DCIS – Ductal Carcinoma In-Situ

(pathology findings explained)

Ductal Carcinoma in-situ, DCIS, is considered a Stage 0 or pre-invasive breast cancer. What does it mean to be in-situ or pre-invasive? It means that when the pathologist looks at the cells under the microscope, they do not see any evidence that the cells have the ability to invade into the surrounding tissue. The cells originate inside the milk duct and are all still confined within the milk duct. This is important because breast cancer kills people by invading into the body and spreading to other parts of the body. Breast cancer cells that do not have the ability to invade, cannot spread.

The Goal in DCIS

The goal in DCIS is to get rid of the bad cells before they gain the ability to spread. This is almost always done by surgery. There is some interest in trying to find a subset of patients that could be treated with an estrogen hormone blocker as an alternative to surgery. Certainly, this would be a nice option but there is little data to support this as a recommended approach and until we have good quality research to support the practice, surgery remains the treatment of choice.

Treatment for DCIS

The surgical treatment for DCIS are similar to invasive breast cancer. Partial mastectomy (sometimes called lumpectomy) is generally encouraged as long as the surgeon feels that breast will tolerate the extent of the resection with an adequate cosmetic outcome and there are no contraindications for breast preservation. Mastectomy is reserved for when there is a large extent of disease or when the patient’s preference is for mastectomy. Reconstruction is always encouraged. We urge all our patients to meet with Plastic Surgery, even those who think they would not want a reconstruction, just to make sure that they understand all the options out there. We also want everyone to be reassured by the skill of our Anchorage based Plastic Surgeons.