Ductal Carcinoma (Invasive and In Situ)
How is ductal carcinoma in situ treated?
No two patients are the same. Your doctor will customize your treatment plan for ductal carcinoma in situ based on your test results and medical history. Among other things, your doctor will consider:
- Tumor location
- Tumor size
- Aggressiveness of the cancer cells
- Family history of breast cancer
Most women with ductal carcinoma in situ don't have the breast removed with a mastectomy. Instead, they receive breast-conserving treatment.
The most common course of treatment consists of a lumpectomy followed by radiation. A lumpectomy is a surgical procedure in which a surgeon removes the cancer and a small area of normal tissue around it. The risk of lymph node involvement with ductal carcinoma in situ is only 1% to 2% so the lymph nodes under the arm do not need to be removed, as may be the case with other types of breast cancer. The area of normal tissue is taken to make sure all the cancer cells have been removed.
After lumpectomy, radiation therapy significantly reduces the likelihood that the cancer will come back. Cancer coming back is called recurrence. Radiation can be delivered from an external source to the entire breast. Or it can be given internally to certain areas of the breast.
Some women with an extremely low likelihood of cancer recurrence may be treated for ductal carcinoma in situ with a lumpectomy only. This may be an option for older women with small tumors whose surgery showed large amounts of healthy tissue on all sides of the cancer. You should discuss the risks of forgoing radiation therapy with your doctor before deciding against it.
You and your doctors may decide that a mastectomy to remove the breast is the best course of treatment if you have any of the following:
- A strong family history of breast cancer
- Very large areas of ductal carcinoma in situ
- DCIS lesions located in multiple areas throughout your breast
Whatever form of treatment you have, you and your treatment team may also consider the use of tamoxifen. Tamoxifen is a breast cancer drug that reduces the risk of invasive breast cancer not only in the involved breast, but in the opposite breast as well. This risk reduction continues even after the tamoxifen is discontinued.