| Non-invasive breast cancer, also known as ductal | | | | and which should be observed? |
| carcinoma in situ, or DCIS, is highly curable. It is most | | | | Since the potential common side effects from |
| commonly detected on a screening mammogram. | | | | radiation therapy, such as a skin reaction and fatigue, |
| The standard of care is surgical removal, followed by | | | | are temporary and the woman's risk for developing |
| breast radiation therapy, in women who wish to | | | | an invasive and potentially life threatening breast |
| conserve their breast. The alternative is a | | | | recurrence is significant, it is prudent for women to |
| mastectomy. Both modalities have equal survival | | | | take the more aggressive approach. |
| outcomes. However, there has been a great deal of | | | | Certain factors, such as the woman's age, her overall |
| controversy about the necessity for radiation | | | | health, the surgical margin (or rim of normal breast |
| therapy for DCIS in women who opt for breast | | | | tissue removed around the DCIS, with the wider the |
| conservation. | | | | margin being more favorable), and the grade of the |
| Proponents for radiation therapy underscore the fact | | | | DCIS (low grade is much less aggressive than high |
| that the risk of a recurrence in the breast can be a | | | | grade and intermediate grade falls between these |
| more aggressive or even an invasive recurrence. Half | | | | two extremes), should factor into the decision |
| of these recurrences are due to invasive breast | | | | making. |
| cancer. The latter has the potential to spread to | | | | Radiation therapy should be strongly considered for |
| lymph nodes of the underarm and to other parts of | | | | young women, women who have close margins, |
| the body. Without radiation therapy, the risk of a | | | | women with DCIS measuring more than ½ |
| local recurrence is approximately 20%. By adding | | | | centimeter (cm) and/or those do not have low grade |
| radiation therapy, the risk of such a failure is reduced | | | | DCIS. On the other hand, studies show that even |
| by half. Needless to say, this is a substantial benefit. | | | | older women with DCIS measuring less than ½ |
| The experts who do not support the routine use of | | | | cm, who have wide margins and/or low grade DCIS, |
| radiation therapy for DCIS espouse that there is no | | | | benefit from the addition of radiation therapy. |
| difference in long-term survival between women who | | | | The good news is that radiation therapy is a very |
| undergo radiation therapy versus those who do not. | | | | easy, painless treatment that can enable women with |
| A woman who is willing to accept the higher risk of a | | | | DCIS to be at low risk of having the disease return in |
| recurrence in the breast may be treated with surgical | | | | the treated breast, and peace of mind that they left |
| removal alone. The question then arises: which | | | | no stone unturned. |
| women with DCIS should undergo radiation therapy | | | | |