For women who have been diagnosed with a tumor in a milk duct within their breast, the standard ductal carcinoma in situ treatment is surgery. There are two primary types of surgery for this type of cancer, also known as DCIS. A lumpectomy only removes the tumor and possibly a small amount of surrounding tissue, while a mastectomy is done to remove the entire breast. Additional treatments, such as radiation or use of the drug tamoxifen, may be recommended if a patient chooses a lumpectomy. Reconstructive surgery can often be performed after a mastectomy if the patient wishes.
Many women choose to have a lumpectomy as their primary ductal carcinoma in situ treatment. The primary advantage of this surgery is that it only removes the cancerous tissue, leaving the rest of the breast intact, which allows the woman to maintain her normal body image and avoid reconstructive surgery. It may be necessary to have additional treatment when DCIS is removed via a lumpectomy, however, so patients will typically want to discuss any risks associated with those treatments before making a final decision.
The other main option for ductal carcinoma in situ treatment is mastectomy. Normally, a simple mastectomy that removes just the breast tissue is sufficient for this disease, as it typically does not spread to the nearby lymph nodes. Though full removal of the breast may seem less desirable than a lumpectomy, in some cases it is the better option. If the DCIS is present over a very large portion of the breast, or in multiple locations, a mastectomy may be the only way to remove all of the cancerous tissue. Some women may not wish to undergo radiation treatment, which is common after a lumpectomy, or they may not be able to; for example, radiation may not be an option if the patient is pregnant.
Though women with very small, low-grade tumors may require a lumpectomy alone, for many, ductal carcinoma in situ treatment involves follow-up therapy as well. Radiation treatment using X-rays to destroy any possible remaining cancer cells in the breast can help ensure that the DCIS does not return. Some women may also be good candidates for the drug tamoxifen; since DCIS is a type of cancer that grows in response to hormones, and tamoxifen blocks estrogen's ability to promote tumor development, it may also help prevent the disease from recurring.