Ductal carcinoma in situ (DCIS) is a very early form of breast cancer. It causes a growth of cancer cells inside a milk duct in the breast. The cancer cells haven't spread into the breast tissue. The term "in situ" means in its original place. Because the cancer cells remain inside the duct, DCIS is sometimes called noninvasive, preinvasive or stage 0 breast cancer.

Sometimes cancer that starts as DCIS can become invasive breast cancer. The cancer cells may break through the duct and grow into the surrounding breast tissue. When this happens, the cancer is called invasive ductal carcinoma. For most people with ductal carcinoma in situ, this never happens.

DCIS raises the risk of developing invasive breast cancer. But most people diagnosed with ductal carcinoma in situ never develop invasive breast cancer. Because healthcare professionals can't always predict whether DCIS will become invasive, they usually recommend treatment. Deciding which treatments to have involves a careful discussion of the benefits and risks with your healthcare team.

Treatment for DCIS often involves surgery. Some people also have radiation therapy or estrogen blocker therapy to lower the risk that the cancer will return.

DCIS has a name that's similar to lobular carcinoma in situ (LCIS), but these are different conditions. LCIS causes a growth of cells in the milk-producing glands, called lobules. LCIS is not considered breast cancer. Instead, it's a condition that increases the risk of developing breast cancer in the future.

Ductal carcinoma in situ can occur on its own or be found along with invasive breast cancer. When DCIS is found with invasive breast cancer, it's treated as invasive cancer. If the invasive area is very small, healthcare professionals may call it DCIS with microinvasion. Even with only this small area of invasion, it's treated as invasive cancer rather than noninvasive DCIS.

Ductal carcinoma in situ (DCIS) has different types. The types describe how the cells grow within a breast duct. These patterns of growth include the following:

• Comedo DCIS has areas of dead cells in the center of the growth of cancer cells. These areas of dead cells are called comedo necrosis.
• Cribriform DCIS has small openings within the growth of cells, making a pattern that looks like a sieve.
• Micropapillary DCIS has small fingerlike projections that extend from the area of cancer.
• Papillary DCIS has fingerlike projections that extend from the area of cancer. The projections contain blood vessels.
• Solid DCIS causes cancer cells to completely fill the duct.

Results from a biopsy or surgery often include the growth pattern of the DCIS. But this pattern is only one part of the diagnosis. Healthcare professionals often rely more on other features, such as the grade and hormone receptor status, to estimate the risk of recurrence and make treatment plans.

Ductal carcinoma in situ (DCIS) often doesn't cause any symptoms.

The cancer is usually found on a mammogram. It appears as tiny flecks of calcium in the breast tissue. These are calcium deposits, often referred to as calcifications.

Sometimes DCIS can cause symptoms such as:

• A breast lump.
• Nipple discharge that is bloody, watery or yellow in color. The discharge often comes out on its own, without squeezing the breast or nipple. It tends to come from one opening in one nipple.

When to see a doctor

Make an appointment with a doctor or other healthcare professional if you notice a change in your breasts. Changes to look for may include a lump, an area of puckered or otherwise unusual skin, a thickened region under the skin, and nipple discharge.

Ask your healthcare professional when to consider breast cancer screening and how often to have it. Most healthcare professionals recommend routine breast cancer screening beginning in your 40s.

The exact cause of ductal carcinoma in situ (DCIS) often isn't known. Healthcare professionals know this cancer starts when changes happen in the DNA inside cells that line a milk duct. But exactly what causes these DNA changes isn't always known.

How DNA changes lead to cancer

A cell's DNA holds the instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to multiply at a set rate. The instructions also tell the cells to die off at a set time. In cancer cells, changes happen in the DNA. The changes alter the instructions for multiplying and dying. The result is that the cells multiply faster than healthy cells. And they can keep living when healthy cells would die. In DCIS, this causes too many cancer cells to build up inside a milk duct.

How DNA changes occur

For most people, the DNA changes that lead to DCIS happen by chance. Sometimes DNA changes that increase the risk are passed from parents to children. Healthcare professionals say these changes are inherited or hereditary.

Not everyone with an inherited DNA change develops DCIS or another form of breast cancer. And most people diagnosed with DCIS don't have an inherited DNA change. It's likely that the cancer develops because of a mix of genetic, environmental and lifestyle factors. More research is needed to understand exactly why these DNA changes happen.

