DCIS - Ductal Carcinoma In Situ

Image - Range of Ductal Carcinoma in situ (DCIS)

Ductal carcinoma in situ (DCIS) is the most common type of non-invasive breast cancer. Ductal means that the cancer starts inside the milk ducts, carcinoma refers to any cancer that begins in the skin or other tissues (including breast tissue) that cover or line the internal organs, and in situ means "in its original place." DCIS is called "non-invasive" because it hasn’t spread beyond the milk duct into any normal surrounding breast tissue. DCIS isn’t life-threatening, but having DCIS can increase the risk of developing an invasive breast cancer later on.

When you have had DCIS, you are at higher risk for the cancer coming back or for developing a new breast cancer than a person who has never had breast cancer before. Most recurrences happen within the 5 to 10 years after initial diagnosis. The chances of a recurrence are under 30%.

Women who have breast-conserving surgery (lumpectomy) for DCIS without radiation therapy have about a 25% to 30% chance of having a recurrence at some point in the future. Including radiation therapy in the treatment plan after surgery drops the risk of recurrence to about 15%. If breast cancer does come back after earlier DCIS treatment, the recurrence is non-invasive (DCIS again) about half the time and invasive about half the time. (DCIS itself is NOT invasive.)

According to the American Cancer Society, about 60,000 cases of DCIS are diagnosed in the United States each year, accounting for about 1 out of every 5 new breast cancer cases.

There are two main reasons this number is so large and has been increasing over time:

People are living much longer lives. As we grow older, our risk of breast cancer increases.
More people are getting mammograms, and the quality of the mammograms has improved. With better screening, more cancers are being spotted early.

Signs and Symptoms of DCIS
DCIS generally has no signs or symptoms. A small number of people may have a lump in the breast or some discharge coming out of the nipple. According to the National Cancer Institute, about 80% of DCIS cases are found by mammography.

Treatment for DCIS
Standard treatment options for DCIS include:

Lumpectomy followed by radiation therapy: This is the most common treatment for DCIS. Lumpectomy is sometimes called breast-conserving treatment because most of the breast is saved.

Mastectomy: Mastectomy, or removal of the breast, is recommended in some cases.
Lumpectomy alone

Hormonal therapy: These treatments, which block or lower the amount of estrogen in the body, are typically used if the DCIS tests positive for hormone receptors.
Chemotherapy, a form of treatment that sends anti-cancer medications throughout the body, is generally not needed for DCIS. DCIS is non-invasive and remains within the breast duct, so there is no need to treat cancer cells that might have traveled to other areas of the body.

Each individual situation is different. You and your doctor will decide what treatment is best for your situation. If the DCIS is large, high-grade, and comedo type, for example, it is likely to be more aggressive, and your doctor may recommend more extensive treatment. The same holds true if you are under age 40, since younger age may increase the risk of recurrence.

Follow-up Care for DCIS

After surgery and radiation therapy, you and your doctor will work together to develop a plan for your follow-up care. If you had a mastectomy and are undergoing breast reconstruction, you will have a series of office visits to check on your healing. If you are taking tamoxifen or another form of hormonal therapy, this usually continues for a period of about 5 years, so your doctor will want to monitor you throughout that time.

Although follow-up care plans can vary from person to person, your plan is at least likely to include:

-a checkup and physical exam by your doctor every 6 to 12 months for 5 years and then once a year after that
-a mammogram every 12 months and possibly other screening methods depending on your doctor’s recommendations

more detail check this http://www.breastcancer.org