What is ductal carcinoma in situ (DCIS)?

Ductal carcinoma in situ (DCIS) is an early form of breast cancer that is non-invasive, meaning it has not spread beyond the milk ducts of the breast into surrounding tissue. DCIS is often referred to as stage 0 breast cancer and is typically found during routine mammograms before any symptoms are noticeable. While DCIS itself is not life-threatening, if left untreated, it has the potential to develop into invasive breast cancer over time. Early detection and treatment of DCIS can prevent this progression and improve long-term outcomes.

Symptoms of DCIS

In most cases, DCIS does not cause any noticeable symptoms, which is why regular breast screening is so important for early detection. However, in rare instances, women with DCIS may experience the following symptoms:

• A lump in the breast.
• Nipple discharge, which may be bloody.
• Changes in the appearance of the breast or nipple.

Because DCIS is usually detected during a mammogram, it’s vital to attend regular screenings as recommended, even if you feel well or do not have any symptoms.

Diagnosis

DCIS is often diagnosed during routine breast screening with a mammogram, which can detect calcifications (small deposits of calcium) in the breast ducts. These calcifications may indicate DCIS or other changes in the breast tissue. If DCIS is suspected, further tests will be carried out to confirm the diagnosis, including:

• Ultrasound: This scan uses sound waves to create an image of the breast and can help identify abnormal areas.
• Biopsy: A small sample of tissue is taken from the suspicious area for analysis to determine if cancerous cells are present. A core needle biopsy or vacuum-assisted biopsy is typically used.
• MRI: In some cases, a magnetic resonance imaging (MRI) scan may be recommended to provide more detailed images of the breast.

Once DCIS is confirmed, your healthcare team will work with you to develop a treatment plan that aims to remove the cancerous cells and reduce the risk of recurrence.

Treatment options

The primary goal of treating DCIS is to prevent it from becoming invasive breast cancer. Treatment options are usually localised to the breast and involve either surgery, radiotherapy, or a combination of both. Common treatment options include:

• Breast-conserving surgery (lumpectomy): This procedure involves removing the area of the breast affected by DCIS, while preserving as much healthy breast tissue as possible. Lumpectomy is often followed by radiotherapy to reduce the risk of the cancer returning.
• Mastectomy: In cases where DCIS affects a large portion of the breast or is found in multiple areas, a mastectomy (removal of the entire breast) may be recommended. This can be done with or without immediate breast reconstruction.
• Radiotherapy: After breast-conserving surgery, radiotherapy is usually recommended to lower the risk of DCIS recurring. Radiotherapy involves using high-energy rays to target and destroy any remaining cancer cells in the breast.
• Hormone therapy: If DCIS is hormone receptor-positive, hormone therapy (such as tamoxifen) may be recommended to reduce the risk of recurrence. Hormone therapy blocks the effects of oestrogen, which can promote the growth of certain breast cancers.

Possible risks and side effects of treatment

While the treatment of DCIS is effective in preventing invasive breast cancer, it does come with some risks and potential side effects. These may include:

• Surgical risks: Like any surgery, lumpectomy or mastectomy carries risks such as infection, bleeding, and scarring. Some women may experience changes in breast shape or size following surgery.
• Radiotherapy side effects: These can include skin irritation, fatigue, and swelling in the treated area. Most side effects are temporary, but long-term effects can include changes in breast appearance or firmness.
• Hormone therapy side effects: These may include hot flashes, fatigue, and a small risk of blood clots.

Your healthcare team will discuss these risks with you and help manage any side effects that occur during or after treatment.

Recovery and follow-up care

Recovery from DCIS treatment varies depending on the type of surgery and additional therapies. After breast-conserving surgery, most women can return home the same day, while recovery from a mastectomy may require a longer hospital stay. Pain management, wound care, and support from a physiotherapist may be part of your recovery process.

Regular follow-up care is crucial after DCIS treatment. You will have scheduled appointments for physical examinations, mammograms, and possibly other imaging tests to monitor for any signs of recurrence or changes in your breast health. Your doctor may also recommend ongoing hormone therapy if appropriate.

Why choose Birmingham Breast Clinic?

At Birmingham Breast Clinic, we provide expert care for patients diagnosed with DCIS. Our dedicated team of breast specialists offers a personalised approach to treatment, using the latest diagnostic and surgical techniques to ensure the best possible outcomes. We prioritise early detection and prevention to help you manage your breast health and reduce your risk of developing invasive breast cancer. Our clinic provides comprehensive support from diagnosis through recovery, offering peace of mind at every stage of your care.

Contact us

If you have concerns about DCIS or need advice about your breast health, please get in touch with Birmingham Breast Clinic to schedule a consultation.