How DCIS becomes invasive

The DNA changes that lead to DCIS cause cancer cells to grow inside a milk duct. At first the cancer cells stay inside the duct. They haven't developed the ability to break through the wall of the duct.

Ductal carcinoma in situ often remains confined to the duct. But sometimes it grows into nearby breast tissue and becomes invasive. Healthcare professionals don't know why this happens in some people. Most people with DCIS never develop invasive breast cancer.

Several factors may increase the risk of ductal carcinoma in situ (DCIS). It is an early form of breast cancer, and it shares many of the same risk factors with invasive breast cancer.

Risk factors related to your personal medical history and your family's medical history include:

• A family history of breast cancer. If a parent, sibling or child had breast cancer, your risk is increased. The risk is higher if your family has a history of getting breast cancer at a young age. The risk also is higher if you have multiple family members with breast cancer. Still, most people diagnosed with breast cancer don't have a family history of the disease.
• A personal history of breast cancer. If you've had cancer in one breast, you have an increased risk of getting cancer in the other breast.
• A personal history of breast conditions. Certain breast conditions are markers for a higher risk of breast cancer. These conditions include lobular carcinoma in situ (LCIS) and atypical hyperplasia of the breast. If you've had a breast biopsy that found one of these conditions, you have an increased risk of breast cancer.
• Increasing age. The risk of breast cancer goes up as you get older.
• Inherited DNA changes that increase cancer risk. Certain DNA changes that increase the risk of breast cancer can be passed from parents to children. The most well-known changes are called BRCA1 and BRCA2. These changes can greatly increase your risk of breast cancer and other cancers, but not everyone with these DNA changes gets cancer.
• Radiation exposure. Radiation treatments to the chest as a child or young adult raise the risk of breast cancer.

Risk factors related to reproductive history and hormone exposure include:

• Beginning your period at a younger age. Beginning your period before age 12 increases the risk of breast cancer.
• Beginning menopause at an older age. Beginning menopause after age 55 increases the risk of breast cancer.
• Being female. Women are much more likely than men are to get breast cancer. But anyone with breast tissue can get breast cancer, including men.
• Having your first child at an older age. Giving birth to your first child after age 35 may increase the risk of breast cancer.
• Having never been pregnant. Having been pregnant one or more times lowers the risk of breast cancer. Never having been pregnant increases the risk.

Other risk factors include:

• Dense breast tissue. Breast tissue is made up of fatty tissue and dense tissue. Fatty tissue is made of fat. Dense tissue is made of milk glands, milk ducts and fibrous tissue. If you have dense breasts, you have more dense tissue than fatty tissue in your breasts. Having dense breasts increases the risk of developing breast cancer and makes it harder to detect cancer on a mammogram. Talk with your healthcare team about other tests you might have in addition to mammograms to look for breast cancer.
• Alcohol use. Drinking alcohol increases the risk of breast cancer. There is no safe amount of alcohol when it comes to breast cancer. The more alcohol you drink, the greater your risk.
• Obesity. Obesity increases the risk of breast cancer.

There's no sure way to prevent ductal carcinoma in situ (DCIS). However, some healthy lifestyle choices may help lower your risk of DCIS and other forms of breast cancer. Screening tests and breast awareness can't prevent breast cancer, but they may help detect it early, when treatment is more likely to be successful.

Ways to lower your risk of breast cancer

• Consider preventive medicines. Talk with your healthcare professional about your risk of breast cancer. People with a high risk might consider preventive medicines that help lower the risk of breast cancer.

• Drink alcohol in moderation, if at all. For breast cancer prevention, there is no safe amount of alcohol. If you're concerned about your breast cancer risk, you may choose to not drink alcohol.

  If you choose to drink alcohol, limit how often you drink and keep the amount small. For overall health, drink one or fewer drinks a day. Do not drink every day. The less you drink, the better.

• Exercise most days of the week. Aim for at least 30 minutes of exercise on most days of the week. If you haven't been active lately, ask your healthcare professional whether exercising is OK and start slowly.
• Maintain a healthy weight. If your weight is healthy for you, work to maintain that weight. If you need to lose weight, ask a healthcare professional about healthy ways to lower your weight. In general, try to eat fewer calories and slowly increase how much you exercise.

