Treatment of Ductal Carcinoma in Situ (DCIS) - American ...

Ductal carcinoma in situ (DCIS) means the cells that line the milk ducts of the breast have become cancer, but they have not spread into surrounding breast ... Search prod Verenespañol | Downloadthistopic[PDF] TreatmentofBreastCancerbyStage TreatmentofDuctalCarcinomainSitu(DCIS) TreatmentofBreastCancerStagesI-III TreatmentofStageIV(Metastatic)BreastCancer TreatmentofRecurrentBreastCancer Home CancerA-Z BreastCancer TreatingBreastCancer TreatmentofBreastCancerbyStage TreatmentofDuctalCarcinomainSitu(DCIS) Ductalcarcinomainsitu(DCIS)meansthecellsthatlinethemilkductsofthebreasthavebecomecancer,buttheyhavenotspreadintosurroundingbreasttissue. DCISisconsiderednon-invasiveorpre-invasivebreastcancer.DCIScan’tspreadoutsidethebreast,butitisoftentreatedbecauseifleftalone,someDCIScellscancontinuetoundergoabnormalchangesthatcauseittobecomeinvasivebreastcancer(whichcanspread). Inmostcases,awomanwithDCIScanchoosebetweenbreast-conservingsurgery(BCS)andsimplemastectomy.Butsometimes,ifDCISisthroughoutthebreast,amastectomymightbeabetteroption.Thereareclinicalstudiesbeingdonetoseeifobservationinsteadofsurgerymightbeanoptionforsomewomen. Breast-conservingsurgery(BCS) Inbreast-conservingsurgery(BCS),thesurgeonremovesthetumorandasmallamountofnormalbreasttissuearoundit.LymphnoderemovalisnotusuallyneededwithBCS.Itmightbedoneafterthefirstsurgeryifanareaofinvasivecancerisfound.ThechancesanareaofDCIScontainsinvasivecancergoesupwithtumorsizeandhowfastthecancerisgrowing.Iflymphnodesareremoved,thisisusuallydoneasasentinellymphnodebiopsy(SLNB). IfBCSisdone,itisusuallyfollowedbyradiationtherapy.Thislowersthechanceofthecancercomingbackinthesamebreast(eitherasmoreDCISorasaninvasivecancer).BCSwithoutradiationtherapyisnotastandardtreatment,butitmightbeanoptionforolderwomen,womenwithothersignificanthealthproblems,orwomenwhohadsmallareasoflow-gradeDCISthatwereremovedwithlargeenoughcancer-freesurgicalmargins. Manywomenwithearly-stagebreastcancer,likeDCIS,canchoosebetweenbreast-conservingsurgery(BCS)andmastectomy. ThemainadvantageofBCSisthatawomankeepsmostofherbreast. Somewomenmightworrythathavinglessextensivesurgerymightraisetheirriskofthecancercomingback.Butstudiesfollowingthousandsofwomenformorethan20yearsshowthatwhenBCSisdonewithradiationinwomenwithearly-stagecancer,survivalisthesameashavingamastectomy. Mastectomy Simplemastectomy(removaloftheentirebreast)maybeneedediftheareaofDCISisverylarge,ifthebreasthasseveralseparateareasofDCISindifferentquadrants(multicentric),orifBCScannotremovetheDCIScompletely(thatis,theBCSspecimenandre-excisionspecimensstillhavecancercellsinornearthesurgicalmargins).Ifamastectomyisneededforanyofthereasonsstatedabove, manydoctorswilldoaSLNBalongwiththemastectomybecausethereisahigherchancethatinvasivecancermightbefound.Ifanareaofinvasivecancerisfoundinthetissueremovedduringamastectomy,thedoctorwon’tbeabletogobackanddoSLNBlater,andasaresultmayhavetodoafullaxillarylymphnodedissection(ALND)instead. WomenhavingamastectomyforDCIStypicallydon’tneedradiationtherapyand maychoosetohavebreastreconstructionrightawayorlater. Hormonetherapyafterbreastsurgery