Ductal carcinoma in situ treatment

It’s important that we know as much information as possible about your DCIS to plan the most effective treatment. You will already have had different tests to help confirm your diagnosis.

Usually, women with DCIS don’t feel any lumps in their breast but we can see the disease on a mammogram. Sometimes this looks like small white ‘dots’, called calcifications, although these can also be a sign of harmless benign (non-cancerous) breast changes as you get older.

We use scans to spot any changes and confirm your diagnosis. Sometimes your consultant may insert small clips around the DCIS at the time of your scan. This can be helpful during surgery to identify the treatment area.

We also take biopsies, which are small samples of breast tissue. We can look at the cells under a microscope or run other tests to find out more about the type of cells and which treatments to use.

A technique called deep inspiration breath hold (DIBH) is standard at GenesisCare. DIBH ensures that delicate organs such as the heart, lung and liver are kept away from the radiation beam, thereby reducing side effects. There’s a lot of evidence to show this makes radiotherapy much safer, so we always do this on the left side (to protect the heart), and for many right-sided DCIS.

You may have been told that your DCIS is ‘hormone sensitive’. This means the DCIS cells are triggered to grow by oestrogen, a female sex hormone that is made mostly by the ovaries or by progesterone. If so, you can be treated with hormone therapy, also known as endocrine therapy.

Hormone therapy drugs work in different ways. Some block oestrogen from attaching to pre-cancerous cells, whilst others reduce the amount of oestrogen your body makes. They can be very effective at preventing DCIS recurrence and can slightly reduce the risk of developing DCIS or breast cancer in the other breast in the future.

Your consultant will discuss your treatment options with you and the best time to start. Usually, hormone therapy is started after surgery and continues for several years, to help prevent DCIS returning and reduce the risk of invasive breast cancer.

They make every effort to make sure your personal cancer treatment plan is working for you and that you’re looked after.

- Cleo, GenesisCare patient

We’ll invite you to join a programme alongside your treatment. The aim is to support your physical and emotional wellbeing, with an exercise medicine prescription as well as wellness therapies.

Together, these therapies are called integrative cancer medicine, and there is a lot of evidence to show that they make a difference to the wellbeing and overall outlook of people going through treatment, even if they don’t have cancer. That’s why we want every patient to benefit.  As a patient at GenesisCare, you will be offered this support at no extra cost to you or your insurance provider.

Exercise now plays an important role in pre-cancer, as well as breast cancer, treatment.  It has been proven in many studies worldwide to reduce the side effects people experience with treatments, build muscle mass, reduce fatigue and even help some therapies to work better.  Overall, it can help you to speed up your recovery and improve long-term outcomes.

We also have a unique partnership with cancer charity, Penny Brohn UK. This ground-breaking charity provides therapies to help you to deal with the side effects of treatment, reduce stress, improve energy levels and help you take back control.

You will be offered a personalised complementary programme, involving a holistic needs assessment with your Wellbeing Consultant to reflect on your strengths and where you might need help. The team will develop a series of therapies that aim to alleviate your concerns and improve your quality of life. These could include acupuncture, counselling, mindfulness, meditation and reflexology.

You can access online cancer support from Penny Brohn UK via their website, including a helpline, online Zoom group sessions and 1-1 sessions.

Learn more about our integrative cancer care services.