Ways to help detect breast cancer early

• Ask about breast cancer screening. Talk with a healthcare professional about when to begin breast cancer screening. Ask about the benefits and risks of screening. Together, you can decide what breast cancer screening tests are right for you.

• Become familiar with your breasts. Do occasional breast self-exams so that you know what your breasts typically feel like. If there is a new change, a lump or something not typical in your breasts, report it to a healthcare professional right away.

  Breast awareness through self-exams can't prevent breast cancer. But it may help you to better understand the look and feel of your breasts. This might make it more likely that you'll notice if something changes.

Ductal carcinoma in situ (DCIS) is most often discovered during a mammogram used to screen for breast cancer. A mammogram is an X-ray of the breast tissue. If your mammogram shows something concerning, you will likely have additional breast imaging and a biopsy.

Mammogram

If an area of concern was found during a screening mammogram, you may then have a diagnostic mammogram. A diagnostic mammogram takes views at higher magnification from more angles than a mammogram used for screening. This examination evaluates both breasts.

A diagnostic mammogram gives your healthcare team a closer look at any calcium deposits detected in the breast tissue. Calcium deposits, also called calcifications, can sometimes be cancerous.

With DCIS, the calcifications are often irregularly shaped, which mammogram results might describe as pleomorphic. The calcifications often are grouped together. Sometimes the calcifications look like thin lines on mammogram images.

If the area of concern needs further evaluation, the next step may be an ultrasound and a breast biopsy.

Breast ultrasound

Ultrasound uses sound waves to make images of structures inside the body. A breast ultrasound may give your healthcare team more information about an area of concern. The healthcare team uses this information to decide what tests you might need next.

Breast MRI

MRI machines use a magnetic field and radio waves to create pictures of the inside of the body. A breast MRI can make more-detailed pictures of the breast. Before a breast MRI, you usually receive an injection of contrast. The contrast material helps the tissue show up better in the images.

Biopsy

A biopsy is a procedure to remove a sample of tissue for testing in a lab. For a breast biopsy, a healthcare professional puts a needle through the skin and into the breast tissue. Imaging, such as X-rays or ultrasound, helps guide the needle to the right place. The healthcare professional uses the needle to draw out tissue from the breast. A marker may be placed in the spot where the tissue sample was removed. This small metal marker shows up on imaging tests. The marker helps your care team find the area of concern.

Lab testing

The tissue sample from a biopsy goes to a lab for testing. Tests can show whether the cells in the sample are cancerous. Other tests give more details about the cells. The testing is done by pathologists. Pathologists are doctors who look for disease in cells, fluids and tissue removed from the body.

Results are often given in a pathology report. The results may show:

• DCIS pattern. DCIS can be divided into types that describe how the cells grow within a breast duct. These patterns of growth include comedo, cribriform, micropapillary, papillary and solid.
• Cell grade. The grade of the cancer cells is based on how the cells look under a microscope. The grade tells the healthcare team whether the cancer is likely to grow slowly or quickly.
• Hormone receptor status. Most breast cancer cells use the hormones estrogen or progesterone to help them grow. Cells that do this have receptors that help them catch the hormones circulating in the bloodstream. If testing finds receptors for one or both hormones, the cancer is hormone receptor positive. If testing doesn't find receptors, then the cancer is hormone receptor negative.
• Necrosis. DCIS sometimes has areas of dead cells among the cancer cells. Healthcare professionals call these areas necrosis. Small areas of necrosis are called focal necrosis. Larger areas of necrosis in the center of the cancer are called comedo necrosis.

DCIS usually isn't tested for the presence of a protein called HER2. Invasive breast cancers are tested for HER2, but noninvasive cancers generally aren't.

A cancer's grade is a number that tells the healthcare team how different the cancer cells look from healthy cells. The grades of ductal carcinoma in situ (DCIS) go from 1 to 3. The grade helps the healthcare team predict how the DCIS may behave over time.

To decide on the grade, doctors in the lab, called pathologists, use a microscope to look at the cancer cells. If the cancer cells look similar to healthy cells, then the cancer cells are low grade. Low-grade cancer grows slowly. If the cancer cells look very different from healthy cells, then the cancer cells are high grade. High-grade cancer grows quickly.

