Ductal Breast Cancer in Situ (DCIS)- Treatment

Ductal Breast Cancer in Situ (DCIS)

Treatment

Treatment of DCIS is usually successful. There are different treatment procedures depending on the type of cellular change, the size of the tumor, the number of tumors or microcalcifications and whether the tumor is hormone dependent or not.

Left untreated, it is estimated that 40-50 percent of DCIS cases may progress to invasive breast cancer in time.

The standard treatment of DCIS is by surgery to remove the mass.

Surgery may be combined with radiotherapy or hormone therapy to improve the prognosis of the condition.

Treatment Protocol for DCIS

Ductal Breast Cancer in situ Treatment Protocol

Lumpectomy - If the DCIS is present over a small area, a simple lumpectomy may be adequate to treat the condition. If it is present over more than one area, or if the size of the DCIS is large, then mastectomy may be needed.

Mastectomy A Mastectomy (complete removal of the breast) may be combined with Breast Reconstruction at the same time. A mastectomy is necessary :

if no clear margin of healthy cells are obtained after a lumpectomy,
if the DCIS is present over a large area or in different areas of the breast.
if there is a strong family history of breast cancer.
if there are gene mutations (BRCA1 and BRCA2)
if the patient is unable to tolerate radiotherapy due to any cause.

Radiotherapy - Radiotherapy usually follows a lumpectomy. It is not necessary after a mastectomy.

Radiotherapy is usually started 4-6 weeks after surgery. It decreases the chance of the DCIS progressing to invasive ductal cancer or of recurring after some time.

Hormone therapy - If the breast tissue after lumpectomy or a breast biopsy is seen to be hormone positive, adjuvant hormone treatment with Tamoxifen (for any woman) or an aromatase inhibitor like Arimidex (for women past menopause) for 5 years after surgery can lower the risk of recurrent DCIS or invasive cancer developing in either breast.

Lymph node surgery is generally not necessary in DCIS. But some surgeons may prefer to do a Sentinel node biopsy - that means, removal of the first node closest to the cancer. It helps rule out or confirm the presence of invasive ductal cancer together with the DCIS.

Read More :

Symptoms and Grades of DCIS

Diagnosis of DCIS