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NCCN Guidelines for Patients


Breast Cancer - Carcinoma in Situ

(stage 0)

, Version 1.2016



Breast cancer treatment

Breast cancer treatment

Chart 3.1

lists the treatment options for DCIS. The

goal of treatment is for you to be free of cancer.

Because DCIS is confined within the breast ducts,

surgery that removes the tumor is the central part

of treatment. As shown in

Figure 3.2

, there are

two types of breast surgery—lumpectomy and total

mastectomy. Other treatments may be used with

breast surgery to rid your body of cancer.

Lumpectomy only

A lumpectomy is a surgery that removes the tumor

along with normal-looking tissue around its edge.

The normal-looking tissue is called a surgical margin.

Lumpectomy is a breast-conserving surgery because

most of the normal breast tissue won’t be removed.

It’s like an excisional biopsy except more tissue is


Chart 3.1 What are my options?

Treatment options

Deciding factors

Lumpectomy only

may be an

option if


these factors describe



• Are older than 50 years of age,

• Have a small tumor,

• Have a low-grade cancer (grade I),

• Your doctor can't feel the tumor, and

• Your surgeon removed large and cancer-free

surgical margins

Lumpectomy + radiation


(AKA breast-conserving

therapy) is an option if


of these

factors describe you


• Haven’t had radiation close to where the cancer is,

• Can have all cancer removed through one cut,

• Have no health conditions that might cause


• Don’t have a genetic risk for breast cancer

• Your breast won’t be too disfigured afterward, and

• Your surgeon removed cancer-free surgical margins

Total mastectomy ± sentinel

lymph node biopsy

is an option



of these factors describe you


• Are unable or refuse to have an lumpectomy, and

• Are healthy enough for surgery