From the Guidelines
The ten-year survival rate for patients with Ductal Carcinoma In Situ (DCIS) is approximately 94% for low-risk patients and 83% for intermediate- and high-risk patients when treated with lumpectomy alone, as reported in a retrospective review 1. This high survival rate reflects the non-invasive nature of DCIS, which is considered a stage 0 breast cancer confined within the milk ducts without spreading to surrounding breast tissue. Some key points to consider include:
- Treatment typically involves surgical removal through lumpectomy (breast-conserving surgery) or mastectomy, often followed by radiation therapy for those who undergo lumpectomy.
- Some patients may also receive hormonal therapy such as tamoxifen or aromatase inhibitors for 5-10 years if their DCIS is estrogen receptor-positive, which further reduces recurrence risk.
- Despite the excellent prognosis, approximately 10-15% of patients may experience a recurrence within 10 years, with about half of these recurrences being invasive breast cancer.
- Regular follow-up mammograms and clinical breast exams are essential for early detection of any recurrence. The high survival rate underscores why DCIS is sometimes referred to as pre-cancer rather than cancer, though proper treatment remains important to prevent progression to invasive disease, with a 20-year breast cancer mortality rate after treatment of DCIS as low as 3% 1.
From the Research
Ten-Year Survival with DCIS
- The ten-year breast cancer-specific survival rate for DCIS is reported to be 97-98% with the current treatment approach 2.
- A study found that the 10-year relapse-free survival rate for DCIS patients treated with mastectomy is 97% 3.
- Another study reported a 10-year disease-free survival rate of 98% for patients treated with mastectomy and 81% for those treated with excision and radiation therapy 4.
- The 10-year disease-specific survival (DSS) rates were found to be highest in lumpectomy with radiation (98.9%), followed by mastectomy (98.5%), and lumpectomy alone (98.4%) 5.
- While the specific ten-year survival rate is not mentioned in the study, it is noted that the actuarial 15-year breast cancer mortality rate was 2.33% for patients treated with lumpectomy alone, 1.74% for patients treated with lumpectomy and radiation, and 2.26% for patients treated with mastectomy 6.
Treatment Options and Survival
- The choice of surgical procedure and adjuvant therapy does not significantly influence breast cancer death in DCIS patients without micrometastasis 2.
- Lumpectomy with radiation therapy is associated with a significant reduction in breast cancer mortality compared to lumpectomy alone or mastectomy alone 6.
- The use of radiotherapy is associated with reduced risk of breast cancer mortality in patients with DCIS 6.