Treatment of ER-Positive Ductal Carcinoma In Situ of Breast (DCIS)
Ductal carcinoma in situ (DCIS) is a non-invasive breast malignancy confined to the ductal system. In patients whose tumour is oestrogen receptor (ER)-positive, risk-reduction strategies after local treatment play a central role in management.
Clinical situation
This protocol applies to patients with ER-positive DCIS who have undergone breast-conserving surgery (BCS) with radiation therapy, or excision alone. After local treatment, the focus shifts to reducing the risk of ipsilateral breast events.
Treatment approach (partial overview)
Endocrine therapy is considered for risk reduction in eligible patients, with the choice of agent informed by menopausal status and individual clinical factors. The full protocol specifies agent selection, duration, and the conditions under which one class of therapy is preferred over another.
Complete regimen details, sequencing, and clinical decision criteria are available in the full protocol below.
References
- Consider endocrine therapy for 5 years for patients with ER-positive DCIS.
- Tamoxifen for premenopausal patients.
- Tamoxifen or aromatase inhibitor for postmenopausal patients with some advantage for aromatase inhibitor therapy in patients <60 years or with concerns for thromboembolism.
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