A diagnosis of ductal carcinoma in situ (DCIS) can be overwhelming, but understanding what to expect during surgical removal can help ease some of that anxiety. DCIS is a non-invasive form of breast cancer, and while it’s considered early-stage, treatment is essential to prevent progression. Surgical removal is a common option, and knowing the process, recovery, and available options can provide clarity and confidence as you take the next steps in your care.
Surgical Options for DCIS
When diagnosing DCIS, the primary surgical options are lumpectomy and mastectomy, and the choice depends on several factors. A lumpectomy is a breast-conserving surgery that removes the DCIS along with a small margin of healthy tissue surrounding it. This option is often recommended when the DCIS is confined to a small area of the breast.
However, for cases where the DCIS is widespread or involves multiple areas, a mastectomy may be necessary. A mastectomy involves removing the entire breast tissue to ensure all abnormal cells are eliminated. While the risk of recurrence is slightly higher with lumpectomy, survival rates for both procedures are similar. In some cases, breast reconstruction can be performed immediately after mastectomy to restore the breast’s appearance.
What to Expect During Surgery
Surgical removal of DCIS is typically performed under general anesthesia, meaning you’ll be asleep and pain-free during the procedure. For lumpectomy, the surgeon will make a small incision and remove the DCIS along with some healthy tissue. The excised tissue is sent to a lab for analysis to ensure all cancerous cells have been removed, and the edges of the tissue (called margins) are clear of any abnormal cells.
For mastectomy, the surgeon will remove the entire breast tissue, including the nipple and areola, if necessary. The surgery can take between one to three hours, depending on the complexity. Both procedures are often done on an outpatient basis, but some patients may need to stay overnight for observation.
What to Expect During Recovery
The recovery process after lumpectomy is generally quicker than that of a mastectomy, but both procedures require post-operative care. After a lumpectomy, you can expect some swelling, bruising, and discomfort, which is usually manageable with pain medication. Most people return to normal activities within a few days to a week.
However, if you’ve undergone a mastectomy, the recovery process may take several weeks, with a higher likelihood of experiencing more discomfort, limited mobility, and fatigue. You may be given drains to remove excess fluid after the surgery, especially after a mastectomy. Both surgeries require follow-up appointments to monitor for infection and ensure proper healing. You may also be advised to avoid strenuous activities during the first few weeks of recovery.
Next Steps After Surgery
After surgery for DCIS, additional treatments may be necessary, depending on the type of surgery performed. If you had a lumpectomy, you will likely undergo radiation therapy to reduce the risk of recurrence. This typically involves daily treatments for several weeks and may cause some fatigue and skin irritation. If you had a mastectomy, radiation is generally not required, although exceptions may apply if the DCIS was particularly large or close to the margins.
Additionally, hormonal therapy may be recommended to reduce the risk of breast cancer in the future. This treatment involves taking medication to block estrogen, which can fuel cancer growth. Your doctor will schedule regular follow-up visits and screenings to monitor for any recurrence of DCIS or new developments.
Moving Forward with Confidence
Undergoing surgery for DCIS can feel overwhelming, but with the right medical care and support, many patients successfully recover and go on to lead healthy lives. Whether you opt for a lumpectomy or mastectomy, understanding your treatment options and what to expect during recovery is key to managing the process. Working closely with your healthcare team ensures you have a comprehensive plan for both physical recovery and emotional well-being, empowering you to move forward with confidence and peace of mind.