From the Guidelines
The treatment for Ductal Carcinoma In Situ (DCIS) typically involves surgery, often followed by radiation therapy and sometimes hormonal therapy, with the primary surgical options including breast-conserving surgery (lumpectomy) or mastectomy for more extensive cases. The choice of treatment strategy is based on biology and tumour extent/location as well as on the age, body habitus, and general health status of the patient and their preferences 1.
- The treatment options for DCIS include:
- Breast-conserving surgery (lumpectomy) where only the abnormal tissue and a small margin of surrounding healthy tissue are removed
- Mastectomy for more extensive cases
- After lumpectomy, radiation therapy is usually recommended to eliminate any remaining cancer cells and reduce recurrence risk 1
- For hormone receptor-positive DCIS, hormonal therapy with tamoxifen (5mg daily) or aromatase inhibitors like anastrozole or letrozole may be prescribed to further reduce recurrence risk 1
- Treatment decisions are individualized based on factors such as the size and grade of the DCIS, patient age, family history, and personal preferences
- DCIS is considered a non-invasive or pre-invasive breast cancer with excellent prognosis when properly treated, as the abnormal cells are confined within the milk ducts and haven't spread to surrounding breast tissue
- Regular follow-up care is essential after treatment to monitor for potential recurrence 1
From the FDA Drug Label
In women with DCIS, following breast surgery and radiation, tamoxifen citrate tablets are indicated to reduce the risk of invasive breast cancer The recommended dose is tamoxifen 20 mg daily for 5 years. The decision regarding therapy with tamoxifen for the reduction in breast cancer incidence should be based upon an individual assessment of the benefits and risks of tamoxifen therapy.
The treatment for Ductal Carcinoma In Situ (DCIS) includes:
- Surgery: Lumpectomy
- Radiation therapy
- Tamoxifen therapy: 20 mg daily for 5 years to reduce the risk of invasive breast cancer 2, 2, 2 Key points:
- The treatment should be individualized based on the patient's risk factors and benefits.
- The decision to use tamoxifen should be based on an assessment of the benefits and risks of therapy.
From the Research
Treatment Options for Ductal Carcinoma In Situ (DCIS)
The treatment for DCIS typically involves a combination of surgical and adjuvant therapies. The primary goal of treatment is to prevent the progression of DCIS to invasive breast cancer.
- Surgical Options:
- Mastectomy: This involves the removal of the entire breast and is often recommended for patients with large tumors or those who are at high risk of recurrence 3.
- Lumpectomy: This involves the removal of the tumor and a small margin of surrounding tissue, and is often followed by radiation therapy to reduce the risk of recurrence 4, 5.
- Adjuvant Therapies:
- Radiation Therapy: This is often used in combination with lumpectomy to reduce the risk of recurrence, and has been shown to decrease the local recurrence rate by about half 4, 6, 5.
- Hormonal Therapy: This may be recommended for patients with hormone receptor-positive DCIS, and has been shown to decrease the risk of recurrence by about 30% 6, 7.
- Other Considerations:
- Prognostic Factors: Factors such as age, extent of DCIS, margin status, grade, and presence of necrosis may be used to determine the risk of recurrence and guide treatment decisions 6, 5.
- Lifestyle Modifications: Low-fat diets, weight loss, and physical activity may be recommended to reduce the risk of recurrence 6.