Ductal carcinoma in situ (DCIS) is the presence of abnormal cells inside a milk duct in the breast.

DCIS is considered the earliest form of breast cancer. DCIS is noninvasive, meaning it hasn't spread out of the milk duct and has a low risk of becoming invasive.

DCIS is usually found during a mammogram done as part of breast cancer screening or to investigate a breast lump.

Symptoms

DCIS doesn't typically have any signs or symptoms. However, DCIS can sometimes cause signs such as:

• A breast lump
• Bloody nipple discharge

DCIS is usually found on a mammogram and appears as small clusters of calcifications that have irregular shapes and sizes.

Causes

It's not clear what causes DCIS. DCIS forms when genetic mutations occur in the DNA of breast duct cells. The genetic mutations cause the cells to appear abnormal, but the cells don't yet have the ability to break out of the breast duct. Researchers don't know exactly what triggers the abnormal cell growth that leads to DCIS. Factors that may play a part include your lifestyle, your environment and genes passed to you from your parents.

Risk factors

Factors that may increase your risk of DCIS include:

• Increasing age
• Personal history of benign breast disease, such as atypical hyperplasia
• Family history of breast cancer
• Never having been pregnant
• Having your first baby after age 30
• Having your first period before age 12
• Beginning menopause after age 55
• Genetic mutations that increase the risk of breast cancer, such as those in the breast cancer genes BRCA1 and BRCA2

Diagnosis

• Breast imaging
• Removing breast tissue samples for testing

Treatment

Treatment of DCIS has a high likelihood of success, in most instances removing the tumor and preventing any recurrence.

In most people, treatment options for DCIS include:

• Breast-conserving surgery (lumpectomy) and radiation therapy
• Breast-removing surgery (mastectomy)

In some cases, treatment options may include:

• Lumpectomy only
• Lumpectomy and hormone therapy
• Participation in a clinical trial comparing close monitoring with surgery

Surgery

• Lumpectomy.
• Mastectomy.

Radiation therapy

Hormone therapy

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