Most common type of non-invasive breast malignancy and currently comprises around 20% of all breast cancers diagnosed
Pathophysiology
- Malignancy of the ductal tissue of the breast that is contained within the basement membrane
- 20-30% of cases (who do not receive treatment) will develop invasive disease
- Sub types include comedo, cribriform, micropapillary, and solid types, however most lesions are mixed
Clinical presentation
- Often asymptomatic - detected during screening
Investigations
- Often detected during screening, where it appears as microcalcifications on mammography, either localised or wide spread
- This will then be confirmed on biopsy
Management
- Any detected localised DCIS should be treated with complete wide excision, ensuring the surrounding tissue of all margins have no residual disease
- Chemoprevention - endocrine therapy
- Cases of widespread or multifocal DCIS normally requires complete mastectomy
Other ductal precursor lesions
- Epithelial hyperplasia of usual type
- Columnar change (+/- atypia)
- Atypical ductal hyperplasia
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