With early detection techniques, we are now finding many cancers at a stage that they are considered carcinoma in situ (CIS). At the present time we have no way to determine for certain if CIS will progress to cancer, but most of the time CIS is considered to be at risk of becoming invasive cancer.
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Overview
With regard to staging, carcinoma in situ is considered stage 0 cancer. Stage 1 to stage 4 are all considered “invasive” cancers, as they have spread beyond something called the “basement” membrane in tissues. When cancers are found at this stage, they should theoretically be 100 percent curable.That said, not all cancers have a CIS stage.
Microscopic Appearance
Carcinoma In Situ vs. Invasive Carcinoma
In contrast to carcinoma, or invasive cancer, carcinoma in situ has not yet invaded thebasement membrane,and there is no stromal invasion. Other than this—the fact that the cells have not yet broken through the supporting structure from which they began—the cells appear the same asinvasive cancer cellswould appear under the microscope.
Meaning of Carcinoma In Situ
In many ways, the term “carcinoma” is simply equated with cancer. Roughly 85 percent of cancers are carcinomas. Carcinomas are composed of epithelial cells; the type of cells that line the skin, breast ducts, and other surfaces of organs in the body.
The subtypes of carcinomas include adenocarcinoma, squamous cell carcinoma, transitional cell carcinoma (in the bladder or kidneys), and basal cell carcinoma.
Tumors such as sarcomas arise in tissues which do not have a basement membrane so that for these types of cancer there is not a stage of carcinoma in situ.In other words, tumors such as bone cancer (osteosarcoma) do not have a pre-invasive stage (there is not a CIS stage) and the cells would either be considered normal or cancer.
Likewise, blood-related cancers, such as leukemias and lymphomas, do not have a preinvasive but cancerous stage for which people can be screened. For cancers that don’t have a CIS stage, screening tests (such as a Pap smear) are not as effective in early detection, because once the abnormal cells are detected, it would already be considered invasive with the potential to spread (metastasize).
Cancers That May Be Diagnosed as CIS
In theory, any cancer which begins in epithelial cells would have a CIS stage. The most common you will hear about, however, include CIS of the breast (bothductal carcinoma in situ (DCIS)andlobular carcinoma in situ (LCIS), bladder, lungs (stage 0 lung cancer), cervix (cervical intraepithelial neoplasia), and skin (squamous cell carcinoma in situ).
Carcinoma In Situ (CIS) vs. Cancer
A million-dollar question lately, especially with controversy over the treatment of ductal carcinoma in situ or in situ breast cancer, is whether or not carcinoma in situ is really cancer.The answer is that it depends on who you talk to.
Carcinoma In Situ vs. Precancerous Cells vs. Dysplasia
There are many terms describing the spectrum of normal cells and invasive cancer cells. One of these is dysplasia. Dysplasia can run the spectrum from mild dysplasia in which the cells are barely abnormal appearing, to carcinoma in situ, which some pathologists describe as severe dysplasia involving the full thickness of the epithelium. The term precancerous cells may also be used to describe cells on this continuum between normal and cancer cells.
These terms are also used in different ways depending on the sample analyzed. For example, cells visualized on a pap smear may show dysplasia (they may appear abnormal), but since the cells are “loose,” nothing can be said about whether carcinoma in situ is present or not.
With cervical dysplasia, a biopsy is required before the diagnosis of CIS is made. A biopsy sample provides a view of the cells as they occur in relation to the basement membrane and other cells, and is needed to understand if abnormal cells seen on a pap smear are concerning.
Stage of Cancer, Carcinoma In Situ, and Additional Terms
A common question is, “What stage of cancer is carcinoma in situ?” Carcinoma in situ is referred to as stage 0 cancer. At this stage, cancer is considered non-invasive. Stage 1 cancers and beyond are considered invasive, meaning that even if low, there is a potential they could spread. Other terms that may be used in defining the same thing as carcinoma in situ or stage 0 cancer include:
Treatment
Carcinoma in situ is usually removed via surgery, though the type of surgery will depend on the location, and even within particular locations there is significant controversy. These decisions are made based on looking at the particular area of abnormality, risk factors that indicate CIS is more likely to become invasive cancer, the age of a person, and much more.
Some people are comfortable observing an abnormality whereas others prefer that anything which could become cancer be removed.
Other treatments may also be used for carcinoma in situ in other regions of the body. For example, some early cancerous (CIS) stages of some types of skin cancer may be treated with topical chemotherapy or other treatments.
