When your doctor tells you that you have noninvasive breast cancer, or Ductal Carcinoma in Situ (DCIS), you may feel a great sense of fear and shock. It's normal to have questions like, 'What do I do now? What kind of treatment do I need?' But don't be afraid. Even though it's called cancer, it's still in the very early stages, meaning it hasn't spread yet. Let's talk about this simply and clearly.
What exactly is DCIS?
Simply put, DCIS is a condition where cancer cells grow only inside the milk ducts in the breast. Think of these milk ducts as little pipes. In DCIS, the cancer cells are only inside these pipes. They haven't spread outside the pipes, meaning they haven't spread to other soft tissues in the breast. This is what doctors call "in situ" (meaning 'in place').
This is also known as 'Stage 0' breast cancer . The most important and best thing about this is that if it is detected before it spreads, it can be completely cured with proper treatment. The main goal of treatment is to completely remove these cancer cells before they break out of the milk ducts and spread to other tissues of the breast.
Do I need to have surgery?
Most likely, yes. The main and most common treatment for DCIS is surgery. But don't be afraid to say "surgery." There are two main types of surgery. Your doctor will explain to you which method is best for your condition.
| Type of surgery | Simply put... | When is it usually used? |
|---|---|---|
| Lumpectomy (Breast conservation surgery) | This does not remove the entire breast. Only the part with the cancer and a small amount of healthy tissue around it are removed. Your breast is left intact. | This is the first option for most DCIS cases, especially if the cancer is in one small area. |
| Mastectomy | In this, the entire breast is surgically removed. | There may be several reasons why your doctor may recommend this surgery. For example: - If the cancer has spread to a large area of the breast. - If the cancer is present in several areas of the breast. - Depending on the location of the cancer, it may be difficult to maintain the appearance of the breast after a lumpectomy. - If you have a higher risk of developing breast cancer in the future due to your family history, genetic test results, or young age. |
What happens after the surgery?
Your treatment doesn't end after surgery. There are still several steps you can take to prevent the cancer from coming back.
Radiation Therapy
If you have had a lumpectomy , radiation therapy is usually recommended after the surgery. The goal is to destroy any small, invisible cancer cells that may remain in the area after surgery. This greatly reduces the risk of the cancer coming back.
- The most common method: This involves externally applying radiation to the breast from a machine for about 5 days a week for several weeks.
- Alternative methods: Sometimes, radiation is given to just the part of the breast where the cancer was, rather than to the entire breast. There is also a method in which a small radioactive seed is inserted into the breast for treatment. However, both of these methods, which deliver radiation to the entire breast, are still being studied to see if they are as effective.
The most important thing is that if you have had a mastectomy , radiation therapy is usually not needed.
Hormonal Therapy
Some women may be recommended to take a hormone therapy drug, such as tamoxifen , in addition to radiation therapy. This also helps reduce the risk of the cancer coming back.
But this medicine is only given if your cancer is 'hormone-receptor-positive' . What does that mean? It means that the hormone estrogen, which is naturally produced in your body, helps the cancer cells grow. Your doctor will test you to see if your cancer is of this type. That will determine whether you need this treatment or not.
Will I need chemotherapy?
Most likely not. This is a big fear for many people. Chemotherapy is a treatment that uses powerful drugs to destroy rapidly dividing cells (like cancer cells) throughout the body. However, because DCIS is a condition that is confined to the milk ducts and has not spread to other parts of the body, chemotherapy is not usually recommended for its treatment.
Will I have to have surgery again?
Sometimes this can happen. Especially if you have had a lumpectomy , if after examining the tissue removed, the doctor thinks that not enough 'clean' (healthy) tissue has been removed around the cancer cells, a second operation may be necessary. This is called 'clear margins'. This is done to completely remove any remaining cancer cells and to protect you.
Should you consider breast reconstruction?
After a lumpectomy or mastectomy, some women choose to have breast reconstruction surgery. This is entirely a personal decision . It is not medically necessary. And it does not have to be done right after the first surgery. If you are interested, feel free to talk to your doctor about what your options are, how it is done, and whether it is right for you.
Take-Home Message
- DCIS is a very early, non-invasive form of breast cancer, so don't be afraid.
- The treatments for this are very successful. The chance of a complete recovery is very high.
- The main treatment is surgery. This can be a lumpectomy (removal of only the lump) or a mastectomy (removal of the entire breast).
- After surgery, radiation therapy or hormone therapy may be needed to prevent the cancer from coming back.
- Chemotherapy is not usually required for DCIS.
- It is your right to discuss all your concerns and fears clearly with your doctor.
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