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Understanding ductal carcinoma in situ.

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Understanding ductal carcinoma in situ

Most women diagnosed with this noninvasive breast cancer are alive 10 years later, and better treatments are emerging.

For the 62,000 women who will be diagnosed with ductal carcinoma in situ (DCIS) this year, the good news is far more important than the bad. While cancer is never a picnic, DCIS is the earliest detectable form of the disease. Some news that sounds "bad" * for instance, that the incidence of DCIS is increasing faster than that of any other type of breast cancer * is encouraging news. It means that more breast cancers are being detected early, while they can be nipped in the bud. Today, with standard treatment, 10-year survival rates for DCIS are approaching 100%, and the treatment is usually not too difficult to tolerate.

What is DCIS?

The name says a lot about the disease. "Ductal" refers to the site of origin, the tiny ducts that form a network connecting the milk-producing structures called lobules. "Carcinoma" indicates a tumor arising in the epithelium, or lining, of the ducts. "In situ" delivers the good news that the tumor is confined to its place of origin; it hasn't invaded the surrounding tissue or metastasized to other body tissues.

The diagnosis of DCIS describes a cluster of cells captured in the process of evolving from normal tissue to breast cancer. The journey is thought to begin with a series of genetic changes in breast cells. At first, these changes stimulate cell growth, resulting in ductal hyperplasia (an overabundance of normal cells), which may begin to fill the duct. Then the cells become distorted and look abnormal under a microscope. At this second stage of change, called atypical ductal hyperplasia, the cells' capacity for growth is further increased. DCIS proper is a third step in the process, in which a cluster of abnormal cells...