This section gives a brief overview of treatment for DCIS. The aim of treatment is to prevent DCIS from developing into an invasive breast cancer.
Each treatment is explained in more detail below and on our pages on surgery, radiotherapy and homonal therapies.
Surgery to remove the DCIS is the main treatment. This may be the only treatment you need. Women are usually treated with an operation that keeps as much of the breast and its shape as possible. This is called a wide local excision (WLE). In certain situations, a woman may be advised to have the whole breast removed (mastectomy).
If you have a mastectomy, you’ll usually also have a sentinel lymph node biopsy. This is a way of checking to see if the lymph nodes in the armpit contain any cancer cells. You’ll also be given the option for breast reconstruction.
Sometimes, radiotherapy is recommended after surgery to reduce the risk of DCIS coming back or of an invasive breast cancer developing.
If you have ER positive DCIS, you may be able to have hormonal therapy, although this isn’t routinely used for DCIS.
Not all DCIS will develop into invasive cancer. Research trials are being carried out to see whether less treatment is possible. In some women with low-grade DCIS, research is looking at giving no treatment but keeping women under close supervision. Your doctor or specialist nurse can give you more information about possible research trials.
Making treatment decisions when you have DCIS can be difficult. It’s important to weigh everything up and take your time when deciding. The information here and in the next few chapters about treatment types may help.
Multidisciplinary team (MDT)
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Your treatment will be planned by a team of specialists (a multidisciplinary team) who work together to decide which treatment is best for you. It usually includes:
a specialist breast surgeon
a breast reconstruction surgeon
a breast care nurse who gives information and support
clinical oncologists – doctors who specialise in treating cancer using radiotherapy and drug treatments (such as hormonal therapy)
a radiologist who reads mammograms and analyses scans
a pathologist who examines cells under the microscope and advises on the type and extent of the cancer.
The MDT may also include other healthcare professionals, such as a physiotherapist, counsellors, psychologists or a social worker.
Your doctors will talk with you about the best treatment for yourself. If you have any questions, don’t be afraid to ask your doctor or specialist nurse.
Making treatment decisions
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Some people find it very hard to make decisions about treatment. If you’re asked to choose between treatments or whether to have treatment, make sure that you have enough information. Your specialist can explain what’s involved and any possible side effects of the treatment so you can decide what’s right for you.
Some women with DCIS are concerned about having treatment for a condition that isn’t life-threatening. However, most women accept that it’s important to treat DCIS to prevent it from developing into an invasive cancer. The aim of treatment is to reduce the risk of an invasive cancer.
Because there are different options, it’s important to think about what’s right for you. DCIS doesn’t need to be treated urgently, so you can take time to think things over. You should ask questions or discuss anything you don’t understand with your surgeon or breast care nurse.
We have more information about making treatment decisions.
Your multidisciplinary team (MDT) uses national treatment guidelines to decide the most suitable treatment for you. Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information.
If you do go for a second opinion, it may be a good idea to take a relative or friend with you, and have a list of questions ready, so that you can make sure your concerns are covered during the discussion.
We have more information about how to get a second opinion.
Before you have any treatment, your doctor will explain its aims. They’ll usually ask you to sign a form saying you give permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you’re asked to sign the form, you should be given full information about:
the type and extent of the treatment
its advantages and disadvantages
any significant risks or side effects
any other treatments that may be available.
If you don’t understand what you’ve been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it’s not unusual to need repeated explanations. It’s a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion. You may also find it useful to write down a list of questions before your appointment.
People sometimes feel that hospital staff are too busy to answer their questions, but it’s important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.
You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.
You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.