Ask an Expert: Ductal carcinoma in situ (DCIS)

Q. I’ve just been diagnosed with ductal carcinoma in situ (DCIS). I’ve heard it described as "stage 0" breast cancer. What does that mean? How worried should I be?

Answer from the expert staff of breast cancer research at the Robert W. Franz Cancer Research Center at Providence Portland Medical Center: It’s important to understand that not all breast cancers are the same. About 20 percent of breast cancers diagnosed are DCIS. This is a non-invasive condition where the cancer cells are all within the ducts in the breast and have not invaded surrounding breast tissue.

While of course no patient ever wants to hear that the diagnosis is cancer, the fact that you’ve been diagnosed with this "stage 0" breast cancer is really a success story. With treatment, the odds of it spreading from the breast to other parts of the body are less than 2 percent. DCIS is easily cured by mastectomy or by lumpectomy combined with radiation. Recent studies have shown that women whose DCIS is treated with lumpectomy and radiation therapy benefit from tamoxifen treatment also.

DCIS is quite similar to carcinoma in situ of the cervix, but many women experience a diagnosis of DCIS as much scarier than a diagnosis of carcinoma in situ of the cervix. Non-invasive cancer of the cervix is generally accepted as low risk and easily cured, but there isn’t the same awareness of the minimal risk and high cure rate of DCIS. I’d like very much to see that awareness raised, and to see women’s alarm about DCIS reduced.

I think many women would also benefit from understanding what a diagnosis of lobular carcinoma in situ (LCIS) means. This condition sounds like cancer, but it isn’t – it’s better described as a condition that predicts an increased risk of future breast cancer. Women with LCIS need to be closely monitored for breast cancer, and should consider risk reduction strategies. 

Tamoxifen has been shown to significantly reduce the risk of breast cancer in high risk women. If you’re diagnosed with LCIS, talk with your doctor about whether tamoxifen could help reduce your risk. I’d also I’d urge you to talk with a genetic counselor, who can help you assess your cancer risk and cope with your reactions to the diagnosis.

Last updated: July 2003

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