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 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 with DCIS in the U.S. choose treatment with lumpectomy followed by radiation therapy [76-77].
Radiation therapy
Radiation therapy is not given to women who are treated with mastectomy for DCIS.
In contrast, lumpectomy for DCIS is usually followed by radiation therapy to lower the risk of invasive breast cancer and DCIS recurrence [66,78-84]. Select women with smaller, lower grade DCIS and clean surgical margins, may be candidates for lumpectomy without radiation therapy [66,79].
Hormone therapy with tamoxifen
The hormone therapy tamoxifen is used to treat invasive breast cancers that are estrogen receptor-positive. It is not used to treat estrogen receptor-negative cancers.
The National Comprehensive Cancer Network (NCCN) recommends women who are treated with lumpectomy plus radiation therapy for estrogen receptor-positive DCIS consider taking tamoxifen for five years [66]. 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 [83-84].
For women who have a mastectomy, the benefit of tamoxifen is likely very small and such treatment is not usually recommended.
Learn more about factors that affect treatment options.
Learn more about mastectomy and lumpectomy.
Learn more about radiation therapy.
Learn more about tamoxifen.
Updated 01/24/12
