OnCo

Ductal carcinoma in situ (DCIS): lines of therapy

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4 standard-of-care settings across 3 lines and 3 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersHR-positiveRisk group
Early / localised1·1
Advanced, first line1··
Other settings·1·

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
All comersLocalised DCIS, breast conservationLumpectomy to 2 mm margins followed by whole-breast radiotherapy (hypofractionated), with radiotherapy omission considered for low-risk lesions (RTOG 9804 criteria or genomic assay).91
Risk groupLow-risk DCISActive monitoring with mammography every six months and optional endocrine therapy, in trials (COMET, LORIS, LORD) or after shared decision-making where guidelines allow.89

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersExtensive or multicentric DCISMastectomy with sentinel node biopsy and optional reconstruction; radiotherapy not needed after mastectomy with clear margins.68

Other settings

SubgroupSettingApproachProducts and trialsEvidence
HR-positiveER-positive DCIS after breast conservationTamoxifen (or anastrozole in postmenopausal women) for five years to reduce ipsilateral and contralateral breast events; low-dose tamoxifen is an option (TAM-01).93

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.