[Ductal carcinoma in situ of the breast]

With the advent of screening mammography, ductal carcinoma in situ (DCIS) is detected with increasing frequency and now accounts for 10-15% of all diagnosed breast cancers. Before 1980, DCIS was usually diagnosed by clinical findings of a breast mass or nipple discharge; today most cases are detected mammographically and nonpalpable. The most common mammographic findings associated with DCIS are a cluster of microcalcifications. The concept that DCIS invariably progresses to invasive breast cancer and requires mastectomy has been challenged. Knowledge of DCIS is limited and primarily based on retrospective data. Further insight will emerge from ongoing randomized prospective studies that are near completion. Currently available data indicate that breast-conserving modalities may offer a valid alternative to mastectomy in selected patients with DCIS.