Treatment Options for DCIS or Non-Invasive Breast Cancer (Stage 0)

[@rrobertsntx]

I was just diagnosed with DCIS and found your video to be one of the most informative. Thank you for providing this to those of us who are just getting diagnosed and have so many questions.

[@nikki7333]

Hi, I was just diagnosed with it 1 week ago. But I had to go back in with another biopsy for another area. I don't have diagnoses of the next yet but hoping it's just more DCIS. Best wishes to you!

[@rrobertsntx]

@@nikki7333 Thank you, best of luck to you as well.

[@sindeekaye2223]

I agree!! ♥️👌🏽

[@yerbba]

Glad it was helpful.

[@phyleasherkeeten424]

I was just diagnosed with DCIS and I do like this video. Your break down is very encouraging and thank you for putting this informative information here for us. Thank you and God Bless

[@yerbba]

So happy that this has been helpful. All the best to you during your treatment.

[@traceymanzano4015]

I was diagnosed with DCIS low grade, back in Aug last year.I decided to have a bilateral mastectomy and be done with it.I know that it was drastic,but I wasnt taking any chances with cancer at all! I also didnt have time to go to radiation everyday for 5 weeks! I'm pleased with my decision, I dont mind being flat chested.I have prosthetic breast forms I wear when I want to switch things up.

[@yerbba]

Thank you for watching and sharing your decision making. I know this helps other people going through the same thing.

[@clairewinters9950]

Tracey how did you weigh up making this decision? X

[@teresathreatts4266]

I was just diagnosed with DCIS in April 2023. I have had a biopsy, a breast MRI, now they want me to have an ultrasound and an additional mammogram. I don't want have to undergo a surgery, but im still in consultation with my doctors. Your video is very informative! Thanks🙏🏾

[@yerbba]

Thank you so much for watching. Keep coming back because we have a lot of content and upcoming videos all the time.

[@Ugandangirl]

Did you do it?

[@bonniecebulak7955]

I had DCIS stage 0 and grade 2-3. I had a lumpectomy and two lympnoids removed. I chose not to have radiation therapy. It's been nine months since I had the surgery and I have nerve pain almost every day, all day. In my research I discovered most doctors do not remove lympnoids for stage 0. Can you explain why some doctors do? I now go every six months for a diagnostic mammogram. I am 68 years old.

[@yerbba]

Thanks for sharing your story. We're hopeful that the nerve symptoms get better soon. You are right…most of the time lymph nodes are not removed in someone with DCIS. But there are a few reasons that would prompt a surgeon to remove lymph nodes in someone with DCIS. It would be completely reasonable to ask your medical team about your own case and why the lymph nodes were removed.

[@dm8553]

I am having a mastectomy for stage 0 grade 2-3? on January 20th. I have a large area of calcifications through half of my breast and also another area that's not cancer but they want to deal with it too. My doctor said I won't need radiation.

[@yerbba]

Thanks for sharing your story. Wishing you all the best.

[@dm8553]

@@yerbba thank you

[@mirandamac6234]

What is consider large size lesion for a dcis

[@yerbba]

DCIS lesions vary in size, but anything over 2.5 cm is often considered relatively large and may impact treatment decisions.

[@ilikecontent2327]

Isn't it true that whether or not you choose radiation, etc. That it has no effect on mortality? And that the only reason to do these drastic procedures is to prevent recurrence? It seems they need to reassess current procedures and re-evaluate the use of radiation as using radiation has so many possible long term side effects. Maybe they can start looking at using much smaller doses rather than such high gray levels? 40-45 grays for a standard treatment seems excessive. That is a lot of Rads. I know they can more accurately pinpoint treatment, but there is still a plus minus error rate in how the machine is calibrated and there is a certain amount of scatter radiation. So I guess if you do use it then do your treatment on your stomach if you can and try to get access to the latest equipment available. They just need to move away from such radical treatments like mastectomy and radiation and spend more money on less aggressive treatments like vaccines...etc... My opinion anyway in treatment of DCIS. Which technically should be called a pre-cancerous condition.