The grades of DCIS include:

• Grade 1. Grade 1 is a low-grade DCIS. The cancer cells look similar to healthy breast cells. Grade 1 DCIS has a lower risk of returning after treatment or becoming invasive.
• Grade 2. Grade 2 is an intermediate-grade DCIS. The cancer cells look somewhat different from healthy breast cells. Grade 2 DCIS has an intermediate risk of returning after treatment or becoming invasive.
• Grade 3. Grade 3 is a high-grade DCIS. The cancer cells look very different from healthy breast cells. Grade 3 DCIS has the highest risk of returning after treatment or becoming invasive.

The grade helps the healthcare team understand the prognosis and make a treatment plan. High-grade DCIS is more likely to return after surgery, so additional treatment may be recommended. Lower grade DCIS has a lower risk of recurrence, so additional treatment may not always be needed.

Ductal carcinoma in situ (DCIS) is usually treated with surgery to remove the cancer. Sometimes other treatments are used after surgery to lower the risk that the cancer will come back. These treatments may include radiation therapy after lumpectomy surgery and estrogen blocker therapy if the DCIS is hormone receptor positive.

DCIS treatment has a high likelihood of success, and this cancer often can be cured. After treatment, the chance that DCIS will come back or become invasive is usually low.

Healthcare professionals can't always predict which cancers are more likely to come back after treatment. For this reason, they may recommend additional treatment after surgery to lower that risk. This is called adjuvant therapy.

Deciding whether to have adjuvant therapy often involves talking with your healthcare team about the possible benefits and risks. Your decision may depend on your specific situation and your preferences.

In most people, treatment options for DCIS include:

• Breast-conserving surgery, called a lumpectomy, and radiation therapy.
• Breast-removing surgery, called a mastectomy.

In some people, treatment options may include:

• Lumpectomy only.
• Lumpectomy and estrogen blocker therapy.

Surgery

If you're diagnosed with DCIS, one of the first decisions you'll have to make is whether to treat the condition with lumpectomy or mastectomy.

• Lumpectomy. A lumpectomy is surgery to remove the breast cancer and some of the healthy tissue around it. It allows you to maintain most of your breast. Other names for this surgery are breast-conserving surgery and wide local excision. Most people have radiation therapy after lumpectomy.

  Research suggests that there is a slightly higher risk of the cancer coming back after lumpectomy compared with mastectomy. However, survival rates between the two treatment approaches are very similar.

  If you have other serious health conditions, you might consider other options, such as lumpectomy plus hormone therapy, lumpectomy alone or no treatment.

• Mastectomy. A mastectomy is surgery to remove all breast tissue from a breast. Total mastectomy also is called simple mastectomy. It removes all of the breast, including the lobules, ducts, fatty tissue and some skin, as well as the nipple and areola. Other procedures include skin-sparing mastectomy, which leaves the skin, and nipple-sparing mastectomy, which leaves the areola, nipple and skin. Breast reconstruction to restore the appearance of the breast can be done at the same time or in a later procedure, if you desire.

Lumpectomy is a good option for most people with DCIS. But mastectomy may be recommended if:

• You have a large area of DCIS. If the area is large relative to the size of your breast, a lumpectomy may not produce acceptable cosmetic results.
• There's more than one area of DCIS. When multiple areas are involved, it is called multifocal or multicentric disease. It's difficult to remove multiple areas of DCIS with a lumpectomy. This is especially true if the areas are found in different parts of the breast.
• Biopsy results show cancer cells at or near the edge of the tissue sample. There may be more DCIS than originally thought. This means that a lumpectomy might not be enough to remove all affected areas. A mastectomy could be needed to remove all of the breast tissue.
• You're not a candidate for radiation therapy. Radiation is usually given after a lumpectomy. Radiation might not be an option if you're in the first trimester of pregnancy or if you've received radiation to your chest or breast in the past. It also might not be recommended if you have a condition that makes you more sensitive to radiation side effects, such as systemic lupus erythematosus.
• You prefer to have a mastectomy. For instance, you might not want a lumpectomy if you don't want to have radiation therapy.

Because DCIS is noninvasive, surgery typically doesn't involve the removal of lymph nodes from under your arm. The chance of finding cancer in the lymph nodes is extremely small.

If the cancer cells may have spread outside the breast duct or if you are having a mastectomy, then some lymph nodes may be removed as part of the surgery.

Radiation therapy

Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources.

Radiation therapy for breast cancer often uses external beam radiation. During this type of radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body.

