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Healthcare professionals never recommend chemotherapy to treat DCIS.

However, radiation oncologists are currently using a complex new tool called DecisionRT to guide treatment decisions in early stage breast cancer, especially DCIS.

Specifically, this test examines the activity or expression of certain genes in cells, usually from a tissue sample.

Moreover, DecisionRT analyzes the activity of specific genes in tumor tissue to assess how likely the cancer is to spread. Consequently,  This helps DecisionRT determine whether treatments like radiation or hormone therapy are necessary, allowing for more personalized care and helping some patients avoid overtreatment.

Consequently, treatment options that doctors may consider for DCIS include:

For instance, Lumpectomy (breast-conserving surgery) with radiation therapy

In this procedure, the surgeon will remove the tumor and some healthy breast tissue close by as a precaution.

Additionally, rarely, they may also remove the lymph nodes and request a biopsy to confirm that the cancer has not spread. Healthcare professionals call this a sentinel lymph node biopsy (SLNB). They are more likely to do this if the tumor is large.

Finally, after surgery a person will receive radiation therapy to destroy any remaining cells.

Lumpectomy

Sometimes, a person will only receive a lumpectomy, However, this is not standard treatment and doctors reserve this for people with a very low-grade DCIS.

Moreover, a person should speak with their doctor about radiation therapy if they are unsure about this approach.

Mastectomy

If the DCIS is in many areas of the breast, or If the calcifications extent over a large area of the breast, then a surgeon may remove the entire breast.

Typically, a surgeon will perform a sentinel lymph node biopsy in the setting of a mastectomy if they find invasive cancer in the mastectomy specimen.

In some cases, a person receives reconstructive surgery immediately after the mastectomy or will have it as a separate procedure.

Furthermore, depending on individual circumstances, a person would not usually receive radiation therapy after a mastectomy.

Hormonal Therapy after Surgery

If doctors know the cancer uses estrogen and progesterone to grow, they will likely suggest hormonal therapy.

This treatment blocks tumor receptors that bind to these hormones, or reduces the amount of estrogen and progesterone in the body. Consequently, a person may continue hormonal therapy for 5 years after surgery.

COMET Trial

The Comparison of Operative to Monitoring and Endocrine Therapy (COMET) trial is a clinical trial focused on people with low risk DCIS.

Specifically, the trial is investigating whether watchful waiting can be a safe option for some women with low risk DCIS, rather than defaulting to surgery. Moreover, it is part of a broader shift in cancer care toward personalized, less invasive treatment where possible.

Importantly, DCIS is noninvasive, and some forms may never progress to invasive cancer. However, current treatment often involves surgery, which may be unnecessary for some people. Consequently, the COMET trial aims to reduce overtreatment and ensure women only receive intervention when it is truly needed.

Notably, the survival rate of DCIS is high because people receive their breast cancer diagnosis early and begin treatment before the cancer progresses to a more invasive type.

Furthermore, the vast majority of people with DCIS can expect to have a normal life expectancy. Nevertheless, they are at a higher risk of developing invasive breast cancer in the future in comparison with the general population.

In instances where a person does not receive treatment for DCIS, the cancer could progress to an invasive type and spread to other parts of the body.