Treatment for ductal carcinoma in situ (DCIS) usually involves surgery with or without radiation therapy. After surgery and radiation therapy, some women may take tamoxifen.
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 milk 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.
Overall survival is the same for women who have mastectomy versus lumpectomy (with or without radiation therapy) .
In the U.S., most women with DCIS choose treatment with lumpectomy followed by radiation therapy [1,3].
Learn more about mastectomy and lumpectomy.
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 [2-8]:
Select women with smaller, lower grade DCIS and clean surgical margins, may be candidates for lumpectomy without radiation therapy [2,8].
Overall survival is the same for women with DCIS who have lumpectomy with or without radiation therapy [4-5].
Learn more about radiation therapy.
For a summary of research studies on lumpectomy plus radiation therapy in the treatment of DCIS, visit the Breast Cancer Research section.
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 . Studies have shown tamoxifen can lower the risk of [9-11]:
Tamoxifen is usually not recommended for women who have a mastectomy for DCIS. These women have an excellent prognosis with a low risk of DCIS recurrence or developing invasive breast cancer, so the benefit of tamoxifen is likely very small.
Learn more about tamoxifen.
Learn more about factors that affect treatment options.
For a summary of research studies on tamoxifen as a treatment for DCIS, visit the Breast Cancer Research section.
Read our perspective on DCIS (March 2013).*
For more information on treatment for DCIS, visit the National Comprehensive Cancer Network (NCCN) or the American Society for Clinical Oncology (ASCO).
*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.
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