For DCIS, radiation therapy is often used after lumpectomy to reduce the chance that the cancer will come back. But it might not be necessary if you have only a small area of DCIS that is considered slow growing and was completely removed during surgery.

Radiation can be applied to the entire breast, called whole-breast radiation, or to part of the breast, called partial-breast radiation. Your healthcare team may talk about these options with you after surgery. The approach your team recommends may depend on your age and the size, grade and hormone receptor status of your cancer.

Estrogen blocker therapy

Estrogen blocker therapy treats breast cancer that is sensitive to hormones. This type of cancer has cells with proteins called receptors. The receptors attach to the hormones estrogen and progesterone. The cancer grows in response to these hormones. Healthcare professionals call these cancers hormone receptor positive. DCIS is usually sensitive to hormones.

For DCIS, estrogen blocker therapy is typically used after surgery or radiation. It lowers the risk that the cancer will come back. It also reduces the risk of developing another breast cancer.

Estrogen blocker therapy treatments can include:

• Medicines that block or destroy hormone receptors. These medicines are called selective estrogen receptor modulators. This category includes the medicine tamoxifen. It may be used before or after menopause.
• Medicines that lower hormone production. These medicines are called aromatase inhibitors. They may be used only after menopause.

Discuss the benefits and risks of estrogen blocker therapy with your healthcare team.

No alternative medicine treatments have been found to cure ductal carcinoma in situ (DCIS). But complementary and alternative medicine therapies may help you cope with side effects of treatment.

Combined with your healthcare team's recommendations, complementary and alternative medicine treatments may provide some comfort. Examples include:

• Art therapy.
• Exercise.
• Meditation.
• Music therapy.
• Relaxation exercises.
• Spirituality.

A diagnosis of ductal carcinoma in situ (DCIS) can be unexpected, and it's natural to have questions about what comes next. You may be receiving a lot of information and facing decisions about surgery, radiation and medical treatments. It's common to have a range of feelings that may change from day to day, and it can take time to process everything. As you move forward, here are some ideas that might be helpful.

Learn enough about DCIS to make decisions about your care

Ask your healthcare team questions about your diagnosis and your pathology results. Use this information to research your treatment options.

Knowing more about your cancer and your options may help you feel more confident when making treatment decisions. Still, some people don't want to know the details of their cancer. If this is how you feel, let your care team know that too.

Find a good listener

Finding someone who is willing to listen to you talk about your hopes and fears can be helpful as you manage a cancer diagnosis. This could be a friend or family member. A counselor, medical social worker or clergy member also may offer helpful guidance and care.

Talk with other breast cancer survivors

You may find it helpful and encouraging to talk to others who have been diagnosed with breast cancer. Ask your healthcare team about support groups in your area, or contact the American Cancer Society or another cancer organization in your area to find resources. Find support online through Mayo Clinic Connect, a community where you can connect with others for support, practical information and answers to everyday questions.

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you. If an exam or imaging test shows that you might have ductal carcinoma in situ (DCIS), your healthcare team will likely refer you to a specialist.

Specialists who care for people with DCIS include:

• Breast medicine specialists.
• Breast surgeons.
• Genetic counselors.
• Oncologists. These doctors specialize in treating cancer.
• Plastic surgeons.
• Radiation oncologists. These doctors treat cancer with radiation.
• Radiologists. These doctors specialize in diagnostic tests, such as mammograms.

Here's some information to help you get ready for your appointment.

What you can do

• Write down your medical history, including any benign breast conditions with which you've been diagnosed. Also mention any radiation therapy you may have received, even years ago.
• Write down your family history of cancer. Note any family members who have had cancer. Note how each member is related to you, the type of cancer, the age at diagnosis and whether each person survived.
• Make a list of all medicines, vitamins or supplements that you're taking. If you are currently taking or have previously taken hormone replacement therapy, tell your healthcare professional.
• Consider taking a family member or friend along. Sometimes it can be difficult to take in all the information you receive during an appointment. Someone who goes with you may remember something that you missed or forgot.
• Write down questions to ask your healthcare professional.

