Case List History Objectives Radiology Images Questions BREAST DISEASE Case #4 - A 55 year old woman with an abnormal mammogram DISCUSSION QUESTIONS: 4.) What is the management of DCIS? Management of ductal carcinoma in situ (DCIS): For localized DCIS, excision is performed. If margins are negative and the DCIS is <1.5 cm in size and there is no necrosis, the patient can be observed. If the size is >1.5 cm or there is necrosis or the margin is < 1 cm, then irradiation is needed. If the margins are positive after the initial excision, re-excision is indicated. If the DCIS is diffuse or if the margins are still positive after re-excision, then total mastectomy is indicated. Irradiation for all patients may reduce risk of invasive carcinoma. Tamoxifen is recommended for 5 years.
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