How is ductal carcinoma in situ (DCIS) graded?

Updated: May 24, 2018
  • Author: Peter Abdelmessieh, DO, MSc; Chief Editor: Marie Catherine Lee, MD, FACS  more...
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DCIS is categorized as low grade (grade I), intermediate grade (grade II), or high grade (grade III). Grading is based on characteristics of nuclei. Designation as low- and intermediate-grade DCIS implies that the cancer cells are growing at a relatively slow rate. Women with low-grade DCIS are at higher risk of developing invasive breast cancer than women without DCIS, but are less likely to have a recurrence of the breast carcinoma or to develop new cancers than women with higher-grade DCIS.

Low-grade DCIS cells appear very much like normal breast cells or atypical ductal hyperplasia cells. Grade II DCIS cells look less like unaffected cells and grow faster than normal. High-grade DCIS cells are growing rapidly; grade III DCIS has the highest risk of progressing to invasive cancer within the first 5 years after diagnosis.

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