What is the prognosis of ductal carcinoma in situ (DCIS)?

Updated: Jun 18, 2020
  • Author: Oudai Hassan, MD; Chief Editor: Chandandeep Nagi, MD  more...
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Answer

Answer

DCIS involving a papilloma likely has the same behavior as common DCIS, and the treatment is the same, although papillomas involved by a focus of DCIS of 3 mm or less may be an exception. In the original article describing such lesions, in which they were called papillomas with atypia, Page et al found women with papillomas involved by an atypical monomorphic focus of 3 mm or less had a 9-fold increased risk of invasive breast cancer (IBC) over women with no proliferative breast disease. [2] Notably, the confidence interval for this 9-fold increased risk was 1.62-56.91. [2]

More recently, a large series by Lewis et al showed that patients with solitary papillomas involved by a monomorphic atypical proliferation of 3 mm or less had only a 5-fold increased risk of developing IBC, [1] smaller than 9-fold increased risk described by Page et al and the 10-fold increased risk recognized in women with DCIS. However, this study pooled patients who had ADH and a separate IDP (L/C ST) with patients in whom the focus of ADH directly involved the papilloma. This study may, therefore, underestimate the IBC risk associated with DCIS involving a papilloma when the proliferation is 3 mm or smaller.

Despite their somewhat differing conclusions, these studies show that small foci of DCIS in a papilloma are associated with increased breast cancer risk. However, at present, the exact magnitude of this increased risk is unclear. [8]


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