Ductal Carcinoma in Situ Breast Cancer: NCCN Guidelines for Patients
July 8, 2022 - read ≈ 4 min
The NCCN Guidelines for Patients were developed by the National Comprehensive Cancer Network (NCCN). NCCN is an organization that unites leading cancer care centers in the United States of America. Its activities are focused on scientific research, treatment and education of patients.
Breast cancer basics
Ductal carcinoma in situ (DCIS) is a type of cancer of the cells that line the ducts found in the breast. DCIS is stage 0 or noninvasive cancer. This means the cancerous cells are in place (in situ) and have not spread outside the ducts. DCIS is treated to prevent invasive breast cancer, a more serious form of cancer.
The breast is an organ and a gland found on the chest. The breast is made of milk ducts, fat, nerves, lymph and blood vessels, ligaments, and other connective tissue. Behind the breast is the pectoral (chest) muscle and ribs. Muscle and ligaments help hold the breast in place.
Breast tissue contains glands that can make milk. These milk glands are called lobules. Lobules look like tiny clusters of grapes. Small tubes called ducts connect the lobules to the nipple.
The ring of darker breast skin is called the areola. The raised tip within the areola is called the nipple. The nipple-areola complex (NAC) is a term that refers to both parts.
Lymph is a clear fluid that gives cells water and food. It also helps to fight germs. Lymph drains from breast tissue into lymph vessels and travels to lymph nodes near your armpit (axilla). Nodes near the armpit are called axillary lymph nodes (ALNs).
Ductal carcinoma in situ
Ductal carcinoma in situ (DCIS) is a type of cancer of the cells that line the ducts. Ducts are thin tubes that carry milk in the breast. DCIS is noninvasive.
Noninvasive means the cancerous cells are in place (in situ) and have not spread. Anyone can deveop this kind of breast cancer, including males. Ductal carcinoma in situ is also called intraductal carcinoma. You may hear that DCIS is pre-invasive or pre-cancerous. DCIS is treated to prevent invasive breast cancer, a more advanced form of cancer.
Lobular carcinoma in situ
Lobular carcinoma in situ (LCIS) is a benign (non-cancerous) condition in which abnormal cells are found in the lobules of the breast. Having LCIS in one breast increases the risk of developing breast cancer in either breast. LCIS is not covered in this book.
How breast cancer spreads
Cancer cells don’t behave like normal cells. Cancer cells differ from normal cells in the following ways.
Over time, cancer cells form a mass called a primary tumor.
Cancer cells can grow into surrounding tissues. Invasive breast cancer is breast cancer that has spread from the milk ducts or milk glands (lobules) into the surrounding breast tissue or nearby lymph nodes.
For more information on invasive breast cancer, read the NCCN Guidelines for Patients®: Breast Cancer – Invasive, available at NCCN.org/patientguidelines.
Unlike normal cells, cancer cells can spread and form tumors in other parts of the body. Cancer that has spread is called a metastasis. In this process, cancer cells break away from the first (primary) tumor and travel through blood or lymph vessels to distant sites. Once in other sites, cancer cells may form secondary tumors.
For more information on metastatic breast cancer, read the NCCN Guidelines for Patients®: Breast Cancer – Metastatic available at NCCN.org/patientguidelines.
- Anyone can develop breast cancer.
- Inside breasts are lobules, ducts, fat, blood and lymph vessels, ligaments, and connective tissue. Lobules are structures that make breast milk. Ducts carry breast milk from the lobules to the nipple.
- Breast cancer often starts in the ducts or lobules and then spreads into the surrounding tissue.
- Breast cancer that is found only inside the ducts or lobules is called noninvasive. Ductal carcinoma in situ (DCIS) is found only in the ducts.
- Invasive breast cancer is cancer that has grown outside the ducts or lobules into surrounding tissue. Once outside the ducts or lobules, breast cancer can spread through lymph or blood to lymph nodes or other parts of the body.
- Metastatic breast cancer has spread to distant sites in the body.
You can read more about Breast Cancer, its treatment methods and follow-up after treatment in the full text of the recommendations for patients by downloading it below.