[@yerbba]

There's a lot here in your comment. Great question about the purpose of radiation therapy. While radiation therapy is indeed focused on preventing local recurrence, we know that half of recurrences in DCIS are invasive cancer, which may require chemotherapy. So while many people don't mind the thought of another breast surgery (often mastectomy) if the cancer recurs, many people do want to avoid going through another cancer that may be associated with a chemotherapy recommendation. In invasive cancer with larger tumors and/or positive lymph nodes, radiation therapy is associated with a survival benefit. In terms of the doses that are used, these doses have been arrived at based on randomized trials. With current radiation therapy planning techniques, radiation to normal tissues (lung, heart) are minimized. Nonetheless, we agree that we can do better! We are grateful for the people who participate in clinical trials of novel approaches to therapy.

[@ilikecontent2327]

@@yerbba Yes indeed! The Vaccine trials look promising. We need to get away from dumping so many rads of radiation into a patient. 35-45 grays of radiation is a lot of rads to expose someone too. Especially when a certain percentage is scatter radiation outside the treatment area and there is a plus minus rate of inaccuracy with the machine's calibration. Getting radiation treatments on your stomach helps. They are more accurate, but the exposure does still increase your cancer risk when you already had an elevated risk to begin with.

[@sterling_roses964]

Dr. Griggs, you are so wonderful and I love the few videos I watched. They are THE most helpful explanation I've been able to find. Thank you. I was diagnosed with ADH with borderline low-grade DCIS. I'm in an extreme rural area, and have one doctor. She has thus far, been evasive as to my questions. I'm worried about this. I see her tomorrow, and 3 days prior to surgery, and she is just NOW discussing my options. Do I have time to get another opinion? It seems so. I am a 59 year old woman. Only my maternal grandma had what seems to be the same thing. I realize this is the internet, but I am excessively stressed that I don't even know what is going on. It seems an extremely tiny area of microcalcificaitons. Biopsy was done. Thank you in advance, and god bless you. I will be checking out your website. 🌹

[@yerbba]

Thanks for watching. Getting another opinion is going to make you more comfortable, and with the information you've provided, you do have time to get more information. You want to be as comfortable as possible with your treatment decisions.

[@PaulNoake]

I'm a guy just diagnosed with DCIS and my nipple is being destroyed from the inside out

[@yerbba]

Yerbba is rooting for you!

[@aisha2luv464]

This is a very informative video!!! Thanks.

[@yerbba]

Glad it was helpful!

[@sarahf.318]

I just got my pathology report today (thank goodness, out of limbo) and it suggests DCIS. I was just wondering if receptor status and "microinvasion" matter. Mine appeared to be grade 3. Thanks!

[@yerbba]

Out of limbo! Yay! Depending on the extent of microinvasion, it may not have any treatment implications. We generally don't test for hormone receptors in DCIS. Come back once you hear more about next steps.

[@sarahf.318]

Thanks! I saw one surgical oncologist who recommended mastectomy for me given size of the area. Waiting on a second opinion but it likely is going to go that way.@@yerbba

[@ssrk369]

I had fibroadenama operation and in biopsy results after operation the tumor which was removed had cribriform dcis,the doctor said since the tumor is removed no need to worry and 3 months once consultation is required... but I have fear whether it'll spread to other

[@yerbba]

A small area of cribriform DCIS is unlikely to cause problems down the road with spreading or even recurrence in the breast. It may be worth asking about the benefit of radiation therapy in your case.

[@jeanniesabol5410]

Why do you say DCIS CAN'T invade surrounding tissue and then sat in the next sentence if left untreated, it CAN invade surrounding tissue? Why not just say it hasn't yet invaded, which is more accurate? It either XAN or CAN'T invade. If it CAN'T, then why treat it?

[@yerbba]

Great questions. Some DCIS will eventually break through the basement membrane, and some won't. We don't know yet which patients will experience progression from non-invasive to invasive, so we probably overtreat a lot of people by removing the tumor. There is a lot of research being done to figure out which people will have progression and which people won't. We are also doing research to find out if there are non-surgical ways to treat DCIS. Thanks so much for your comments.

