Ductal Carcinoma in Situ (DCIS)

Feelings about having a wide local excision

Currently, women with DCIS are either treated by wide local excision (WLE) or mastectomy. Wide local excision (sometimes called lumpectomy) involves the surgical removal of the affected breast tissue, together with an area (margin) of normal breast tissue around it, to ensure that all affected tissue is removed. WLE is an example of breast-conserving surgery – only the area of DCIS is removed, rather than the whole breast. Mastectomy involves removal of the whole breast and is usually recommended if the DCIS affects a large area of the breast, if it has not been possible to get a clear area of normal tissue around the DCIS by wide local excision, or if there is more than one area of DCIS. The treatment offered depends on factors such as the extent of DCIS and the grade.
 
Many women said that their doctor recommended a WLE because the area of DCIS was small. Though shocked at the diagnosis, which was unexpected, most were pleased or relieved to have a WLE instead of a mastectomy, some saying they felt ‘lucky the DCIS had been caught early’.
One woman, whose mother had a mastectomy in the past, felt reassured that she would not have to lose her breast. Another, whose father had had breast cancer, was worried that she might need a second operation if it wasn’t all removed or if it recurred. She asked the doctor whether it would be better for her to have a mastectomy instead of a WLE. Another woman was offered the choice of a WLE or a double mastectomy to prevent problems in future because of her family history of breast cancer. She felt shocked by this choice and decided on a WLE because a she felt a mastectomy would have been too ‘drastic’.
Some women felt they weren’t given a choice about treatment. They said they went along with the doctor’s recommendation and never realised there was a choice. One woman, who was caring for her elderly mother, said she preferred to have a WLE because the recovery would be quicker. Two women had a WLE to determine the diagnosis because their biopsy result had been inconclusive. Neither had heard of DCIS before and one said she was asked to take part in a clinical trial about DCIS treatment.

Last reviewed October 2013.

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