A. Simple mastectomy, i.e., removal of the breast--sometimes with a few lymph nodes under the arm. Mastectomy has been a traditional treatment for women with DCIS. The appeal of a mastectomy is that it offers almost 100% chance of a cure. You would not require follow-up radiation therapy or chemotherapy. Most women incorporate reconstructive surgery, either beginning immediately or at a later date, into this approach.

B. Wide excision of the affected area in the breast and close observation. If you are followed closely by your physician and you are committed to practice monthly breast self-examination and annual mammography, observation alone may be a reasonable option for you. If you have a very strong family history of breast cancer,we may advise more aggressive treatment, i.e., mastectomy or radiation therapy to the breast. Some women are uneasy with observation alone and favor more treatment.

C. Wide excision of the affected area of the breast and radiation therapy to the breast. This treatment for DCIS has come into use only recently, and patients who have received it have been followed for only a short time. However, the preliminary results suggest very few recurrences within the breast after radiation therapy. We will need to follow women treated this way for 20-30 years in order to see what the true long-term recurrence rate will be.

Women with LCIS probably have about a 20% risk of developing infiltrating cancer over their lifetime. The infiltrating cancer may arise is either breast, not necessarily the one just biopsied. It is recommended that they follow a program of close oberservation, i.e., physical exams two or three times a year, monthly breast self-examinations, and an annual mammogram.

Occasionally a mastectomy, sometimes bilateral, is recommended for a woman who has a strong family history of breast cancer. This is a difficult decison that needs to be thought out carefully.