Breast cancer in situ

Last reviewed: 4 Jun 2022
Last updated: 26 Jan 2022

Summary

Definition

History and exam

Key diagnostic factors

  • family history of breast cancer
More key diagnostic factors

Other diagnostic factors

  • nipple discharge
  • breast lump
  • eczema-like rash on breast
  • ulceration
Other diagnostic factors

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
More risk factors

Diagnostic investigations

1st investigations to order

  • mammography
More 1st investigations to order

Investigations to consider

  • biopsy (fine-needle or core)
  • stereotactic biopsy
  • sentinel lymph node biopsy (SNLB)
  • ultrasound-guided biopsy
  • magnetic resonance imaging (MRI)
  • ultrasonography
  • hormone receptor testing
  • genetic testing
More investigations to consider

Emerging tests

  • nipple aspirate fluid

Treatment algorithm

ACUTE

women with low-risk ductal carcinoma in situ

women with high-risk DCIS; all men with DCIS

lobular carcinoma in situ

ONGOING

local recurrence of DCIS

Contributors

Authors

Edward R. Sauter, MD, PhD, FACS
Edward R. Sauter

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.

  • Breast cancer in situ images
  • Differentials

    • Locally invasive breast cancer
    • Atypical hyperplasia
    • Fibroadenoma
    More Differentials
  • Guidelines

    • ACR appropriateness criteria: supplemental breast cancer screening based on breast density
    • ACR appropriateness criteria: transgender breast cancer screening
    More Guidelines
  • Patient leaflets

    Breast cancer: DCIS (very early breast cancer) in women

    Breast cancer, locally advanced: what is it?

    More Patient leaflets
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