Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer. In DCIS, abnormal cells are contained in the milk ducts. It is called “in situ” (which means "in place") because the cells have not left the milk ducts to invade nearby breast tissue. DCIS is also called intraductal (within the milk ducts) carcinoma. You may also hear the terms “pre-invasive” or “pre-cancerous” to describe DCIS.
DCIS is non-invasive, but without treatment, the abnormal cells could turn into invasive cancer over time. Left untreated, about 20 to 30 percent of low grade DCIS will progress to invasive breast cancer . Higher grade DCIS may be more likely to turn into invasive cancer if left untreated.
At this time, health care providers cannot predict which cases of DCIS will progress to invasive breast cancer and which will not. Because DCIS might turn into invasive breast cancer, almost every case of DCIS is treated.
Surgery (with or without radiation therapy) is recommended for the treatment of all DCIS. Prognosis is usually excellent.
Learn more about DCIS and risk of invasive breast cancer.
Treatment guidelines for DCIS
Although the exact treatment for DCIS varies from person to person, guidelines help ensure quality care. These guidelines are based on the latest research and the consensus of experts. The American Society of Clinical Oncology (ASCO) and National Comprehensive Care Network (NCCN) are two respected organizations that regularly update and post their guidelines online. The National Cancer Institute (NCI) also has overviews of treatment options.
In September 2013, the Institute of Medicine (IOM) released a set of recommendations (below) on improving cancer care in the U.S. The report Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis recommends improvements to fix shortcomings that add cost and burden to cancer care. In the U.S., there are about 14 million cancer survivors and more than 1.6 million new cases are diagnosed each year. By 2022, the IOM projects that there will be 18 million cancer survivors and, by 2030, cancer incidence is expected to rise to 2.3 million new diagnoses per year. Therefore, the IOM convened a committee of experts to examine the quality of cancer care in the U.S. and made recommendations for improvement. The committee concluded that the cancer care delivery system is in crisis due to a growing demand for cancer care, increasing complexity of treatment, a shrinking workforce and rising costs. Changes across the board are urgently needed to improve the quality of cancer care.
Susan G. Komen® endorses these recommendations as they have special significance in the breast cancer field. “Issues of accessibility, quality treatments and survivorship are especially complex for breast cancer patients, who may be treated for many years,” said Chandini Portteus, Komen’s Chief Mission Officer.
The report identified key ways to improve quality of care:
- Ensure that cancer patients are engaged and understand their diagnosis so they can make informed treatment decisions with their health care providers
- Develop a trained and coordinated workforce of cancer professionals
- Focus on evidence-based care, using information technology to provide better information about the potential benefits of treatments
- Focus on quality measurements
- Provide accessible and affordable care for all
The study was chaired by a Susan G. Komen Scholar Patricia Ganz, M.D., with participation by Komen’s Chief Scientific Advisor, George Sledge, M.D. Komen was one of 13 organizations sponsoring the study. Read the full report at www.nas.edu and www.iom.edu.
*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.