Ductal Carcinoma in Situ (DCIS) Treatment
Ductal carcinoma in situ (DCIS) is sometimes referred to as ‘stage 0 breast cancer,’ as it’s a noninvasive, non-aggressive form of cancer that typically doesn’t spread beyond its origin in the milk ducts. However, in some instances, it can spread and develop into a more invasive form of breast cancer. There is not yet a reliable way to determine which DCIS cases will eventually progress into a more advanced-stage cancer, so prompt treatment is essential for all patients with the disease.
Fortunately, DCIS is highly treatable and at Moffitt Cancer Center, we offer a wide range of ductal carcinoma in situ treatment options. This includes surgery to remove cancerous cells from the breast, as well as radiation therapy and hormone therapy to destroy residual cells. And, through voluntary participation in our clinical trials, patients can also access some of the newest and most promising therapies before they are widely available in other settings.
Surgery for DCIS
Because this cancer is noninvasive, it’s often possible to remove all of the cancerous cells from the body during a single surgery. Many patients opt for a breast-sparing lumpectomy, in which a surgeon removes all of the cancerous cells but leaves the majority of the breast intact. However, some patients may need a mastectomy (removal of the entire breast) if the area of DCIS is very large or there are multiple cancerous areas within the breast. Some patients also choose a mastectomy even if their case of DCIS doesn’t necessarily warrant the more aggressive surgery, simply for additional peace of mind. A preventive double mastectomy may be necessary for patients with a high likelihood of recurring cancer.
Chemotherapy for DCIS
Chemotherapy works by destroying rapidly dividing cells, which means that it’s highly effective at targeting cancerous cells that multiply very quickly, but it can also affect healthy cells within the body which can cause symptoms like hair loss and nausea. There are many different types of chemotherapy, which can be administered intravenously (with an IV) or as an oral medication. For early-stage breast cancers like DCIS, our oncology team typically recommends a combination of chemotherapy medications. However, each patient receives an individualized treatment plan with the goal of achieving the best possible outcome.
Radiation therapy for DCIS
Radiation therapy is typically recommended after surgery to help ensure that the entire malignancy has been destroyed and to reduce the chances of the disease recurring. It can be particularly beneficial for treating patients who have especially large tumors, high-grade malignancies or tumors that are not hormone receptor-positive. This treatment can be delivered via:
- External beam radiation therapy – High-energy beams are delivered to part or all of the breast from an external machine
- Internal partial-breast irradiation – Radioactive implants are inserted directly into the breast to deliver ionizing radiation therapy to a more limited area, then removed after several weeks
Hormone therapy for DCIS
For hormone receptor-positive cases of DCIS, our team may prescribe hormone therapy medications on their own or after surgery. These medications work to prevent recurrence as well as other types of cancer from forming. Patients may need to take these medications for up to five years. Hormone therapy may include:
- Tamoxifen – A medication that can attach itself to the receptors on hormone-receptive breast cancer cells, preventing the cells from receiving growth signals
- Aromatase inhibitors – Another form of hormonal therapy that can help reduce the amount of estrogen produced by the patient’s body and potentially reduce the risk of a recurrence of DCIS
DCIS Clinical Trials
It’s our mission to stay at the forefront of DCIS treatment by researching and developing new therapies through our clinical trials program. These emerging therapies have the potential to create better patient outcomes, allow for a higher quality of life and minimize side effects. Through our robust DCIS clinical trials, researchers are continually able to:
- Compare the effectiveness of multiple therapies
- Identify which patients are most likely to benefit from each type of treatment
- Evaluate and determine the optimal dose of each medication or therapy
- Investigate the side effects of new treatments and discover the best ways to mitigate them
Why choose Moffitt Cancer Center for DCIS treatment?
At Moffitt, each patient’s treatment plan is designed by a collaborative, multispecialty team of oncologists and other cancer experts, with treatment options carefully selected based on the potential outcomes and likely impact on the patient’s quality of life. Reconstructive surgeries, integrative medicine services and other supportive options are also provided as part of our commitment to comprehensive care. We are proud to be a National Cancer Institute-designated Comprehensive Cancer Center. When you seek DCIS treatment at Moffitt, you can count on:
- Treatment from a dedicated team of specialists that includes surgeons, medical oncologists, radiation oncologists, radiologists and supportive care professionals
- A comprehensive treatment plan that includes standard and cutting-edge treatments, which are all available in one convenient location
- Transparency and honesty from your team, with the goal of empowering you to make informed decisions about your treatment
- Weekly tumor board reviews of your case
- Emotional and social support throughout the entire treatment process and beyond