Ductal Carcinoma in Situ (DCIS)

DCIC is a NON-invasive breast malignancy.  It is present in the milk ducts and it has NOT spread into the surrounding normal breast tissue.  DCIS is not life-threatening, but it is associated of higher risk of developing an invasive breast cancer.  The rates of DCIS are increasing because people are living longer and because of improved breast screening and imaging.

DCIS usually does not present with any symptoms, but is a finding on a mammogram.  A small number of women present with a mass or bloody discharge or nipple changes.

Diagnosis usually involves physical examination of the breasts, imaging (mammogram +/-USS+/-MRI) and core biopsy.   If core biopsy is not conclusive, then excisional biopsy is usually necessary.

The pathology report will include the diagnosis of the DCIS, grade of DCIS (grade1-3) and whether any microinvasion is present.  In Wellington region the hormonal receptor status on DCIS is not performed.

Standard Treatments for DCIS

• Lumpectomy alone

• Lumpectomy followed by radiation therapy

• Mastectomy with or without breast reconstruction

“One size fits all” does NOT apply to treatment recommendations of DCIS or invasive breast cancer.

In Wellington region, all cases of DCIS and invasive breast cancer are discussed at the Breast multidisciplinary meeting following surgery.  Members of this meeting include:  breast surgeons, breast radiologist, medical oncologist (chemotherapy specialists), radiation oncologists (radiotherapy specialists), breast pathologists and may include breast physicians.  Recommendations of any further treatment are made at this meeting.  If radiation treatment is recommended, then patients are referred to be seen by the Radiation Oncologist for discussion of risks and benefits of radiation treatment.