Chapter 55: Breast- DCIS

Question 1

What does DCIS stand for?

Answer 1

Ductal Carcinoma In Situ

Question 2

What is DCIS also known as?

Answer 2

Intraductal carcinoma

Question 3

Describe DCIS

Answer 3

Cancer cells in the duct without invasion (in situ: cells do not penetrate the basement membrane)

Question 4

What are the signs/symptoms?

Answer 4

Usually none; usually nonpalpable

Question 5

What are the mammographic findings?

Answer 5

Microcalcifications

Question 6

How is the diagnosis made?

Answer 6

Core or open biopsy

Question 7

What is the most aggressive histologic type?

Answer 7

Comedo

Question 8

What is the risk of LN metastasis with DCIS?

Answer 8

<2% (usually when microinvasion is seen)

Question 9

What is the major risk with DCIS?

Answer 9

Subsequent development of infiltrating ductal carcinoma in the same breast

Question 10

What is the treatment for DCIS in the following cases:

Tumor <1 cm (low grade)?

Answer 10

Remove with 1-cm margins and XRT

Question 11

What is the treatment for DCIS in the following cases:

Tumor >1 cm?

Answer 11

Perform lumpectomy with 1-cm margins and radiation or total mastectomy(no axillary dissection)

Question 12

What is a total (simple) mastectomy?

Answer 12

Removal of the breast and nipple without removal of the axillary nodes (always remove nodes with invasive cancer)

Question 13

When must a simple mastectomy be performed for DCIS?

Answer 13

• Diffuse breast involvement (e.g., diffuse microcalcifications)
• >1 cm and contraindication to radiation

Question 14

What is the role of axillary node dissection with DCIS?

Answer 14

No role in true DCIS (i.e., without microinvasion)

some perform a sentinel LN dissection for high-grade DCIS

Question 15

What is adjuvant Rx for DCIS?

Answer 15

Tamoxifen if ER+

Postlumpectomy XRT

Question 16

The breast in which DCIS breast cancerarises?

Answer 16

Cancer arises in the same breast as DCIS