[@alwayslearning-ds1jw]

You've mentioned research. Can you please share those research studies? @@yerbba

[@marivallejo6718]

I recency got DCIS and abnormal blood clot from biopsy what should i do? Get surgery or do radiation

[@yerbba]

In people with DCIS, both surgery and radiation therapy are recommended at this point.

[@mijanurrahman9777]

Mam, my mother DICS 4 th stage,high grade whwat can i do?

[@yerbba]

DCIS is stage 0. While there can be high grade DCIS, this is still not stage IV (4). DCIS is treated with surgery and, in people who have breast conserving surgery, usually radiation therapy. We hope this is helpful.

[@jlin4223]

Is it possible for me to skip radiation therapy if I am over 50, after lumpectomy, second surgery to remove more tissue and have clear margin, tumor grade 3 and not benefit from hormonal therapy?

[@yerbba]

Thanks for asking this question. We generally do not omit (skip) radiation therapy in people with a higher grade. The risk of the cancer recurring is higher than we are comfortable with skipping radiation therapy.

[@hamanijamatiarollno2968]

My mother is diagnosed dcis with her2 positive..what is the treatment option for this ???

[@yerbba]

We're sorry to hear about your mother's diagnosis. Treatment options for DCIS with include surgery and radiation therapy. There is no implication of the HER2-positive status in DCIS. In fact, most all DCIS is HER2-positive and is actually associated with a better prognosis.

[@dhabiaal-saffarr8991]

Have DCIS After the Surgery I did the Radiator therapy Till now i dient go tova gynocologist..I am Expertin they will give me this Medizin which makes my Hormonen less I dont want this As far as i know this Leids to Osteoperosis What do u think??? Thanx for the Info

[@yerbba]

Anti-estrogen therapy is an important part of treatment of invasive cancer. In DCIS, the major benefit is in reducing the risk of cancer returning in the involved breast and the other breast. There is no survival benefit. Tamoxifen does not lead to osteoporosis in postmenopausal women, so if endocrine therapy is something that you are interested in taking, tamoxifen would be a good option. In premenopausal women, tamoxifen can lead to some thinning of the bones, but it is reversible.

[@judynee9311]

I’m having stage one her2 positive ! I’m being mastectomy and flat closure ! Also one year finished traumas! I’m chest pain every day ! Tried! Any advice ?!

[@NVChannel-pn5yr]

I had a lumpectomy for atypical intraductal papilloma 3weeks ago ...but doctor said you are normal person......is it true?....no need radiation and tablets

[@NVChannel-pn5yr]

Please reply me mam

[@NVChannel-pn5yr]

You need Every 3month check up only told my oncologist

[@yerbba]

In general, people with an atypical intraductal papilloma do not require any additional therapy.

[@NVChannel-pn5yr]

Thank you for your response mam

[@sahilnazirr]

How can i conact you? My mother was recently diagnosed with DCIS. She underwent Wide Local exision of the tumor and Axillary Lymph node disection. And the pathology revealed the following Extensive DCis and ER=Negative PR=Negative Her 2 neu= positive What are the treatment options now.. Please reply

[@yerbba]

Your mother is fortunate to have you. Decisions about treatment in DCIS are generally made without consideration of the ER, PR, and HER2 status. In people who have a mastectomy, there is little if any benefit from radiation therapy or endocrine therapy. In people who have breast conserving surgery, radiation therapy is generally recommended, and endocrine therapy is often offered even if the DCIS is ER-negative.

[@sahilnazirr]

They doctors here said it will require adjuvant chemo plus radiotherapy... We are confused now.. What if she skips chemo

[@edrinabudiharsono1196]

Thank you so much for the informative video! I got diagnosed with DCIS earlier this year, and I’m thinking to do mastectomy with reconstruction but I’m really afraid to do this big change and thought or maybe it’s better to leave the DCIS untreated. Could you maybe give me some insights? I’m 28 years old

[@yerbba]

DCIS at this point in our knowledge does need to be attended to. We are not yet at the place where we can figure out who can skip treatment. In addition to mastectomy, there are other less drastic surgical options that a breast surgeon will be able to explain to you.

