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Treating Noninvasive Breast Cancer (Ductal Carcinoma in Situ)

Medically Reviewed by Laura J. Martin, MD on May 10, 2020

If you’ve been diagnosed with noninvasive breast cancer, you’re probably wondering what treatment you’ll need. Doctors often call this type of breast cancer ductal carcinoma in situ (DCIS). It gets this name because the cancer is only in the breast ducts that carry milk. Sometimes you may also hear it called stage 0 breast cancer.

There are different ways to treat DCIS. The goal of treatment is always the same -- to get rid of the cancer before it has a chance to get out of the ducts and into soft breast tissue.

Will I Need Surgery?

Most likely, yes. Surgery is the most common way that doctors treat DCIS. Most often, it’s done with a procedure called a lumpectomy. A surgeon removes only the affected area of the breast while leaving healthy tissue. Doctors also call this breast-conserving surgery.

Sometimes, a doctor might suggest removing the whole breast. This type of surgery is a mastectomy. Reasons why a doctor might suggest you have a mastectomy instead of a lumpectomy for DCIS include:

  • The cancer covers a large area of the breast.
  • The cancer is in more than one place.
  • The location of the cancer makes it hard for a lumpectomy to have a good cosmetic result.
  • You’re at high risk for a future breast cancer based on family history, genetic test results, or young age.

What Happens After Surgery?

After a lumpectomy, you usually have radiation treatment to lower the chance the cancer will come back. If you had a mastectomy, you usually won’t need radiation. There are different ways you may get radiation for DCIS.

  • Radiation of the whole breast is the most common treatment. A machine delivers the radiation, often 5 days a week for several weeks.
  • It might be an option to get radiation for only part of the breast. It’s not clear if this works as well as whole breast radiation.
  • Instead of using a machine, a doctor might insert a radioactive seed or pellet into your breast. It’s not yet clear if this works as well to prevent cancer from coming back.

In addition to radiation, some women may take the drug tamoxifen or another hormonal therapy to lower the chance the cancer will come back. Doctors recommend this type of treatment for DCIS that is hormone-receptor-positive -- which means it responds to the hormone estrogen. Sometimes it may be an option to take tamoxifen and skip the radiation. Check with your doctor to find out if your cancer is hormone-receptor-positive or not.

Do I Need Chemo?

No, most likely not. Chemotherapy uses drugs given throughout the body to kill fast-growing cells, including cancer. Because DCIS is only in the breast ducts, doctors don’t usually recommend chemotherapy to treat it.

Will I Need Another Surgery?

It’s possible. Sometimes after a first lumpectomy, a doctor may need to do a second one. This usually happens when the tissue removed in the first surgery doesn’t have enough healthy tissue around it for doctors to be sure they got it all. At this point, you might also consider a mastectomy to make sure all the cancer is gone.

After a lumpectomy or mastectomy, some women may choose to have surgery to reconstruct their breast. The decision to have breast reconstruction is a personal one. It isn’t medically necessary, and it doesn’t have to happen right away. Talk to your doctor about reconstruction to decide if it’s something you may want.

WebMD Medical Reference

Sources

SOURCES:

National Comprehensive Cancer Network Foundation: “Breast Cancer Noninvasive.”

breastcancer.org: “Treatment for DCIS,” “Breast reconstruction.”

American Cancer Society: “Treatment of Ductal Carcinoma In Situ (DCIS).”

Clinicaltrials.gov: “Radiation Therapy (WBI Versus PBI) in Treating Women Who Have Undergone Surgery For Ductal Carcinoma In Situ or Stage I or Stage II Breast Cancer.”

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