AU - Agrawal, Sujan TI - Ductal carcinoma In situ: The challenges and approaches PT - REVI DP - 2016 Jul 1 TA - Archives of International Surgery PG - 137-145 VI - 6 IP - 3 4099- https://www.archintsurg.org/article.asp?issn=2278-9596;year=2016;volume=6;issue=3;spage=137;epage=145;aulast=Agrawal;type=0 4100- https://www.archintsurg.org/article.asp?issn=2278-9596;year=2016;volume=6;issue=3;spage=137;epage=145;aulast=Agrawal AB - Cancer cells are in situ or invasive depending upon whether they have invaded basement membrane or not. Ductal carcinoma in situ (DCIS) signifies in situ growth in the ductal system of the breast. Screening mammography has revolutionized the screening and diagnosis of this clinically occult disease. Diagnosis may be further improved by ultrasonography and magnetic resonance imaging in selected cases. Suspicious area in the breast is subjected to fine needle aspiration cytology (FNAC). The drawback of this simple procedure (FNAC) is that basement membrane cannot be assessed, and hence, image-guided, core needle biopsy or tru-cut biopsy is used to overcome this drawback. After confirmation of the diagnosis, DCIS may be treated by breast conservation or mastectomy and/or radiation. This paper discusses the various challenges encountered at every step in this clinically occult disease during screening, diagnosis, and treatment. Means and ways are highlighted to overcome the challenges.