NCCN Guidelines for Patients
Breast Cancer - Carcinoma in Situ
, 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
Tamoxifen blocks estrogen so
cell growth isn't triggered