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Understanding
DCIS
- Causes of
DCIS
- Genetic
Testing
- Self
Advocacy
- Decisions
- Screening
- Getting a
Biopsy
- When DCIS
is Diagnosed
- Getting
a Second Opinion
- Psychological
Impact
- Understanding
Risk
- Treatment
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Indications for Breast-Conserving Surgery When localized DCIS (lesions that appear in one limited place) has been detected on a mammogram or by physical exam, breast-conserving surgery (lumpectomy) in which the breast is not removed may be used as a treatment. There is a decrease in local recurrence of both DCIS and invasive cancers in women who receive radiation therapy following this type of surgery. |
To be specific, breast conservation surgery is recommended only if the extent of the DCIS found is equal to or less than 4 centimeters (about 1 5/8 inches). When DCIS masses are larger, there is little data to support breast conservation. It is difficult to accurately measure the size of DCIS, making definitive recommendations difficult.
Even though breast-conserving surgery does not remove the
whole breast, it must be extensive enough to reduce the probability of
recurrence. It is important to have negative margins of DCIS or cancer
cells around the incision. When DCIS is detected on a mammogram as microcalcifications,
all malignant calcifications must be removed before starting radiation.
Indications for breast-conserving surgery alone
(no radiation)
Some medical centers report that there seems to be a low rate of recurrence
for surgery alone when the tumors are low-grade, of small volume, and
surgically removed with clean margins. The maximum size of DCIS for which
radiation therapy can be safely omitted is not known. Patients choosing
this option must be highly motivated and clearly understand the risk and
need for close follow-up.
