Types of DCIS

Ductal carcinoma in situ

DCIS  are abnormal cells that have the features of cancer, but are still confined to the inside of the duct. If DCIS is left untreated, it can go on to become an invasive cancer, so it is often called pre-cancer.

DCIS with microinvasion (DCIS-MI)

DCIS-MI is stage I breast cancer. The cancer cells have started to break through the wall of the duct.

Invasive ductal cancer (IDC)

Breast cancer is no longer considered  DCIS. It is now an invasive ductal carcinoma, the most common type of breast cancer. IDC can be diagnosed at any stage from I-IV.

Grades of DCIS

Grade I (low grade)

Grade 1 looks like normal cells but grows faster than normal cells. Grade 1 cancer is considered slow growing, but enough nourishment to feed all the cells.

Grade II (moderate grade)

Looks less than the normal breast cell and grows faster than the normal cell. Grade II cancer is considered slow growing, but enough nourishment to feed all the cells.

Grade III (high-grade)

Looks considerably different from a healthy breast cell and grows quickly. People with high-grade DCIS have a higher risk of invasive cancer.

How can DCIS be detected?

Physical examination of the breast

DCIS usually cannot be felt during a physical exam, but you may be able to feel a small lump.A noticeable lump is rare with DCIS, .

Mammogram

Mammogram will always show the cancer cells inside the ducts whether it forms into calcifications or microcalcifications

3D Ultrasound

Looks considerably different from an ultrasound can identify If there are calcifications, which depending on the type of DCIS may appear on the screen as white flecks or dark spots.

Biopsy

Your doctor will order a biopsy if you have a suspicious mammogram. During the biopsy, a needle is inserted into the breast, and samples of cells are removed and examined under a microscope.

Treatment options for DCIS

You and your doctor will decide the best treatment plan for your kind of DCIS. Chemotherapy is usually not a need for DCIS as it is non-invasive and remains within the breast duct, but each individual situation is different.

Lumpectomy

Remove the area of DCIS and margin of healthy breast tissue around it.This is usually a very good option if the DCIS only appears in one area of the breast and can be completely removed with clear margins of healthy tissue. Lumpectomy is also called breast-conserving surgery(BCS) and it is the most common treatment for DCIS

Lumpectomy followed by radiation

After a lumpectomy for breast cancer, radiation therapy is typically used. Lumpectomy is a surgery that removes only the tumor and a small amount of normal breast tissue around it. Lumpectomy plus radiation has been shown to be as effective as mastectomy. Almost all women get radiation therapy after lumpectomy to reduce the risk of recurrence.

Mastectomy

Removal of all the breast tissue. This treatment is recommended in some cases

Hormonal therapy

NOTE:

Ask your doctor if they will be testing for the hormone receptors, some hospitals may not test for hormone receptors for DCIS.

• People with DCIS are at a higher risk of developing another breast cancer in the future. Adding hormonal therapy can lower the risk If your hormone receptors test positive. Hormonal therapy such as tamoxifen will be prescribed  to block or lower the amount of estrogen in the body.