When you’re told you have ductal carcinoma in situ (DCIS), the instinct is often to treat it quickly and aggressively. But what if some DCIS doesn’t need immediate surgery at all?
A new study published in The BMJ (British Medical Journal) suggests that for some women, waiting and watching may be a safe option.
In this observational cohort study, researchers followed 1,780 women across the U.S. who were diagnosed with DCIS but chose not to have surgery within the first six months of diagnosis. The goal was to understand how many later developed invasive breast cancer and how many died from breast cancer.
Over the next eight years, only about 11% developed invasive breast cancer in the same breast—and among those considered “low risk” (meaning they had smaller, hormone-positive, lower-grade lesions found by screening), that number dropped to 8.5%. Those women whose DCIS had more aggressive features had a 14% chance.
Even more reassuring: across the board, 96% of the women were still alive and had not died from breast cancer after 8 years—and among the low-risk group, the survival rate was even better: 98%.
What This Means for DCIS Patients
This study doesn’t suggest that surgery should be skipped entirely. Instead, it highlights that DCIS is not one-size-fits-all, and some women may be able to safely delay or even avoid surgery, at least in the short to medium term, and especially when their risk of progression is low. While active monitoring (regular imaging and follow-up instead of immediate treatment) is still being tested in clinical trials, this real-world data helps inform patients and doctors who are exploring all options.
The takeaway? Your DCIS diagnosis doesn’t have to mean rushing into the most aggressive treatment. It’s okay to pause, get the facts, and choose the path that fits your life, your values, and your goals. If you’ve been diagnosed, work with your care team to determine your personal risk and all your available treatment options.
Click here to read the full study.