Grading and receptors for DCIS

Your cancer doctor needs certain information about the DCIS to help plan the best treatment for you.

Planning treatment for DCIS

Your cancer doctor needs certain information about the DCIS to help plan the best treatment for you. This includes:

  • the size of the DCIS
  • whether it is only in 1 part of the breast
  • the grade of the DCIS
  • whether the DCIS has certain hormone receptors.

DCIS describes the earliest changes to cells that might become breast cancer. With invasive breast cancer, the stage usually describes the size of the cancer and where it started. But with DCIS, there is no breast invasive breast cancer. So it is described as stage 0. This is the earliest stage. DCIS can be any size, but will always be stage 0.


The grade of a cancer describes how the cells look and how quickly they grow compared with normal cells. In DCIS, the grade of the cells is important. It indicates how likely DCIS is to come back in the breast. It also indicates how likely it is to develop into an invasive cancer.

There are 3 grades.

Grade 1 (low-grade DCIS)

The cells look similar to normal breast cells and usually grow slowly. They are less likely to spread into surrounding tissue.

Grade 2 (moderate- or intermediate-grade DCIS)

The cells look more abnormal and grow slightly faster than low-grade DCIS.

Grade 3 (high-grade DCIS)

The cells look quite different from normal breast cells and grow more quickly.

High-grade DCIS is more likely to come back or develop into invasive cancer. Low-grade DCIS can still develop into invasive cancer, but the risk is low. Most people treated for high-grade DCIS have no further problems.

Knowing the grade of the DCIS helps you and your doctors decide on the best treatment for you.

DCIS with microinvasion

The pathologist will examine the tissue to see whether the cells have started to spread through the walls of the lobules or ducts. These very small areas of spread are called areas of microinvasion.

Hormone receptors

DCIS cells may have receptors on them. These allow hormones such as oestrogen to attach to the cancer cell. These hormones can help cancer cells grow. A pathologist checks for receptors by testing the tissue that was removed during the biopsy or surgery.

Hormonal therapies can reduce levels of oestrogen in the body. If the DCIS is oestrogen receptor positive (ER positive), your doctor may suggest hormonal therapy to shrink the DCIS before or after surgery.

About our information

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Dr Rebecca Roylance, Consultant Medical Oncologist and Professor Mike Dixon, Professor of Surgery and Consultant Breast Surgeon.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

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We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.

Date reviewed

Reviewed: 01 October 2023
Next review: 01 October 2026
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.