What is the first treatment for ductal carcinoma in situ?

Ductal carcinoma in situ means abnormal cells are contained within a milk duct. A mammogram often shows the calcifications or other changes that lead to assessment, and a breast biopsy confirms the diagnosis. A lumpectomy removes the area of DCIS with a surrounding margin while keeping most of the breast. Radiotherapy may be discussed after lumpectomy to reduce the chance of DCIS returning in the treated breast. A mastectomy removes the breast tissue and may be considered when DCIS covers a large area, appears in more than one area, or cannot be removed with a clear margin while preserving the breast. Hormone therapy may be offered when the cells have hormone receptors.

Ask the breast team to explain the imaging, biopsy findings, and margin plan in plain language. Bring questions about breast shape, recovery, reconstruction, and whether radiotherapy or hormone therapy would follow surgery. Tell the team about previous breast procedures, medicines, allergies, and any family history that concerns you. Read about Mammogram, Breast Biopsy, Lumpectomy, Mastectomy, Radiotherapy, and Hormone Therapy for Cancer before making a decision.

After breast surgery, seek prompt medical advice for increasing redness, swelling, warmth, drainage, wound separation, fever, uncontrolled pain, or sudden breathlessness. A new breast change before treatment should also be reported, particularly bloody nipple discharge, skin breakdown, or a rapidly enlarging area.

Can the DCIS be removed with a lumpectomy and a clear margin? What would make mastectomy more suitable? Would radiotherapy or hormone therapy be recommended afterward? What recovery and breast changes should I expect?