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23

NCCN Guidelines for Patients

®

Breast Cancer - Carcinoma in Situ

(stage 0)

, Version 1.2016

3

DCIS

Treatment planning

Treatment planning

Medical history

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.

Physical exam

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

Breast MRI (

m

agnetic

r

esonance

i

maging) also

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

machine.

Pathology review

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.