” DCIS rarely leads to death from breast cancer – approximately 11 out of 100 women treated by lumpectomy only go on to develop invasive cancer within eight years of the initial diagnosis of DCIS, and only 1 to 2 percent of women die of breast cancer within 10 years of diagnosis.

DCIS (ductal carcinoma in situ) is the most common form of non-invasive breast cancer and is considered stage 0 cancer. While DCIS isn’t considered life threatening, it does increase the risk of developing invasive breast cancer later in life.

DCIS isn’t life-threatening, but having DCIS can increase the risk of developing an invasive breast cancer later on. When you have had DCIS, you are at higher risk for the cancer coming back or for developing a new breast cancer than a person who has never had breast cancer before.

Women diagnosed with DCIS have very good prognoses. Ten years after DCIS diagnosis, 98% to 99% of women will be alive. Based on this good prognosis, DCIS usually is treated by lumpectomy followed by radiation therapy. If the DCIS is large, a mastectomy may be recommended.

It assumes that all breast carcinomas begin as DCIS and take 9 years to go from a single cell to an invasive lesion for the slowest growing lesions, 6 years for intermediate growing DCIS lesions, and 3 years for fast-growing DCIS lesions.

Clusters of abnormal cells like D.C.I.S. can sometimes disappear, stop growing or simply remain in place and never cause a problem.

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.

DCIS is also called intraductal carcinoma or stage 0 breast cancer. DCIS is a non-invasive or pre-invasive breast cancer. This means the cells that line the ducts have changed to cancer cells but they have not spread through the walls of the ducts into the nearby breast tissue.

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.

Chemotherapy, a form of treatment that sends anti-cancer medications throughout the body, is generally not needed for DCIS. DCIS is non-invasive and remains within the breast duct, so there is no need to treat cancer cells that might have traveled to other areas of the body.

DCIS can’t spread outside the breast, but it still needs to be treated because it can sometimes go on to become invasive breast cancer (which can spread).

DCIS that is high grade, is nuclear grade 3, or has a high mitotic rate is more likely to come back (recur) after it is removed with surgery. DCIS that is low grade, is nuclear grade 1, or has a low mitotic rate is less likely to come back after surgery.

Results of a number of small studies (16-18,25,29,31-40) suggest that women whose initial DCIS lesions have comedo necrosis or high nuclear grade have a high recurrence rate (13%–38%) over 5–10 years, whereas women with low-nuclear-grade DCIS lesions or lesions without comedo necrosis have a low recurrence rate (5%–7%) …

Recurrences were confirmed using information from the cancer registry or hospital pathology reports. Approximately 15% of women experienced a recurrence within the first 5 years after diagnosis [95% confidence interval (CI), 12-18%]; 31% had a recurrence within 10 years (95% CI, 24-38%).

There was no significant difference in the distribution of grades between the DCIS detected by mass screening and the DCIS not detected by mass screening (from the interval group); 16.4–18.8 % were low grade, 27.2–31.6 % were intermediate grade, and 52.0–54.0 % were high grade (Table 3).

Surgery is nearly always the first treatment for DCIS, and it is very effective. There are two types of surgery used for DCIS. The less-invasive option is a lumpectomy, in which a surgeon removes the area that’s abnormal as well as a little bit of the normal tissue around it.

DCIS is graded as: Low grade – the cancer cells look most like normal breast cells and are usually slow growing. Intermediate grade – the cancer cells look less like normal breast cells and are growing faster. High grade – the cancer cells look different to normal breast cells and may be fast growing.

Grade 3 cells, also called “poorly differentiated,” are more abnormal in their behavior and appearance. Surgical margins: When cancer cells are removed from the breast, the surgeon tries to take out the whole cancer with an extra area or “margin” of normal tissue around it.

Ductal carcinoma is more likely to spread than lobular carcinoma, among tumors that are the same size and stage. While many breast cancers do not spread to lymph nodes until the tumor is at least 2 cm to 3 cm in diameter, some types may spread very early, even when a tumor is less than 1 cm in size.

With most breast cancers, each division takes one to two months, so by the time you can feel a cancerous lump, the cancer has been in your body for two to five years.

Treatments for invasive ductal carcinoma (IDC) include surgery, chemotherapy, radiation therapy, hormonal therapy, and targeted therapy. You and your doctor will decide what treatment or combination of treatments is right for you depending on the characteristics of the cancer and your personal preferences.

What Is Invasive Ductal Carcinoma? Invasive ductal carcinoma describes the type of tumor in about 80 percent of people with breast cancer. The five-year survival rate is quite high — almost 100 percent when the tumor is caught and treated early.

With aggressive treatment, stage 3 breast cancer is curable; however, the risk that the cancer will grow back after treatment is high.

Ductal Carcinoma In Situ is very early cancer that is highly treatable, but if it’s left untreated or undetected, it can spread into the surrounding breast tissue.

Mastectomy involves removal of the whole breast and is usually recommended if the DCIS affects a large area of the breast, if it has not been possible to get a clear area of normal tissue around the DCIS by wide local excision, or if there is more than one area of DCIS.

Causes and Risk Factors

• Age.
• A history of benign breast disease.
• A family history of breast cancer.
• First pregnancy after the age of 30.
• Obesity.
• Using combination estrogen-progestin hormone replacement therapy for more than five years after menopause.

Invasive ductal carcinoma recurrence is possible after the completion of an initial course of treatment. In general, most physicians consider cancer to be a recurrence, rather than a progression, if a patient has exhibited no signs or symptoms for at least one year.

These results suggest that among older women treated with lumpectomy and tamoxifen for Stage I, estrogen receptor-positive breast cancer, skipping radiation therapy increases the risk of local cancer recurrence but does not adversely affect overall survival.

The researchers subdivided patients to analyze those with the best prognosis — small tumors with less-aggressive properties and no positive lymph nodes. Even these women had appreciable recurrence rates between years five and 20, at about 1 percent per year, or 10 percent over 15 years.

On average, 7 percent to 11 percent of women with early breast cancer experience a local recurrence during this time. For patients with a family history of cancer, or a BRCA1 or BRCA2 gene mutation, the cancer recurrence rate is higher.