Types of breast cancer and related breast conditions
DCIS is an early breast cancer. It means that some cells in the lining of the ducts of the breast tissue have started to turn into cancer cells. These cells are all contained inside the ducts. They have not started to spread into the surrounding breast tissue.
Doctors might describe DCIS in different ways. These include:
pre invasive
non invasive
ductal intraepithelial neoplasia (DIN)
intra ductal cancer
In some people if DCIS is not treated, it could become an invasive cancer. DCIS and invasive breast cancer are not the same thing.
In invasive breast cancer, the cancer cells have broken out of the ducts and spread into the surrounding breast tissue. There is then a chance that the cells can spread into nearby or other parts of the body.
Find out about invasive breast cancer
Around 7300 women are diagnosed with DCIS in the UK each year.
DCIS is diagnosed more often now than in the past. It is often picked up in women when they have mammograms as part of the UK breast screening programme. Men don't have a breast screening programme because DCIS and breast cancer are so rare in men.
Many people don't have any symptoms when they are diagnosed. A small number of people have:
a lump in the breast
discharge from the nipple which might be blood stained
a rash on the nipple that may be red and scaly
Doctors use the grade and stage of a cancer to help them decide which treatment you need. Grading means how abnormal the cells look under a microscope. Staging means how big the cancer is and how far it has spread.
DCIS grade is divided into:
low grade (more slowly growing)
intermediate grade
high grade (more quickly growing)
Doctors think that high grade DCIS is more likely to:
come back after treatment
spread into the surrounding breast tissue (become an invasive cancer)
DCIS is a pre invasive breast cancer. The cancer cells are in breast ducts and have not started to spread into the surrounding breast tissue.
There are different ways of staging breast cancer. In the UK, the most common one is the TNM system. You might also be told about the number system.
The TNM staging system stands for Tumour, Node, Metastasis.
T describes the size of the tumour (cancer)
N describes whether the cancer has spread to the lymph nodes
M describes whether the cancer has spread beyond the lymph nodes to a different part of the body
In the TNM staging system, DCIS is the same as Tis N0 M0.
The number staging system divides cancers into 5 stages, from 0 to 4. In the number staging system, DCIS is stage 0.
Surgery is the main treatment for DCIS.
You might have surgery to remove:
an area of the breast (breast conserving surgery)
the whole breast (mastectomy)
Your surgeon might recommend that you have a particular surgery or they might give you a choice of operations.
You may have different reasons for choosing a particular operation. For example, some people prefer to keep as much of their breast as possible. Others prefer to have the whole breast removed because it makes them feel more confident that the DCIS has been removed.
It is important to discuss your options with your doctor or nurse.
Many people have surgery to remove the area of DCIS and a border of healthy tissue (a margin) around it. This is called breast conserving surgery, or a wide local excision (WLE) or sometimes a lumpectomy.
After this surgery, you might have radiotherapy to the rest of the breast tissue if the DCIS cells look very abnormal (high grade). The radiotherapy treatment aims to kill off any abnormal cells that might still be in the breast tissue. Your doctor or breast care nurse will discuss with you the possible benefits and risks of radiotherapy.
You might have a mastectomy if:
the area of the DCIS is large
there are several areas of DCIS
you have small breasts and too much of the breast is affected by DCIS to make breast conserving surgery possible
You may have surgery to your armpit called a sentinel lymph node biopsy if you have a mastectomy. This means having about 1 to 3 lymph nodes removed to see if they contain cancer cells.
If you want to, you can choose to have a new breast made (breast reconstruction) at the time of the mastectomy, or some time afterwards.
Find out about breast reconstruction
Hormone therapy is recommended for 5 years if you have breast conserving surgery for DCIS and:
your cancer cells have oestrogen receptors (oestrogen positive)
you do not have radiotherapy
Research shows that taking hormone therapy after breast conserving surgery for DCIS reduces the risk of it coming back (recurrence).
Trials show that hormone therapy can reduce the number of further invasive breast cancers or DCIS. But in these trials, the people taking a hormone therapy tablet called tamoxifen did not live any longer than those who didn't take it.
After treatment you usually have regular check ups. At the check ups your doctor or a breast care nurse will examine you and ask about your general health. This is your chance to ask questions and to tell them if anything is worrying you.
How often you have check ups depends on your individual situation but you might have them for at least 5 years. This might include yearly .
It’s important to remember that you can contact your doctor or nurse between appointments if you are worried about a symptom or have questions. You don't have to wait for your next appointment. You can also speak to your GP.
In some hospitals you don't have regular appointments after treatment. But if you have new symptoms or are worried about anything you can phone your doctor or breast care nurse or make an appointment to see them.
UK guidelines say that everyone who has had treatment for early breast cancer should have a copy of a written care plan. The care plan has information about tests you will have, and signs and symptoms to look out for. It will also include contact details for specialist staff, such as your breast care nurse.
The chance of the DCIS coming back depends on various factors. But after mastectomy DCIS almost never comes back. In women who have just the area of DCIS removed the chance of it coming back is a bit higher. But it depends on the grade and type of DCIS.
Your doctor can give you more information about the chance of the DCIS coming back in your case.
One clinical trial looked at the possible causes of DCIS. In particular, genetic changes that might increase the risk of developing it. The study team concluded that there may be some evidence that there is a genetic cause of DCIS and invasive breast cancer. But more research is needed.
Researchers are also trying to find out whether people with low or intermediate risk DCIS need to have treatment.
Coping with DCIS can be difficult. There is help and support available to you and your family.
Last reviewed: 15 Jun 2023
Next review due: 15 Jun 2026
Most people begin their breast cancer treatment with surgery. Find out about the different types of surgery for breast cancer, how to prepare for your operation, and how to recover well.
Treatment for breast cancer depends on a number of factors. Find out about breast cancer treatments, where and how you have them, and how to cope with possible side effects.
You usually start by seeing your GP. Or you may have had changes picked up through breast screening. Find out about being referred to a breast clinic and the tests you might have.
There are different types of breast cancer and breast conditions, including breast cancer in men, and conditions related to breast cancer. Find out more about the different types.
You may find it difficult coping with a diagnosis of breast cancer both practically and emotionally. Find out about the things you can do and who can help you cope.
Find out about breast cancer, including symptoms, diagnosis, treatment, survival, and how to cope with the effects on your life and relationships.
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