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Ductal Carcinoma In Situ (DCIS) is a non-invasive (stage 0) breast cancer where abnormal cells are confined to milk ducts, without invading surrounding tissue. It’s a precursor to invasive ductal carcinoma, comprising 20-25% of screen-detected breast cancers, with ~60,000 US cases annually in 2025. Graded low/intermediate/high based on nuclear atypia, high-grade has higher progression risk (30-50% if untreated).
DCIS is usually asymptomatic, detected via screening mammography as microcalcifications. Rare symptoms include nipple discharge (bloody/clear), lump, or Paget’s disease (nipple rash). No pain or systemic symptoms typically.
Causes involve genetic mutations (e.g., HER2 amplification in high-grade), with risk factors like age (over 40), family history, dense breasts, nulliparity, late menopause, hormone replacement, and BRCA mutations. In 2025, hormonal and environmental factors are emphasized.
Diagnosis uses mammography showing clustered microcalcifications, ultrasound/MRI for evaluation, and core biopsy with immunohistochemistry (ER/PR+, HER2 variable). Sentinel node biopsy if high-risk. In 2025, AI mammography improves detection.
Treatment includes lumpectomy + radiation (reducing recurrence by 50%), or mastectomy for extensive DCIS. Endocrine therapy (tamoxifen) for ER+ reduces risk by 30%. Active surveillance trials for low-risk. In 2025, de-escalation minimizes overtreatment.
In 2025, DCIS has 99% 10-year survival, but 20-30% progress if untreated. Research on biomarkers predicts progression, reducing overtreatment. By 2030, personalized approaches could identify low-risk cases for surveillance, maintaining near-100% cure.
The information for DCIS is drawn from Mayo Clinic’s “Ductal carcinoma in situ (DCIS) – Symptoms and causes” for symptoms; Cleveland Clinic’s “Ductal Carcinoma in Situ (DCIS): Symptoms & Treatment” for treatment; BCRF’s “Ductal Carcinoma in Situ (DCIS)” for understanding; Johns Hopkins’s “Ductal Carcinoma in Situ (DCIS)” for outlook; Dana-Farber’s “Ductal Carcinoma in Situ (DCIS) Program” for management; National Breast Cancer Foundation’s “Ductal Carcinoma In Situ (DCIS)” for prognosis; NCBI’s “Breast Ductal Carcinoma in Situ – StatPearls” for diagnosis; Medical News Today’s “Ductal carcinoma in situ (DCIS): Symptoms, screening, and more” for screening; Breastcancer.org’s “DCIS (Ductal Carcinoma In Situ): Symptoms, Treatment, and More” for symptoms; Banner Health’s “Ductal Carcinoma in Situ (DCIS): What to Know About” for treatment.
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