What Should You Do if You’re Diagnosed with DCIS?

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A group of specialists at the National Cancer Institute recently issued a report calling for a redefinition of the word “cancer,” suggesting that it no longer be applied to certain premalignant and non-lethal conditions. Such a change, the panel wrote, may ease the fears of patients, making them less inclined to seek unnecessary and potentially harmful treatments. The findings reinforce earlier studies by physicians at Dana-Farbers’ Susan F. Smith Centers for Women’s Cancers and others.

An example of this kind of condition is ductal carcinoma in situ (DCIS), in which cancerous cells are confined to the milk ducts of the breast. It is the most common form of non-invasive breast cancer, found in more than 60,000 women in the U.S. each year, according to the American Cancer Society.Here, Eric Winer, MD, director of the Breast Oncology Center at the Susan F. Smith Center for Women’s Cancers at Dana-Farber, answers some common questions about DCIS and its treatment.

Eric Winer, MD, director of the Breast Oncology Center at Dana-Farber’s Susan F. Smith Center for Women’s Cancers

Q:  Should DCIS be considered cancer?

It doesn’t matter what we call it. It matters that women have a conversation with their physician about what DCIS is and what a diagnosis of the condition means. DCIS cells are true cancer cells, but they’re located entirely within the milk ducts of the breast.

Q:  Is DCIS a life-threatening condition?

A woman’s chance of dying from DCIS itself is almost zero. The reason DCIS is important is that, if left untreated, it has the potential to become invasive breast cancer.

Q:  If I have calcifications in a breast, does that mean I have DCIS?

Most calcifications are not a sign of DCIS. In some cases, however, the appearance of certain calcifications on a mammogram increases the likelihood that DCIS is present.

Q:  Do women with DCIS need to be treated?

Because of the risk that DCIS is a forerunner of invasive breast cancer, we recommend treatment.    

Q:  What are the treatments for DCIS?

Treatment typically includes surgery, sometimes followed by radiation and/or hormonal therapy. The type of surgery performed is usually a lumpectomy, in which only the abnormal tissue and a layer of surrounding tissue are removed. Sometimes a mastectomy is performed, in which the entire breast is removed. Mastectomy may be recommended if the DCIS is very extensive and the surgeon cannot remove it entirely with a lumpectomy.

Radiation therapy is generally given after a lumpectomy, although there is a great deal of debate over who should and shouldn’t receive radiotherapy after a diagnosis of DCIS. Occasionally, the drug tamoxifen is prescribed to prevent a recurrence of DCIS.

You can see a video on DCIS here.

7 Comments:

  1. I was diagnosed with DCIS last December and had a left breast mastectomoy. with immediate reconstruction. Did not do chemo, doctors did not feel the need, and I decided not to take the tamoxifen after much thought and discussion with the doctors. Recent mammo was negative and all blood was good. I was very pleased with the treatment at Tufts and the excellent care from all involved.

  2. I had DCIS three years ago. I tried taking the tamoxifen three times. Each time my body would ache all over. I couldn’t even squeeze the shampoo bottle. My Dr. was no help. She said if you can’t take it then I guess you can go off it. I Also had stage II Melanoma six months before. I just hope I never have cancer again because I will have to find another Oncologist. Thanks for the information. I feel better with my decision now.

  3. I dealt with DCIS in 2000. It was not diagnosed as cancer by the specialists I saw in a well-known teaching hospital in northern FL. My late uncle was a retired pathologist and cancer researcher, who sent off copies of my slides to a colleague, who diagnosed DCIS. Based on that diagnosis, I had a lumpectomy (they called it a segmental mastectomy), radiation, & took tamoxifen for several years. I’m happy to report that I have been cancer free since then. I feel like it is best to “call it cancer” and treat it aggressively. I still feel as though my late uncle saved my life! In 2009, I was diagnosed with ovarian cancer. It was easier the second time with cancer, since it was found at an early stage like the breast cancer and knowing that I would do what I had to do for treatment, I had faith that I would have another positive outcome. And I have been recurrence free for the past 4 years…

  4. I was diagnosed 5 years ago with DCIS. Had a lumpectomy, chemo, radiation and Herceptin for a year. Thank God for my oncologist getting me thru all of this. Come march 2014 I hit my 5 year cancer free mark. From the time I had the biopsy to the time I had surgery multiple tumors were found.

  5. I was diagnosed with DCIS in April of 2007. I had a mastectomy /reconstruction and took Tamoxifin for 5 years. I have had two more brushes with cancer- sarcoma and uterine. Dana Farber was there every step of the way for me. I feel blessed to have their expertise and compassion. I only wish insurance would have allowed me the peace of mind to have had a preventative mastectomy on the left breast since I do have calcifications there as well.

  6. Helen M. Pluciennik

    Thank goodness! At Last! What has taken them so Long?

    Four years ago, I had Invasive Breast Cancer with a
    double “breast removal” (I hate the other word!)——-I had Reconstructive at the same time and did Chemo— had extra nodes taken out–a month later—–lost my hair ———etc—-lots of neuropathy now.

    At the time and even now I get so upset when I hear so many women calling their Ductual “cancer”

    It took me a long time to get in contact with someone who
    actually had cancer has I did.

    Let’s stop calling non-cancer ———-cancer and please
    could we stop calling future treatments “battling the disease.”

  7. I had DCIS in 2012. I refused a core needle biopsy; why rupture the duct and risk spread. I had a CO2 laser procedure to remove the duct intact. It was pre-cancerous. No further treatment needed since the duct was removed intact. The surgery was 1 hour in office suite with no after pain or swelling. I went out to lunch after it! Why are surgeons still using scalpels when this is available??????? Why would anyone do a core needle biopsy knowing that it risks spread of disease?

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