Consensus conference on the treatment of in situ ductal carcinoma of the breast, April 22-25, 1999
Ductal carcinoma in situ (DCIS/intraductal carcinoma/noninvasive ductal carcinoma) is a proliferation of malignant cells confined within the basement membrane of the ducts of the breast. Until the late 1970s, DCIS was detected infrequently, usually presenting as a mass or as nipple discharge. As screening mammography became almost universally accepted, the mammographic finding of calcifications leading to the diagnosis of DCIS has become commonplace. When initially described two generations ago, DCIS was considered an initial step in an inexorable progression to invasive breast carcinoma. Within the past generation, it has been documented that only a minority of patients develop invasive breast carcinoma after the excision of DCIS, so treatment options have expanded. Mastectomy had been the initial treatment for the majority of patients with DCIS, but as this additional information has become available, many physicians currently treat women with DCIS by local excision and radiation therapy or local excision alone as an alternative to mastectomy. (C) 2000 American Cancer Society.