The Case for NO TREATMENT of Low-risk DCIS 

“Many DCIS lesions will never progress to IBC during the patient’s lifetime [3]. Biopsy review studies of patients where DCIS was initially misdiagnosed as benign and thus not treated after biopsy suggest that up to 85% of all DCIS will never progress into IBC [3,4,5,6]. Consequently, there is a growing concern about possible overtreatment for low-risk, with favorable characteristics, DCIS [3,7,8,9]. DCIS treatment de-escalation trials are being conducted to investigate the safety of active surveillance in women with low-risk DCIS [10,11,12].” -Prediction Models and Decision Aids for Women with Ductal Carcinoma In Situ: A Systematic Literature Review, Published online Jul 2, 2022.

References mentioned in above article

3. Cancer Outcomes in DCIS Patients Without Locoregional Treatment

4. The natural history of ductal carcinoma in situ of the breast: a review

5. Outcomes of Active Surveillance for Ductal Carcinoma in Situ: A Computational Risk Analysis

6. The natural history of low-grade ductal carcinoma in situ of the breast in women treated by biopsy only revealed over 30 years of long-term follow-up

7. Ductal carcinoma in situ: to treat or not to treat, that is the question

8. Effect of three decades of screening mammography on breast-cancer incidence

9. Prioritization of Research Addressing Management Strategies for Ductal Carcinoma In Situ

10. Addressing overtreatment of screen detected DCIS; the LORIS trial

11. The COMET (Comparison of Operative versus Monitoring and Endocrine Therapy) trial: a phase III randomised controlled clinical trial for low-risk ductal carcinoma in situ (DCIS)

12. Feasibility of a prospective, randomised, open-label, international multicentre, phase III, non-inferiority trial to assess the safety of active surveillance for low risk ductal carcinoma in situ – The LORD study

About Donna Pinto

I am originally from New Jersey and moved to Los Angeles with my family at age 12. After graduating from San Diego State University with a BA in Journalism, I had a short-stint in magazine advertising sales before landing my "dream job" with Club Med. For two years I worked at resorts in Mexico, The Bahamas, The Dominican Republic and Colorado. My husband Glenn & I met in Ixtapa, Mexico and we embarked on a two year honeymoon around the world. This was also a research project for a book we wrote called "When The Travel Bug Bites: Creative Ways to Earn, Save and Stay Abroad." I am also the author of a quote book for new graduates -- "Cheatnotes on Life: Lessons From The Classroom of Life." In 1997, we settled in San Diego and I was blessed to work part-time from home for non-profit organizations while raising our two boys. In 2010, a DCIS diagnosis changed my life. DCIS 411 is the culmination of my on-going journey and discoveries.
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2 Responses to The Case for NO TREATMENT of Low-risk DCIS 

  1. Diane Thorpe says:

    My doctor is scaring me after being diagnosed at stage 0 but he said it’s a nuclear 3, That is the reason for the total masectomy he is suggesting. I haven’t heard anyone talk about the nuclear stage. Do you know what he is talking about?


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