[@Ugandangirl]

I have DCIS grade 3. Should I remove both breasts? 47

[@annaortiz2252]

I had a lumpectomy for intermediate grade DCIS. Then a re-excision to get better margins. The tumor was ER/PR positive but I’m still on the fence about hormonal therapy. Is radiation therapy a good option in the event that I choose not to proceed with hormonal therapy? I’m a new subscriber and I find your content very informative and helpful. Thank you for making these videos!

[@jeangresty3831]

I was diagnosed with left breast DCIS, Intermediate Grade back on January 2, 2024 (way to start the new year!) via core biopsy. I also had microcalcifications in my right breast that needed surgical excision. My Surgeon encouraged me to have both a lumpectomy in my left and an excision in my right breasts. The right breast was benign - there are reasons why it could not be core or needle biopsied, but it turned out okay. The left was still DCIS/LCIS with good margins - but because it was Intermediate Grade I decided to go ahead with Hypofractionated Radiation (16 session @ 42Gy) - it turned out well with no real discomfort. Someone from another board called Radiation Therapy "fumigating" the breast for any leftover (cancer) bugs. I'm now on to Endocrine (hormonal) Therapy - ER/PR positive - as I don't want any more "off" mammograms , that's where the hell all started. I'm 70 years old - diet, exercise, take Calcium/D3 - so I'm on Anastrozole. It's week 2 so nothing other than hot flashes so far but I will take whatever could be coming (hopefully nothing) to not have a recurrence. Hope my experience helps!

[@yerbba]

Thanks for watching. In people who are not going to take endocrine therapy, radiation therapy is more strongly recommended. The studies that looked at the omission of radiation therapy all enrolled people who agreed to take endocrine therapy.

[@user-cy5ls9ge8w]

My mother had dvis grade1 (low) she had her mastectomy and after that hormonal therapy was going on .Their is no chemo ir radiation therapy taken by her. Are their chances of coming back of dcis again

[@yerbba]

Thank you for writing. After mastectomy for DCIS, radiation is generally not needed. While it is possible to have a chest wall recurrence, such an event is quite rare. Endocrine therapy will reduce the risk of a new cancer in the other breast, but that risk is already quite low.

[@kellymarsden7476]

I have stage 0 DCIS, Grade 1, ( low ) 66 years old. Had surgery to remove the complicated cyst, 1mm margin clear, pathologists requires a second surgery to get to 2mm. Can I skip radiation as I am going to take exemestane ?

[@yerbba]

Thanks for your question. You may be a candidate for omission of radiation therapy, yes, depending on the size of the DCIS. Definitely worth a discussion.

[@pennylch]

I was diagnosed with stage 0

[@yerbba]

Thank you for watching and your comment. It's important to acknowledge that every stage of breast cancer comes with its own challenges, and it's a significant step to receive a diagnosis. Remember, you're not alone, and there are resources and support available to you. Know that you have a community here to support you.

[@parmeshwaridewani8235]

My mom does not have any lump but mri report shows there is possibility of dcis and she got bloody nipple discharge from right breast only once and dr suggested surgery to remove that area of concern..she is very scared and is there any way to get treated without surgery? Please suggest

[@yerbba]

Such a good question. The best way that is known to remove DCIS is with surgery. While researchers are hoping to find another way, surgery is the best approach. Your mother is fortunate to have you helping her out.

