Ductal Carcinoma

Ductal carcinoma in situ, intraductal breast carcinoma or simply DCIS is considered a pre-malignant disease or a marker and it is the most common type of non-invasive breast cancer. Non-invasive cancers are those that do not invade other tissues unlike invasive breast cancer. Ductal is the term used to refer to a cancer that started in the milk ducts and carcinoma is any type of cancer beginning in the skin or lining tissues of the internal organs. Ductal carcinoma is also called “in situ” when the cancerous cells do not leave the primary site. All in all, women with DCIS have an increased risk to develop invasive breast cancer. With other words, DCIS is the earliest stage of breast cancer which can be detected and treated before evolving to invasive breast cancer.
Differentiated invasive ductal carcinoma is a way to classify the types of breast cancer according to the degree in which cells differentiate. Whereas, healthy cells differentiate by taking different shapes and sizes to function as part of an organ, cancerous cells are disorganized as cell division becomes uncontrolled and cell nuclei less uniform. Differentiated invasive ductal carcinoma is actually the degree of differentiation of cancerous cells in the ducts. These cells may be well differentiated, moderately or poorly differentiated. The latter types of carcinomas are the most aggressive and with the worse prognosis.
Intraductal breast carcinoma is diagnosed with mammograms and a biopsy may be performed to find out whether a necrosis is also present. Necrosis is the medical term used to describe dead or dying cells in a tissue sample. Diagnosing breast ductal carcinoma is primarily done based on the patient’s symptoms, medical history and a physical exam. If there are suspicions of breast cancer, several imaging tests may be helpful in establishing an accurate diagnosis. They mainly consist in digital and diagnostic mammograms, MRI of the breast, computer-aided detection and diagnosis (CAD), breast ultrasound or ductograms. In cases when nipple discharge is present, nipple discharge tests may be performed to find out if the liquid contains cancerous cells. Other tests that may be used in breast cancer diagnosis are ductal lavage and nipple aspiration, and ultimately biopsies.

Breast ductal carcinoma may be prevented with weekly self-examinations, regular physical examinations performed by a doctor and by having taken mammograms at least once a year. Breast carcinoma can occur to women, and rarely men, of all ages but it is more common in women older than 40 years. There are several screening tests available that can prevent or detect cancer in early curable stages. It is considered that DCIS is the pre-malignant stage, stages 1 to 3 are early stages which can be cured in most cases and stage 4 is the most advanced and usually incurable.
The outcomes of the treatment vary based on the stage, size and aggressiveness of the tumor and also on the age of the patient and the general health. Generally speaking ductal carcinoma in situ has a good prognosis as it is the earliest stage of breast cancer and is usually responsive to treatment and it did not spread to other tissues.