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What is “Stage Zero” Breast Cancer—and Should You Be Worried About it?

In the early 20th century, in a lab at Johns Hopkins Hospital in Baltimore, a surgeon named Joseph Colt Bloodgood made a series of medical observations that have influenced how doctors treat breast cancer to this day. Bloodgood argued that a biopsy could show “a pre-existing local defect which is benign and in which later there may be a cancerous development” and was the first to describe, in a 1934 paper, “precancerous” lesions of the breast. In other words, abnormal cells (the “local defect”) could exist without turning into cancer. There may be a cancerous development.

What Bloodgood described 85 years ago as precancerous tissue of the breast is what doctors now call DCIS, ductal carcinoma in situ, or breast cancer that originates in the milk ducts and stays there without spreading. (Cancer, by definition, must be invasive.) Doctors have been diagnosing DCIS ever since the American Cancer Societyfirst recommended regular mammography in 1976, and the organization estimates that there were 63,000 new cases of DCIS in 2017. The condition accounts for one in every four new cases of breast cancer each year.

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