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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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Taking Time to Make Your Many women want time to think about their treatment options, obtain second opinions, and investigate complementary treatments. This may take time, and for some women it is well worth the extra time involved as long as they do not wait months to come to a decision. If you are a woman who wants to move more quickly and is comfortable with your treatment choice, then you should proceed with treatment. |
If invasive breast cancer cells are present, the diagnosis is no longer DCIS, and your doctor will order more tests to find out whether your cancer has spread and to help determine your treatment. Some of these will probably include: chest X-ray, blood tests, and tumor marker tests (estrogen-receptor and progesterone-receptor status, Her-2-neu). Sometimes, additional studies such as a bone scan or computer tomography (CT), or PET (Positive Emission Tomography) will be ordered. Unfortunately there is no test that can completely reassure a woman that her cancer has not spread. These additional studies are done based on risk for metastatic disease, large tumor size, high grade and multiple involved lymph nodes.
The HER-2-neu (pronounced her-to-new) test is not necessary for routine evaluation of noninvasive breast carcinomas. However, there are reports that DCIS that has high levels of HER-2-neu may, like high-grade DCIS, be more likely to recur and invade the breast.
With removal of all the DCIS and a thorough investigation of the tissue by a pathologist, very few women diagnosed with DCIS die of breast cancer. Neither radiation treatment nor tamoxifen has been found to increase a woman's already excellent survival rate after a diagnosis of DCIS. The major benefits of proper treatment of DCIS are a reduction in the odds of DCIS recurring in the breast and a reduction in the odds of developing an invasive breast cancer from DCIS. Because either of these events could result in the loss of the entire breast, breast preservation is also a goal of DCIS treatment.
You are less likely to have a recurrence in the same breast after a diagnosis of DCIS if your treatment includes:
- Removal of all the DCIS.
- Clear margins around the DCIS of at least 1 millimeter (4/100 of an inch) and preferably 10 millimeters (1 centimeter, or 2/5 of an inch).
- Careful examination of all breast tissue that is removed to be sure that invasive breast cancer is not present.
- Follow-up mammography when your breast has healed from surgery to determine that no suspicious areas remain. If such an area is present, you will want to have it removed before making further treatment decisions.
