DCIS – Ductal carcinoma in situ : as the name clearly suggests DCIS is presence of tumor or cancerous cells in the milk duct of the breasts. It is a localized growth and as such is non – invasive , though it can take an invasive form and as such needs to be treated immediately. One out of every five breast cancer is a DCIS. There has been a rise in DCIS incidence among women due to improved breast cancer screening programs and better quality mammograms which detect DCIS with quite a precision. This cancer is usually categorized under type 0 cancer, which implies a non – invasive cancer in early stages.
DCIS can be categorized into three grades depending upon the growth of cancerous cells: Grade I, II and III. The low grade of grade I tumor in DCIS refers to cells which are normal looking and slow growth cells. Grade I and Grade II are relatively slow growth tumors in DCIS as compared to grade III DCIS. Grade III DCIS patients have increased chances of developing invasive cancer with progress in time and these patients are at a higher risk of recurrence of cancer as compared to the grade I and grade II DCIS – within a span of 5 years and not after 5 years.
A term – “comedo necrosis” is also used to describe these cancers. In grade I and grade II DCIS is described as non – comedo while in grade III DCIS is explained as comedo necrosis. Comedo implies an area of dead or necrotic cancer/ tumor cells. In grade I and grade II DCIS, the cells get enough nourishment to grow unlike in grade III DCIS where cells starve and die giving rise to necrosis cells.
Majority of the affected female population did not have any specific presenting complaints, though a small portion report feeling pain in the breast and sometimes a discharge from the nipple of the breast. Usually DCIS does not cause any lump formation in the breast.
DCIS cases are easily detected by mammograms, about 80% of DCIS cases are diagnosed through a mammogram. The basic functionality of a mammogram is detection of dead cancer cells through calcium that develops in them. These calcifications due to comedo necrosis is presented as shadows in a mammogram. On a positive mammogram for ductal carcinoma in situ, the next step is a tissue biopsy, in which with the use of needles tissue sample is taken from the breast and pathology of the tissue is done. Other tests like ultrasound and MRI are also performed on the patient to know more about the DCIS cancer. These tests are able to give a definitive picture of the tumor size and the spread of the tumor cells.