Emerging Areas in the Treatment of DCIS
DCIS (ductal carcinoma in situ) is a non-invasive breast cancer. Researchers are studying the best ways to treat DCIS.
Emerging areas in the treatment of DCIS include:
- Ways to predict which cases of DCIS will progress to invasive breast cancer (to target treatment to those who are at higher risk)
- Determining which women may not need radiation therapy after lumpectomy for DCIS
Kornelia Polyak, M.D., Ph.D.
Komen Scientific Advisory Board member
“Understanding why some patients with DCIS develop invasive breast cancer, while others do not, would help our understanding of drivers of tumor progression and the design of more effective therapies.”
Avoiding radiation therapy after lumpectomy for DCIS
Radiation therapy is a standard treatment for most people who have lumpectomy for DCIS. It’s usually given every day, 5 days a week, for 3-4 weeks.
Radiation therapy decreases the risk of [5-12]:
- DCIS recurrence (a return of DCIS) in the treated breast
- Invasive breast cancer in the treated breast
However, overall survival is the same for women with DCIS who have lumpectomy with or without whole breast radiation therapy [5-7].
Since radiation therapy after lumpectomy for DCIS doesn’t improve survival, there are questions about the need for all women to get radiation therapy after lumpectomy for DCIS.
Researchers are studying which women might be able to avoid radiation therapy after lumpectomy for DCIS.
Some women, with small, low-grade or intermediate-grade DCIS, and widely negative surgical margins have a low risk of DCIS recurrence or invasive breast cancer after a lumpectomy . (Low-grade and intermediate-grade DCIS tend to grow more slowly than high-grade DCIS. Margins are negative when there are no cancer cells in the rim of breast tissue surrounding the tumor that was removed during surgery.) Some of these women may choose to avoid radiation therapy altogether or consider limited radiation therapy such as partial breast radiation therapy [5,12-13].
Learn more about getting radiation therapy.
Learn about the side effects of radiation therapy.
For a summary of research studies on treatment for DCIS with a lumpectomy plus whole breast radiation therapy, visit the Breast Cancer Research Studies section.
Tumor profiling tests and radiation therapy for DCIS
Tumor profiling tests are under study to see if they can help predict the chance DCIS will return as DCIS or invasive breast cancer [20-21]. These tests check a sample of the tumor (removed during a biopsy or surgery) for a group of genes.
The tumor profiling tests Oncotype DX Breast DCIS Score® and DCISionRT® are under study for use in the treatment of DCIS [20-22]. These tests might help identify which cases of DCIS would benefit most from radiation therapy after lumpectomy, and which women might be treated with lumpectomy alone [22-24].
The Oncotype DX Breast DCIS and DCISionRT tests need further study and aren’t part of the standard of care.
After discussing the benefits and risks with your health care provider, we encourage you to join a clinical trial if there’s one right for you.
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