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Ductal Carcinoma in Situ (DCIS): Is It Cancer?

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Published on January 7, 2020

Key Takeaways

  • DCIS is considered pre-cancer but doesn’t always lead to cancer.
  • Watchful waiting can be considered as a treatment option.

Is ductal carcinoma in situ (DCIS) considered breast cancer? How can people diagnosed with DCIS manage risk? Patient Power’s Andrea Hutton is joined by expert Dr. Susan Love to discuss how DCIS develops in the body and treatment options available. Watch as Dr. Love explains what DCIS is, the potential risks of DCIS progressing to an invasive cancer, and ways to take an active role in your care. 

 

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Transcript | Ductal Carcinoma in Situ (DCIS): Is It Cancer?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrea Hutton:          

Dr. Love, as the preeminent expert on the breast, I mean, you literally wrote the book on the breast, talk to me about DCIS. Because we hear about it all the time: “Is it cancer? Isn’t it cancer?” What does somebody who has been diagnosed—is that even the right word, diagnosed… 

Dr. Love:                   

Right. 

Andrea Hutton:          

…with DCIS? What should they know? What should they talk to their doctors about? What are we doing with it?

Dr. Love:                   

So, DCIS is—breast cancer starts in the lining of the milk ducts. So, you have six to eight milk ducts, and they’re suspended in fat and fibrous tissue. And that’s where the milk is made that comes out for when you’re breastfeeding your baby, but along that line—and then at the end of the ducts are lobules that make the milk. So, you have lobules and ducts. And what you can get is, along the lining of that tube, you can get extra cells. Almost like rust. At least, that’s the way I think about it. And that’s DCIS. It’s not cancer, but it does show that there’s a factor that’s telling the cells to grow a little bit more within the duct. And, as long as it’s within the duct, it can’t spread, it can’t kill you. But, if you don’t do anything, eventually in some people, it gets out, and then it’s invasive cancer, because it’s invading out of the duct. 

Not because it’s invading out of the breast, but it’s gotten out of that tube, and then it has the potential to spread to other parts of the body. Now, most invasive cancer does not spread to other parts of the body, and why some do and some don’t we haven’t totally figured out. But that’s why DCIS is sort of pre-cancer, the step before cancer. And it puts you in a funny situation as to whether to watch it—and there are several large studies going on about watchful waiting right now with DCIS, and people are doing quite well—or, whether you should do something. You can take hormonal therapy, like tamoxifen (Nolvadex or Soltamox), and that can help keep it from progressing—or, whether you should have surgery.

And so, in some ways, because it’s so early, you have a whole range of options. And there’s not one right way to do it, and it’s going to depend somewhat on your own head, and what makes you nervous, and what doesn’t and all kinds of other things.

Andrea Hutton:          

So, when I hear pre-cancer, I shouldn’t necessarily think, “Oh, pre definitely means…

Dr. Love:                   

…automatically no, no, no.

Andrea Hutton:          

Definitely. Right. Just, “If I wait long enough it will be.” Not necessarily. 

Dr. Love:                   

No, not necessarily. In some people, it will turn into it.

Andrea Hutton:          

But we don’t know who they are yet.

Dr. Love:                   

But we don’t know who they are. Exactly. 

Andrea Hutton:          

Okay. So, if my doctor says, “Well, we can wait. There’s this thing called watchful waiting.” that means I get screened though, right? 

Dr. Love:                   

That’s right. That means that they monitor you with imaging, and they can follow you along. Now, what I’m hoping—we’re developing this way to map the breast ducts, then you could actually maybe just get a little bit of fluid from the duct that has the abnormal cells and be able to monitor it that way. And that would give you a liquid biopsy, and it would give you even more information. But that’s in development, so stay tuned. Maybe by next year, I’ll have that set.

Andrea Hutton:          

Okay. We’ll stay tuned. Thank you so much. 

Dr. Love:                   

You’re welcome.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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