Treatment of DCIS

What Happens if DCIS is Left Untreated?

We do not know precisely what happens if DCIS is left untreated. Various studies suggest that the risk of DCIS developing into invasive cancer (raising the possibility of widespread disease and death) is approximately 65% if left untreated for 10 years. The risk is higher for high-grade DCIS with cell death (necrosis).

What are the Treatment Options for DCIS?

Non-invasive cancer/DCIS can be treated by mastectomy or by a limited, but complete, removal of the abnormal area, called a wide local excision. Mastectomy is indicated for widespread DCIS or DCIS located behind the nipple area. The cure rate is approximately 98% for mastectomy. As mentioned earlier, removal of the glands of the armpit is not usually necessary for non-invasive cancer/DCIS.

For those women who have a lumpectomy (removal of tumour lump) rather than a mastectomy (removal of breast), radiotherapy is recommended in most cases. The use of tamoxifen may also be necessary in some cases where the risk of recurrence is high.

Treatment
Cure rate
Lumpectomy alone
76%
Lumpectomy + radiotherapy
87%
Lumpectomy + radiotherapy + tamoxifen
92%
Total mastectomy
98%

The table above lists the over-all cure rates. Some DCIS lesions that are small and low grade can be cured completely by local removal alone, with no additional treatment. The chance of dying from DCIS is only 1-2%.

For more information on the optimal management of the DCIS from articles written by Professor K Mokbel

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127594/ 

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