Aa
Aa
A
A
A
Close
Avatar universal

Wide Excision Only for DCIS?

When is it appropriate to treat DCIS with wide excision alone, as opposed to wide excision followed by radiation?  Is it to do with the size of the affected area and/or the grade of the DCIS as shown from the biopsy? Or, are there are other factors at play?

Thank you.
3 Responses
Sort by: Helpful Oldest Newest
Avatar universal
MEDICAL PROFESSIONAL
Hi.  With ductal carcinoma in situ, "size" would refer to the extent of spread of the DCIS within the ducts. This is determined by microscopic examination of the breast tissue after excision.  With DCIS, the cancer has not yet invaded or penetrated through the ducts, but it is possible for the cancer to "creep" within the ducts and involve a sizable area.
Helpful - 0
Avatar universal
Dr. Roque:

Thank you for your answer. One more question - as DCIS is not really a lump, or tumor - how do you measure the size of the affected area? And, what is considered "small?"

Thank you again for taking the time to respond.  It is very helpful.
Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Hi.  According to the latest National Comprehensive Cancer Network (NCCN) guidelines, the recommended treatment for ductal carcinoma in situ (DCIS) is either mastectomy alone or lumpectomy plus radiation.  Radiotherapy is added to the lumpectomy because it decreases local recurrence rates by 50% compared to lumpectomy alone.  Wide excision is NOT equivalent to lumpectomy (lumpectomy is a more extensive type of surgery), and is not the recommended procedure for treating DCIS.

Lumpectomy alone, without subsequent radiotherapy, may be an appropriate treatment if the DCIS is considered to have a "low risk" of recurrence. The risk of recurrence depends on certain factors such as size, tumor grade, age of patient and status of surgical margins.  "Low risk" refers to a tumor which is small, with low tumor grade, and negative surgical margin, occurring in older patients.
Helpful - 0
Have an Answer?

You are reading content posted in the Breast Cancer Community

Didn't find the answer you were looking for?
Ask a question
Popular Resources
A quick primer on the different ways breast cancer can be treated.
Diet and digestion have more to do with cancer prevention than you may realize
From mammograms to personal hygiene, learn the truth about these deadly breast cancer rumors.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.