Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer. Many issues in the treatment of DCIS are under study. These include ways to predict which cases of DCIS will progress to invasive breast cancer (to target treatment to those who are at higher risk) and which women may not need radiation therapy after lumpectomy for DCIS.
After discussing the benefits and risks with your health care provider, we encourage you to consider joining a clinical trial of a new treatment for DCIS.
BreastCancerTrials.org in collaboration with Susan G. Komen offers a custom matching service that can help you find a clinical trial that fits your health needs. Learn more about clinical trials.
Read our perspective on DCIS (March 2013).*
*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.
Hormone receptor testing of DCIS tumors is becoming more common as the benefits of tamoxifen appear limited to hormone receptor-positive (estrogen receptor-positive and/or progesterone receptor-positive) DCIS [2,11].
Learn more about hormone receptor status and invasive breast cancer.
Women with hormone receptor-positive DCIS may benefit from hormone therapy. At this time, tamoxifen is the only hormone therapy used to treat hormone receptor-positive DCIS. The use of aromatase inhibitors (instead of tamoxifen) for DCIS treatment is under study, but results are not yet available .
Learn more about aromatase inhibitors.
For women with early breast cancer, radiation therapy is given after lumpectomy (also called breast conserving surgery). However, there are questions about the need for radiation therapy after lumpectomy for DCIS.
A pooled analysis of data from four randomized controlled trials found that radiation therapy after lumpectomy for DCIS decreased the risk DCIS recurrence, and possibly the risk of invasive breast cancer .
Select women with smaller, lower-grade DCIS and clean surgical margins may be candidates for lumpectomy without radiation therapy [2,8]. However, which women might avoid radiation therapy is still under study.
For a summary of research studies on lumpectomy plus radiation therapy as a treatment for DCIS, visit the Breast Cancer Research section.
Oncotype Dx is a test that helps predict the chance of metastasis (when cancer spreads to other organs) for some invasive breast cancers. It tests a sample of the tumor (removed during a biopsy or surgery) for a group of 21 genes.
The Oncotype DX test for invasive breast cancer has been modified to help predict the chance that DCIS will return as DCIS or invasive breast cancer . This could help identify which cases of DCIS would benefit most from radiation therapy after lumpectomy (and which women might be treated with lumpectomy alone) . This test needs further study and is not yet part of standard practice.
Learn more about Oncotype DX for invasive breast cancer.
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