Treatment for ductal carcinoma in situ (DCIS) usually involves surgery with or without radiation therapy. After surgery and radiation, some women may take tamoxifen.
Surgery
The first step in treating DCIS is surgery to remove the abnormal tissue in the breast. Depending on how far the DCIS has spread within the ducts, surgery can be either mastectomy or lumpectomy.
If DCIS has spread throughout the ducts, affecting a large part of the breast, you will need a total (simple) mastectomy. In a total mastectomy, the surgeon removes the entire breast but no other tissue or lymph nodes.
If there is little spread of DCIS within the ducts, a choice can be made between mastectomy and lumpectomy. With lumpectomy, the surgeon removes only the abnormal tissue, but the rest of the breast is left intact. In most cases, it does not include the removal of any lymph nodes.
Most women in the United States with DCIS choose treatment with lumpectomy followed by radiation therapy [98-99].
Learn more about mastectomy and lumpectomy.
Radiation therapy
Radiation therapy is not given to women who are treated with mastectomy for DCIS.
Lumpectomy for DCIS is usually followed by radiation therapy to lower the risk of invasive breast cancer and DCIS recurrence [100-105]. Select women with smaller, lower grade DCIS and clean surgical margins, may be candidates for lumpectomy without radiation therapy [100,106].
Overall survival appears to be similar for women with DCIS who have lumpectomy with or without radiation therapy [102-103].
Learn more about radiation therapy.
Hormone therapy with tamoxifen
The National Comprehensive Cancer Network (NCCN) recommends women who are treated with lumpectomy plus radiation therapy for estrogen receptor-positive (ER+) DCIS consider taking tamoxifen for five years [100]. Studies have shown tamoxifen can lower the risk of a recurrence of DCIS as well as the risk of getting invasive cancer in both the affected breast and the opposite breast [104-105,107].
Because women who have a mastectomy for DCIS have an excellent prognosis with a low risk of recurrence, the benefit of tamoxifen is likely very small and such treatment is not usually recommended.
Learn more about tamoxifen.
Learn more about factors that affect treatment options.
*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 Therefore, some information may be out of date at this time.
Updated 04/19/13