Questions to ask your doctor

Your time with your healthcare professional is limited. Prepare a list of questions so that you can make the most of your time together. List your questions from most important to least important in case time runs out. For breast cancer, some basic questions to ask include:

• Do I have breast cancer?
• What tests do I need to determine the type and stage of cancer?
• What treatment approach do you recommend?
• What are the possible side effects or complications of this treatment?
• In general, how effective is this treatment?
• Am I at risk of this condition recurring?
• Am I at risk of developing invasive breast cancer?
• How will you treat DCIS if it returns?
• How often will I need follow-up visits after I finish treatment?
• What lifestyle changes can help reduce my risk of a DCIS recurrence?
• Do I need a second opinion?
• Should I see a genetic counselor?

In addition to the questions that you've prepared, don't hesitate to ask other questions you think of during your appointment.

What to expect from your doctor

Be prepared to answer some questions about your symptoms and your health, such as:

• Have you gone through menopause?
• Are you using or have you used any medicines or supplements to relieve the symptoms of menopause?
• Have you had other breast biopsies or operations?
• Have you been diagnosed with any breast conditions, including noncancerous conditions?
• Have you been diagnosed with any other medical conditions?
• Do you have any family history of breast cancer?
• Have you or your blood relatives ever been tested for BRCA gene changes?
• Have you ever had radiation therapy?
• What is your typical daily diet, including alcohol intake?
• Are you physically active?

Ductal carcinoma in situ (DCIS) is a stage 0 breast cancer. The stage is a way to describe the size of the cancer and whether it has spread. Breast cancer stages range from 0 to 4. A lower number means the cancer is less advanced and more likely to be cured. As the cancer grows into the breast tissue and gets more advanced, the stages get higher.

• Stage 0. When DCIS occurs on its own, it's a stage 0 breast cancer. This means the cancer is found inside a duct and shows no signs of growing into nearby tissue.
• Stages 1, 2, 3 and 4. Stages 1 through 4 are used for invasive breast cancers. If an area of DCIS is found along with invasive cancer, it's considered an invasive cancer. This includes very small areas of invasive cancer, called microinvasions.

Sometimes tests suggest that the cancer is DCIS, but surgery shows that it is invasive breast cancer. Because of this, the stage might not be known until after surgery.

The survival rates for ductal carcinoma in situ (DCIS) are excellent. DCIS is a noninvasive breast cancer. The cancer cells are contained within the milk ducts and haven't grown into nearby breast tissue. Most people diagnosed with DCIS are successfully treated, and the risk of dying from breast cancer is very low.

Survival statistics

Cancer survival rates come from studying many people with the same cancer to see how many are living years after diagnosis. The survival rate can give you an idea of survival for people in your situation. But the numbers can't predict your chances of survival.

Studies of people with DCIS have found that the 10-year survival rate is greater than 98%.

These statistics are based on people who had DCIS by itself, without an invasive breast cancer. DCIS is classified as stage 0 breast cancer when it occurs by itself. When DCIS occurs along with invasive breast cancer, the survival rate may vary by the stage of the invasive cancer rather than the DCIS.

Prognosis

Cancer prognosis describes how likely it is that a cancer can be treated successfully or cured. It is based on the details of your cancer, as well as your overall health. If you want to understand your prognosis, talk with your healthcare team. Your team can explain the factors to consider and what they mean for you.

The prognosis for DCIS is generally excellent. For most people, the cancer never comes back after treatment. Your risk of recurrence may depend on the specifics of your cancer. Factors that may affect prognosis include:

• Age at diagnosis. People diagnosed with DCIS before age 40 generally have a higher risk of recurrence than those diagnosed later in life.
• Cancer grade. Low-grade DCIS has a lower risk of recurrence than high-grade DCIS.
• How the DCIS was found. DCIS found through routine screening mammograms tends to have a lower risk of recurrence. If a breast lump or other symptoms lead to the diagnosis, there may be a higher risk of recurrence.
• Necrosis within the cancer. DCIS sometimes has areas of dead cells, called necrosis, among the cancer cells. When the necrosis forms in the middle of the DCIS, it's called comedo necrosis. Comedo necrosis raises the risk of recurrence.
• The size of the cancer. DCIS that affects a larger area of the breast may have a higher risk of recurrence than DCIS that involves a smaller area.
• Surgical margins. During a typical breast cancer surgery, the surgeon removes the cancer along with a small amount of the tissue that surrounds it. This tissue is called the margin. If the margin is free of cancer, the risk of recurrence is lower.

Talk with your healthcare team about your risk of recurrence. Ask about treatments and other things you can do to lower the risk.