A Word From Verywell
Being told you have carcinoma in situ can be very frightening. While some people with invasive cancer may consider CIS or stage 0 cancer as less concerning, the uncertainty associated with this finding, and wondering about whether and how to treat the abnormality, can sometimes be more challenging to deal with than a clearly diagnosed invasive cancer.
Frequently Asked QuestionsOften, it has no symptoms. With ductal carcinoma in situ (DCIS), though, you may have a lump or nipple discharge.Usually, DCIS is diagnosed after a mammogram.Learn MoreWhat Is Stage 0 Breast Cancer?Carcinoma in situ, or CIS, is usually not considered cancer. Rather, it’s recognized as a condition that may become cancer.However, depending on the location of the cells, doctors may recognize it as a type of cancer that has not moved past the original cells and is non-invasive.Learn MoreWhat Does It Mean to Have Precancerous Cells?There are situations in which carcinoma in situ can be completely removed. Procedures may include cryosurgery in which the abnormal cells are frozen, traditional surgery, or application of topical chemotherapy.Learn MoreCervical Cryosurgery: Everything You Need to Know
Frequently Asked Questions
Often, it has no symptoms. With ductal carcinoma in situ (DCIS), though, you may have a lump or nipple discharge.Usually, DCIS is diagnosed after a mammogram.Learn MoreWhat Is Stage 0 Breast Cancer?
Often, it has no symptoms. With ductal carcinoma in situ (DCIS), though, you may have a lump or nipple discharge.Usually, DCIS is diagnosed after a mammogram.
Learn MoreWhat Is Stage 0 Breast Cancer?
Carcinoma in situ, or CIS, is usually not considered cancer. Rather, it’s recognized as a condition that may become cancer.However, depending on the location of the cells, doctors may recognize it as a type of cancer that has not moved past the original cells and is non-invasive.Learn MoreWhat Does It Mean to Have Precancerous Cells?
Carcinoma in situ, or CIS, is usually not considered cancer. Rather, it’s recognized as a condition that may become cancer.However, depending on the location of the cells, doctors may recognize it as a type of cancer that has not moved past the original cells and is non-invasive.
Learn MoreWhat Does It Mean to Have Precancerous Cells?
There are situations in which carcinoma in situ can be completely removed. Procedures may include cryosurgery in which the abnormal cells are frozen, traditional surgery, or application of topical chemotherapy.Learn MoreCervical Cryosurgery: Everything You Need to Know
There are situations in which carcinoma in situ can be completely removed. Procedures may include cryosurgery in which the abnormal cells are frozen, traditional surgery, or application of topical chemotherapy.
Learn MoreCervical Cryosurgery: Everything You Need to Know
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cho H, Mariotto AB, Schwartz LM, Luo J, Woloshin S.When do changes in cancer survival mean progress? The insight from population incidence and mortality.J Natl Cancer Inst Monographs. 2014;2014(49):187-97. doi:10.1093/jncimonographs/lgu014National Cancer Institute.SEER Training: Code 0: In Situ.Centers for Disease Prevention and Control.Cancer Screening Tests.Barrio AV, Van zee KJ.Controversies in the Treatment of Ductal Carcinoma in Situ.Annu Rev Med. 2017;68:197-211. doi: 10.1146/annurev-med-050715-104920Srivastava S, Ghosh S, Kagan J, Mazurchuk R.The Making of a PreCancer Atlas: Promises, Challenges, and Opportunities.Trends Cancer. 2018;4(8):523-536. doi: 10.1016/j.trecan.2018.06.007Van seijen M, Lips EH, Thompson AM, et al.Ductal carcinoma in situ: to treat or not to treat, that is the question.Br J Cancer. 2019;121(4):285-292. doi: 10.1038/s41416-019-0478-6National Cancer Institute.Skin Cancer Treatment (PDQ) – Patient Version.Breastcancer.org.Ductal Carcinoma In Situ (DCIS).National Cancer Institute.Cancer Staging.National Cancer Institute.Skin Cancer Treatment (PDQ®)–Patient Version.Additional ReadingMerrill, A., Esserman, L., and M. Morrow.Ductal Carcinoma In Situ.The New England Journal of Medicine. 2016. 374:390-392.National Cancer Institute. SEER Training Modules. In Situ (Stage = 0).