IftheDCISishormonereceptor-positive(estrogenorprogesterone),treatmentwithtamoxifen(foranywoman)oranaromataseinhibitor,suchasexemestaneoranastrozole,(forwomenpastmenopause)for5yearsaftersurgerycanlowertheriskofanotherDCISorinvasivecancerdevelopingineitherbreast.Ifyouhavehormonereceptor-positiveDCIS,discussthereasonsforandagainsthormonetherapywithyourdoctor. Writtenby References TheAmericanCancerSocietymedicalandeditorialcontentteam Ourteamismadeupofdoctorsand oncologycertifiednurseswithdeepknowledgeofcancercareaswellasjournalists,editors,andtranslatorswithextensiveexperienceinmedicalwriting. CollinsLC,LarongaC,andWongJS.Ductalcarcinomainsitu:Treatmentandprognosis.InVoraSR,ed.UpToDate.Waltham,Mass.:UpToDate,2021.https://www.uptodate.com.LastupdatedJuly13,2021.AccessedAugust17,2021. HenryNL,ShahPD,HaiderI,FreerPE,JagsiR,SabelMS.Chapter88:CanceroftheBreast.In:NiederhuberJE,ArmitageJO,DoroshowJH,KastanMB,TepperJE,eds. Abeloff’sClinicalOncology.6thed.Philadelphia,Pa:Elsevier;2020. JagsiR,KingTA,LehmanC,MorrowM,HarrisJR,BursteinHJ.Chapter79:MalignantTumorsoftheBreast.In:DeVitaVT,LawrenceTS,LawrenceTS,RosenbergSA,eds. DeVita,Hellman,andRosenberg’sCancer:PrinciplesandPracticeofOncology.11thed.Philadelphia,Pa:LippincottWilliams&Wilkins;2019. NationalCancerInstitute.PhysicianDataQuery(PDQ).BreastCancerTreatment–HealthProfessionalVersion.2021.Accessedathttps://www.cancer.gov/types/breast/hp/breast-treatment-pdqonAugust17,2021. NationalComprehensiveCancerNetwork(NCCN).PracticeGuidelinesinOncology:BreastCancer.Version6.2021.Accessedathttps://www.nccn.org/professionals/physician_gls/pdf/breast.pdfonAugust17,2021. References CollinsLC,LarongaC,andWongJS.Ductalcarcinomainsitu:Treatmentandprognosis.InVoraSR,ed.UpToDate.Waltham,Mass.:UpToDate,2021.https://www.uptodate.com.LastupdatedJuly13,2021.AccessedAugust17,2021. HenryNL,ShahPD,HaiderI,FreerPE,JagsiR,SabelMS.Chapter88:CanceroftheBreast.In:NiederhuberJE,ArmitageJO,DoroshowJH,KastanMB,TepperJE,eds. Abeloff’sClinicalOncology.6thed.Philadelphia,Pa:Elsevier;2020. JagsiR,KingTA,LehmanC,MorrowM,HarrisJR,BursteinHJ.Chapter79:MalignantTumorsoftheBreast.In:DeVitaVT,LawrenceTS,LawrenceTS,RosenbergSA,eds. DeVita,Hellman,andRosenberg’sCancer:PrinciplesandPracticeofOncology.11thed.Philadelphia,Pa:LippincottWilliams&Wilkins;2019. NationalCancerInstitute.PhysicianDataQuery(PDQ).BreastCancerTreatment–HealthProfessionalVersion.2021.Accessedathttps://www.cancer.gov/types/breast/hp/breast-treatment-pdqonAugust17,2021. NationalComprehensiveCancerNetwork(NCCN).PracticeGuidelinesinOncology:BreastCancer.Version6.2021.Accessedathttps://www.nccn.org/professionals/physician_gls/pdf/breast.pdfonAugust17,2021. LastRevised:October27,2021 AmericanCancerSocietymedicalinformationiscopyrighted material.Forreprintrequests,pleaseseeourContentUsagePolicy. TreatmentofBreastCancerbyStage TreatmentofDuctalCarcinomainSitu(DCIS) TreatmentofBreastCancerStagesI-III TreatmentofStageIV(Metastatic)BreastCancer TreatmentofRecurrentBreastCancer MoreInBreastCancer AboutBreastCancer RiskandPrevention EarlyDetectionandDiagnosis UnderstandingaBreastCancerDiagnosis Treatment BreastReconstructionSurgery LivingasaBreastCancerSurvivor BackToTop Close * Close Imageof Previous Next Close Close SelectAHopeLodge