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Ductal carcinoma in-situ grade 3 vs. grade 1 treatment

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Lawrence J. Solin, MD, FACR
Last Modified: February 17, 2002

Dear OncoLink "Ask The Experts,"

If a diagnosis of ductal carcinoma in situ is made what is the significance of the grade. How is grade 3 treated differently from grade 1?  

Lawrence J. Solin, MD, FACR, Professor of Radiation Oncology at the University of Pennsylvania, responds:

Ductal carcinoma in situ (DCIS) is a proliferation of abnormal "cancer-like" cells that are confined to the duct spaces in the breast without invasion. Treatment for DCIS is based on a number of factors, one of which is grade. Grade 1 (low grade) appears more favorable under the microscope to the pathologist than grade 3 (high grade). However, other factors are also important to determine best treatment, such as extent of disease, whether the tumor can be excised (sometimes referred to as undergoing a "lumpectomy") with clear margins of resection, age of the patient, and whether the patient has other important medical problems. So, grade needs to be considered in the context of many other factors before an optimal treatment program can be established for an individual patient.