NCCN Guidelines for Patients
Breast Cancer - Carcinoma in Situ
, Version 1.2016
Your medical history includes any health events and
medicines you’ve taken in your life. Your doctor will
want to know about illnesses, breast biopsies, prior
treatment with radiation, and if you are pregnant. It
may help to make a list of old and new medications
while at home to bring to your doctor’s office.
Breast cancer and other health conditions can run in
families. Thus, your doctor will ask about the medical
history of your relatives. About 10 out of 100 breast
cancers are due to abnormal genes that are passed
down from a parent to a child. Such cancers are
called hereditary breast cancers.
Doctors often perform a physical exam along with
taking a medical history. A physical exam is a study of
your body for signs of disease. During this exam, your
doctor will listen to your lungs, heart, and gut.
Your doctor will also look at and feel parts of your
body. This is done to see if organs are of normal
size, are soft or hard, or cause pain when touched.
A clinical breast exam involves your doctor touching
your breasts and nearby lymph nodes. Your breasts
may be felt while you sit or stand up as well as when
you lie back. Some women feel uneasy having their
breasts touched by their doctor. Keep in mind that this
test provides important information and is quick.
Bilateral diagnostic mammogram
A mammogram is a picture of the insides of your
breast. The pictures are made using x-rays.
Mammograms that are used for breast cancer
screening are often made from two x-rays of each
breast. A computer combines the x-rays to make
detailed pictures. Read
page 14 for more information.
Many women with DCIS have had a bilateral diagnostic
mammogram. If you haven’t had this test, it is advised.
A bilateral mammogram is a picture of each breast.
Diagnostic mammograms are made with more x-rays
from different angles than screening mammograms.
By using more x-rays, the picture is clearer and can
better show if there is more than one mass.
Breast MRI (
makes pictures of the insides of the breasts. The
pictures are made using a magnetic field and radio
waves. Breast MRI is not usually done for treatment
planning of DCIS, but it is an option. It may help show
the extent of the cancer.
Before the test, a contrast dye may be injected into
your vein to make the pictures clearer. The dye may
cause you to feel flushed or get hives. Rarely, serious
allergic reactions occur. Tell your doctor if you have
had bad reactions before.
For breast MRI, you must remove your top and bra
and lie face down on a table. The table has padded
openings for your breasts. In the openings, there are
coils that help to make pictures. During breast MRI,
the table moves slowly through the tunnel of the MRI
All tissue removed from your body must be viewed by
a pathologist. He or she will confirm if you have DCIS,
invasive breast cancer, or another condition. If an
invasive cancer is found, read the NCCN patient book
related to the cancer stage.
If DCIS is confirmed, the type and grade will be
assessed. There are 3 grades of DCIS. Grade I looks
the most like normal cells and is the least likely to
spread. Grade II also grows slowly. Grade III looks the
least like normal cells and is the most likely to spread.