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cho H, Mariotto AB, Schwartz LM, Luo J, Woloshin S.When do changes in cancer survival mean progress? The insight from population incidence and mortality.J Natl Cancer Inst Monographs. 2014;2014(49):187-97. doi:10.1093/jncimonographs/lgu014National Cancer Institute.SEER Training: Code 0: In Situ.Centers for Disease Prevention and Control.Cancer Screening Tests.Barrio AV, Van zee KJ.Controversies in the Treatment of Ductal Carcinoma in Situ.Annu Rev Med. 2017;68:197-211. doi: 10.1146/annurev-med-050715-104920Srivastava S, Ghosh S, Kagan J, Mazurchuk R.The Making of a PreCancer Atlas: Promises, Challenges, and Opportunities.Trends Cancer. 2018;4(8):523-536. doi: 10.1016/j.trecan.2018.06.007Van seijen M, Lips EH, Thompson AM, et al.Ductal carcinoma in situ: to treat or not to treat, that is the question.Br J Cancer. 2019;121(4):285-292. doi: 10.1038/s41416-019-0478-6National Cancer Institute.Skin Cancer Treatment (PDQ) – Patient Version.Breastcancer.org.Ductal Carcinoma In Situ (DCIS).National Cancer Institute.Cancer Staging.National Cancer Institute.Skin Cancer Treatment (PDQ®)–Patient Version.Additional ReadingMerrill, A., Esserman, L., and M. Morrow.Ductal Carcinoma In Situ.The New England Journal of Medicine. 2016. 374:390-392.National Cancer Institute. SEER Training Modules. In Situ (Stage = 0).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cho H, Mariotto AB, Schwartz LM, Luo J, Woloshin S.When do changes in cancer survival mean progress? The insight from population incidence and mortality.J Natl Cancer Inst Monographs. 2014;2014(49):187-97. doi:10.1093/jncimonographs/lgu014National Cancer Institute.SEER Training: Code 0: In Situ.Centers for Disease Prevention and Control.Cancer Screening Tests.Barrio AV, Van zee KJ.Controversies in the Treatment of Ductal Carcinoma in Situ.Annu Rev Med. 2017;68:197-211. doi: 10.1146/annurev-med-050715-104920Srivastava S, Ghosh S, Kagan J, Mazurchuk R.The Making of a PreCancer Atlas: Promises, Challenges, and Opportunities.Trends Cancer. 2018;4(8):523-536. doi: 10.1016/j.trecan.2018.06.007Van seijen M, Lips EH, Thompson AM, et al.Ductal carcinoma in situ: to treat or not to treat, that is the question.Br J Cancer. 2019;121(4):285-292. doi: 10.1038/s41416-019-0478-6National Cancer Institute.Skin Cancer Treatment (PDQ) – Patient Version.Breastcancer.org.Ductal Carcinoma In Situ (DCIS).National Cancer Institute.Cancer Staging.National Cancer Institute.Skin Cancer Treatment (PDQ®)–Patient Version.
Cho H, Mariotto AB, Schwartz LM, Luo J, Woloshin S.When do changes in cancer survival mean progress? The insight from population incidence and mortality.J Natl Cancer Inst Monographs. 2014;2014(49):187-97. doi:10.1093/jncimonographs/lgu014
National Cancer Institute.SEER Training: Code 0: In Situ.
Centers for Disease Prevention and Control.Cancer Screening Tests.
Barrio AV, Van zee KJ.Controversies in the Treatment of Ductal Carcinoma in Situ.Annu Rev Med. 2017;68:197-211. doi: 10.1146/annurev-med-050715-104920
Srivastava S, Ghosh S, Kagan J, Mazurchuk R.The Making of a PreCancer Atlas: Promises, Challenges, and Opportunities.Trends Cancer. 2018;4(8):523-536. doi: 10.1016/j.trecan.2018.06.007
Van seijen M, Lips EH, Thompson AM, et al.Ductal carcinoma in situ: to treat or not to treat, that is the question.Br J Cancer. 2019;121(4):285-292. doi: 10.1038/s41416-019-0478-6
National Cancer Institute.Skin Cancer Treatment (PDQ) – Patient Version.
Breastcancer.org.Ductal Carcinoma In Situ (DCIS).
National Cancer Institute.Cancer Staging.
National Cancer Institute.Skin Cancer Treatment (PDQ®)–Patient Version.
Merrill, A., Esserman, L., and M. Morrow.Ductal Carcinoma In Situ.The New England Journal of Medicine. 2016. 374:390-392.National Cancer Institute. SEER Training Modules. In Situ (Stage = 0).
Merrill, A., Esserman, L., and M. Morrow.Ductal Carcinoma In Situ.The New England Journal of Medicine. 2016. 374:390-392.
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