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NCCN Guidelines for Patients


Breast Cancer - Carcinoma in Situ

(stage 0)

, Version 1.2016



Risk reduction treatment

of cancer cells isn’t triggered. Tamoxifen may also

be given to women without menstrual periods (post-

menopausal). Otherwise, post-menopausal women

may be given medicines called aromatase inhibitors.

These medicines lower the amount of female

hormones in the body.

Although endocrine therapy lowers breast cancer risk,

it can cause side effects. Side effects vary between

medicines. Some side effects of endocrine therapy

are hot flashes, cataracts, leg cramps, joint pain,

blood clots, and other cancers. Ask your treatment

team for a complete list of side effects. Your doctor

may also know about research of endocrine therapy

or other medicines that you can join.

If you start endocrine therapy, you will have follow-up

visits with your doctor. Tell your doctor about any side

effects from endocrine therapy. There may be ways

to get relief. Depending on which medicine you’re

taking, you may need to get GYN (



exams, vision tests, and bone density tests.


A third risk-reduction treatment is surgery. A total

mastectomy is an option to reduce your risk in

a breast that did not have cancer. This surgery

completely removes your breast but no lymph nodes

and chest muscles. Following the mastectomy, or in

some cases at the same time as the mastectomy,

you may want to have breast reconstruction. Breast

reconstruction is discussed next in this chapter.

Your doctor may suggest that you have a bilateral

salpingo-oophorectomy. This surgery removes both

ovaries and both fallopian tubes. It is only advised if

you have or very likely have mutations in the





Figure 3.3 Endocrine therapy

Endocrine therapy stops cancer growth caused by hormones. Taking endocrine therapy

for 5 years may prevent a second breast cancer among women who have been treated for

DCIS. Tamoxifen is a commonly used endocrine therapy.

Estrogen binds to

receptors and triggers

cell growth

Tamoxifen blocks estrogen so

cell growth isn't triggered