking about your diagnosis. You may feel angry or sad.

    Talk about your feelings with your doctor. Your doctor may have some strategies to help alleviate your symptoms.

    Combined with your doctor's recommendations, complementary and alternative medicine treatments may also help. Examples include:

    • Art therapy
    • Exercise
    • Meditation
    • Music therapy
    • Relaxation exercises
    • Spirituality

    Source: http://www.mayoclinic.com

    Coping and support

    A diagnosis of DCIS can be overwhelming and frightening. To better cope with your diagnosis, it may be helpful to:

    • Learn enough about DCIS to make decisions about your care. Ask your doctor questions about your diagnosis and your pathology results. Use this information to research your treatment options.

      Look to reputable sources of information, such as the National Cancer Institute, to find out more. This may help you feel more confident as you make choices about your care.

    • Get support when needed. Don't be afraid to ask for help or to turn to a trusted friend when you need to share your feelings and concerns.

      Talk with a counselor or medical social worker if you need a more objective listener.

      Join a support group — in your community or online — of women going through a situation similar to yours.

    • Control what you can about your health. Make healthy changes to your lifestyle, so you can feel your best. Choose a healthy diet that focuses on fruits, vegetables and whole grains. Try to be active for 30 minutes most days of the week. Get enough sleep each night so that you wake feeling rested. Find ways to cope with stress in your life.

    Source: http://www.mayoclinic.com

    Risk factors

    Factors that may increase your risk of DCIS include:

    • Increasing age
    • Personal history of benign breast disease, such as atypical hyperplasia
    • Family history of breast cancer
    • Never having been pregnant
    • Having your first baby after age 30
    • Having your first period before age 12
    • Beginning menopause after age 55
    • Genetic mutations that increase the risk of breast cancer, such as those in the breast cancer genes BRCA1 and BRCA2

    Source: http://www.mayoclinic.com

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