Summary
Definition
History and exam
Key diagnostic factors
- family history of breast cancer
Other diagnostic factors
- nipple discharge
- breast lump
- eczema-like rash on nipple
- ulceration
Risk factors
- family history of breast cancer
- benign breast disease on prior biopsy
- hereditary breast ovarian cancer syndrome
- Li-Fraumeni syndrome
- Cowden syndrome
- hereditary diffuse gastric cancer (HDGC)
- Peutz-Jeghers syndrome
- Klinefelter syndrome
- older age at menopause
- older age at first full-term pregnancy
- nulliparity
- low physical activity
- high vitamin A intake
- ataxia telangiectasia
Diagnostic investigations
1st investigations to order
- mammography
Investigations to consider
- core biopsy
- stereotactic biopsy
- sentinel lymph node biopsy (SLNB)
- ultrasound-guided biopsy
- magnetic resonance imaging (MRI)
- ultrasonography
- hormone receptor testing
- genetic testing
Treatment algorithm
women with low-risk ductal carcinoma in situ
women with high-risk DCIS; all men with DCIS
lobular carcinoma in situ
local recurrence of DCIS
Contributors
Authors
Edward R. Sauter, MD, PhD

Medical Officer
Breast and Gynecologic Cancer Working Group
Division of Cancer Prevention
National Cancer Institute
Bethesda
MD
Disclosures
ERS is an author of a reference cited in this topic.
Acknowledgements
Dr Edward R. Sauter would like to gratefully acknowledge Dr Rachel L. Ruhlen, a previous contributor to this topic.
Disclosures
RLR declares that she has no competing interests.
Peer reviewers
Carla Boetes, MD, PhD
Radiologist
Radboud University Nijmegen Medical Centre
Nijmegen
The Netherlands
Disclosures
CB is an author of a number of references cited in this topic.
Alessandra Balduzzi, MD
Assistant in the Division of Medical Oncology
European Institute of Oncology
Milan
Italy
Disclosures
AB declares that she has no competing interests.
Kala Visvanathan, MBBS, FRACP, MHS
Associate Professor in Epidemiology and Medical Oncology
Johns Hopkins School of Medicine and Bloomberg School of Public Health
Baltimore
MD
Disclosures
KV is an author of a number of references cited in this topic.
Glyn T. Neades, MB ChB, FRCS(Glas), FRCS(Ed), ChM
Consultant Surgeon and Honorary Senior Lecturer
Edinburgh Breast Unit
Western General Hospital
Edinburgh
UK
Disclosures
GTN is a principal investigator for the IBIS-II trial, and is an author of a guideline cited in this topic.
Differentials
- Invasive breast cancer
- Atypical hyperplasia
- Fibroadenoma
More DifferentialsGuidelines
- Exercise, diet, and weight management during cancer treatment
- Nutrition and physical activity guidelines for cancer survivors
More GuidelinesPatient leaflets
Breast cancer: DCIS (very early breast cancer) in women
Breast cancer, locally advanced: what is it?
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