Understanding Mastectomy and Treatment after Surgery for DCIS Breast Cancer (Stage 0)

If you have been diagnosted with DCIS, or ductal carcinoma in situ, you are likely feeling frightened or confused about your treatment options. It is important to know that you are not alone. Millions of women have been successfully treated for DCIS, with a survival rate approaching 100%¹. Since DCIS is classified as Stage 0, or an early, non-invasive form of breast cancer, the question likely facing you is not “Will I live,” but “how much treatment will I need?”

Usually, the first step is to treat DCIS with surgery to remove the cancer, most often a breast-conserving procedure (lumpectomy). Based on the characteristics of your DCIS, your doctor may also suggest additional treatments such as radiation or hormonal therapy. You should learn all that you can about your individual disease before deciding on your surgical and treatment plan.

What is right for one woman is often not right for another. You need to learn all that you can about your individual cancer before making your treatment decision.

What is a Mastectomy?

With mastectomy, the surgeon removes the entire breast and often also the underarm lymph nodes. Mastectomy is performed under general anesthesia, and recovery time is usually a few weeks. During the procedure, the surgeon may place one or several small tubes to drain any fluids that may accumulate for the first several weeks following surgery. Your doctor might recommend mastectomy if your DCIS covers a large area or appears in several different areas of your breast.

What Additional Treatment Will I Need?

after your surgery, your treatment options may include radiation therapy, hormonal therapy, or no further therapy. Because DCIS is non-invasive, chemotherapy is not recommended. As you consider the next steps in your treatment plan, it is important to:

Take your time to decide. With DCIS, you can take several weeks to learn more about your individual disease and consider your treatment options.

Understand that more treatment is not always the right choice. If your risk is low, additional treatment may not add to your survival rate, and yet its side effects can last a lifetime.

Ask your doctor about the Oncotype DX Breast DCIS Score test, which is performed on a small amount of the tissue removed during your surgery. The Oncotype DX test reveals the underlying biology of your disease by measuring the activity of certain genes, and can help determine the risk that your cancer will come back in the same breast, either as DCIS or as invasive breast cancer. Knowing that risk is a key factor—along with other information such as your family and health history, personal preferences, and pathology results –that will help you and your doctor decide what treatment is best for you.

1. Breast Cancer Mortality After a Diagnosis of Ductal Carcinoma In Situ. Narod et al. JAMA Oncol. 2015;1(7):888-896. doi:10.1001/jamaoncol.2015.2510