[@angelaportalatin1473]

Thank you

[@yerbba]

You're welcome

[@FilAMPina]

hi dr griggs, i have a question.i know someone who has dcis tumor was 5mm ER PR + 100% strong. she already had surgery with clear margins. she has a referral to see a medical and radiation oncology. is treatment after surgery a combination of radiation with medication ? or one or the other?. is it possible she could skip the meds? shes elderly and doesn't want to add another medication to her routine. thanks

[@yerbba]

Great questions. Some people can omit radiation therapy if they are willing to take endocrine therapy. In people who are ambivalent about endocrine therapy, the recommendation is that they receive radiation therapy. Of course, each person's situation is different. Expressing ambivalence to the medical team is the first step in having a treatment plan concordance with her values. She's fortunate to have you

[@dahpnebrown7350]

I am from South Africa. Year and half ago I had a cancer lump removed as well as a few lymph glands. The lymph glands were negative of cancer cells I was told I did not need radium or chemo therapy. I was 79. Now i am 81 and have another cancer tumer on the same breast just a few centimeters below where the previous one was. Now the Dr's. Say after the new cancer is removed I must have radium treatment. I am sad and tearful as now at 81 I face this again. I am also a spinal cripple. I was never told what kind of cancer it was and what the new cancer it all i know is the biopsy said grade three. What do i do seeing i am 81and not a healthy person please give me some advice

[@yerbba]

Thanks for writing, and of course, we wish you weren't going through this. Radiation treatment will decrease the risk of cancer recurrence, and it sounds as if your medical team is recommending it for you. Your doctor will help address your specific concerns. We are wishing you the absolute best.

[@FirstLast-ms6hn]

@dahpnebrown7350 This is not medical advice. DYOR. Consult a doctor. FENBENDAZOLE ANTI CANCER TREATMENT • Fenbendazole (222mg) • Vitamin E (800IU daily) • Curcumin (600mg daily) • CBD oil (25mg per day) • Berberine & Quercetine Consult your doctor first. Some medications may not be compatible with this regiment and may cause a reaction. This is NOT medical advice.

[@sindeekaye2223]

Great video! Thank you!

[@yerbba]

Glad you enjoyed it .

[@izyanasyura6840]

After biopsy last month, my diagnosis is benign fibroepithelial lesion.. But microscopic result shows there is evidence of DCIS...is it same as DCIS? Still consider that im having DCIS ? Because i will undergo surgery on August this year. My doctor suggests for surgery to remove that lump...

[@yerbba]

If there is evidence of DCIS, the standard approach would be to remove the area of the abnormality to make sure that a correct diagnosis can be made.

[@lauracanada3116]

Carcinoma in situ “ invasive grade 1 is the same To dcis ?

[@monicaurquidi2039]

No DCIS is stage 0

[@yerbba]

Yes, they all refer to the same thing. Noninvasive breast cancer, in situ carcinoma, and ductal carcinoma are all the same thing.

[@lauracanada3116]

@@yerbba when the lymp node centinela are negative is not possible the Risk of metastatic ? In tumor of 2.4 cm. ?

[@Sad_Bumper_Sticker]

@@yerbbaOh my. Now I know why I was so confused after reading many papers/websites which use either one of the terms which made me believe they were separate diagnoses.

[@Mythinking019]

​@@yerbbathanks. My mother fnac report was ductal cercinoma, and had mastectomy. Waiting for biopsy result.

[@jumjumjumuk]

Thank you dr. 🙏

[@yerbba]

Thank you for watching.

[@lourdesdorr2757]

Very informative, I watched until she said “remove your breast will make look better” I have small breast I can’t even imagine looks better without one of my breast Terrible 😞 😞 😢😢

[@yerbba]

It is so important that you be given all the options available. Some patients want to have symmetry and find that a bilateral mastectomy is the only way to achieve this symmetry.

[@maryingr1616]

What type of after treatment is recommended with stage 1 non invasive dcis breast cancer with having a bilateral mastectomy

[@yerbba]

Non-invasive breast cancer (DCIS) is stage 0 rather than stage I. In someone with stage 0 disease after bilateral mastectomy, there is no additional treatment needed with some exceptions (rare). In Stage I disease, chemotherapy may be offered depending on the biology of the tumor (ER, PR, HER2, grade, 21-gene assay results, etc.).

[@jonniemaemiddletonlotte6747]

Thank you.

[@yerbba]

You're welcome

[@vegetableautopsy3551]

The music playing in the background just kinda highlights the insanity of it all.

[@yerbba]

We appreciate your feedback. In response to viewer preferences, recent videos have been created without background music.