Ductal Carcinoma in Situ (DCIS) & Mastectomy

In India Breast Cancer is the top occurring cancer amongst females with a mortality rate of 12.7 per 1,00,000. A non-invasive form of breast cancer, Ductal carcinoma in situ (DCIS) is a common form of cancer in India. Ductal means ducts as its starts in the milk ducts and carcinoma means cancer that starts in the skin or any other tissues covering the internal organs and in situ means in its original place. The reason this cancer is known as non- invasive cancer is that is has not spread beyond the milk duct to the neighboring tissues.

DCIS is a grade 0 cancer and is not a life threatening cancer but having it in first place does increase the risk of developing an invasive breast cancer later on compared to people who haven’t had it before. The possibility of recurrence is usually 5 or 10 years post the first appearance with a 30% likelihood.

Ductal carcinoma in situ (DCIS)

The possibility of recurrence in women undergoing the breast conserving surgery is around 25% to 30% . To lower the risk of recurrence by 15% you need to include radiation therapy in the treatment plan. Also, if DCIS comes back after treatment it could either be non-invasive or invasive too, chances are 50% for each.

Here’s a look through the symptoms, causes, diagnosis and treatment of the condition.

DICS – Symptoms
Generally there are no visible symptoms of DCIS. Only a few people might have a lump in the breast or some nipple discharge. Diagnosis is only possible for most of the cases through mammography.

DICS – Diagnosis
Breast Examination – A physical examination of breasts is carried out if a lump is present though such lump is rarely noticeable.

Mammography – A mammography can easily detect DCIS. Even when a physical examination fails, mammography can be used to detect DCIS.

Biopsy – Biopsy is only carried out when a mammogram does not give a clear result. There are two kinds of non-invasive biopsies which involve a bit of surgery.

  •  Core needle biopsy – A large needle is inserted for a big sample of tissue from the suspicious area.
  •  Fine needle biopsy – A sample of cells are obtained by inserting a small hollow needle in the breast and then examining it under the microscope.

Though more invasive biopsies are rarely need for DCIS, if the above are not able to give conclusive results then biopsies like incisional and excisional biopsy’s are to be done.

Treatment – Once the diagnosis confirms DCIS, surgery is done to remove the cancer as well as the border of the healthy tissues surrounding the cancer, known as the clear margins. This means doing the procedure of lumpectomy or sometimes mastectomy.