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Recommended Treatments for Ductal Carcinoma in Situ

 

Breast Surgery
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Radiation Therapy
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Tamoxifen
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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].

 

  

For a summary of research studies on lumpectomy plus radiation therapy as a treatment for DCIS, visit the Breast Cancer Research section.

 

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. 

 

For more information on treatment for DCIS, visit the National Comprehensive Cancer Network (NCCN) or the American Society for Clinical Oncology (ASCO).

 

For a summary of research studies on tamoxifen as a treatment for DCIS, visit the Breast Cancer Research section. 

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

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