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DCIS is a high risk non-invasive lesion that is “in place” and cannot spread. Approximately 20% of DCIS will transform into breast cancer if left untreated. The challenge for your oncologist is that it is difficult to know which cases of DCIS will transform into a cancerous tumour and thus everyone is treated for this lesion in a similar manner to prevent a cancer from establishing itself.

DCIS generally has no signs or symptoms. A small number of people may have a lump in the breast or some discharge coming out of the nipple. According to the National Cancer Institute, about 80% of DCIS cases are found by screening mammography.

Another in situ form of localized non-invasive disease is called LCIS. There are two main forms of LCIS, classical and pleomorphic. Classical is much more common than pleomorphic. These are non-invasive lesions that remain within the breast lobule and do not grow beyond it. It is not a cancer. “In situ” means that a lesion does not pass the basement membrane which is why this lesion cannot spread to the lymph nodes or other organs. LCIS is thus, non life-threatening. The classical type is merely an indicator of risk and extensive surgery is not required. Pleomorphic LCIS, however, acts more like DCIS as a high risk lesion, that in some cases may develop into an invasive cancer by continuing to grow beyond the basement membrane and this is why the recommendation is to remove it, to prevent this from happening.

Standard treatment options for DCIS (and LCIS) include:

  • Lumpectomy followed by radiation therapy: This is the most common treatment for DCIS. Lumpectomy is sometimes called breast-conserving treatment or surgery (BCT and BCS) because most of the breast is preserved.
  • Mastectomy: Mastectomy, or removal of the breast, is recommended in some cases of very extensive DCIS that is throughout the majority of the breast. In this case radiation is not required.

Chemotherapy, a form of treatment that sends anti-cancer medications throughout the body, is generally not needed for DCIS. DCIS is non-invasive and remains within the breast duct, therefore additional treatment to attack cancer cells that might have traveled to other areas of the body is usually unnecessary. One exception to this is DCIS that is ER/PR + may benefit from post-operative hormone therapy to reduce the likelihood of recurrence.

Welcome to the BTC Treatment Decision ToolHave you or someone you love recently received a diagnosis of breast cancer?

Whether you received a diagnosis yesterday or three months ago, you are likely dealing with an upheaval in your life as you’ve known it. Perhaps you have also started the process of meeting with your doctors to discuss what treatment options are available, and which therapies (or combination of therapies) will be the best for you. It is a lot of information to sort through and make sense of.

So we’re here to help.

The team at Be the Choice are a diverse group of women and men who have had experiences with a breast cancer diagnosis and treatment. Some of us have undergone treatment for breast cancer, some of us have provided care for a loved one who has been through treatment, and some of us are physicians and other health care professionals who provide treatment to breast cancer patients.

United in our concern that all people who receive a diagnosis of breast cancer should have access to comprehensive, state-of-the-art treatment information in a comfortable and user-friendly format, we designed this interactive treatment decision tool.

How to use:

Your diagnosis of breast cancer has come with an assessment of your unique clinical and hormonal characteristics. These should be carefully discussed with your medical team and deliberated carefully in advance of any treatment decisions.

This tool will enable you to get to know the “big picture” as well as the “individual picture” behind any breast cancer treatment decision, and to become an active participant in determining your own treatment process. You are the ultimate decision-maker in this process. We hope that you will use the information on this website to inform and empower yourself.

What this tool is not designed to do is deliver individual treatment recommendations. It should be used as a way to get a sense of the full range of treatments available to you as well as what your own treatment plan might look like given your unique profile.