Dana-Farber Brigham Cancer Center is launching a new program designed to address the unique needs of women diagnosed with the earliest form of breast cancer. Nearly 60,000 women in the United States this year will be diagnosed with Ductal carcinoma in situ (DCIS), a type of breast cancer in which cancerous cells grow but are confined within the milk duct of the breast. The new program will offer DCIS patients outstanding clinical care delivered by Dana-Farber Brigham Cancer Center experts and will be the only such program in Greater Boston offering patients access to clinical trials specific to DCIS.

About 1 in 5 new breast cancers diagnosed in the U.S. this year will be DCIS, according to the American Cancer Society, with more than 2,200 cases in New England alone last year. Most people with DCIS experience no outward symptoms and about 80% of DCIS cases are diagnosed by regular screening mammography.

The Ductal Carcinoma in Situ Program at Dana-Farber Brigham Cancer Center is the only program in the Northeast dedicated to DCIS, combining expert clinical care with in-depth research and educational resources to provide outstanding individualized care for each patient. The specialized team with the DCIS program includes distinguished breast cancer surgeons, medical oncologists, and radiation oncologists with specific expertise in DCIS as well as dedicated physician assistants and nurse practitioners. The team works in concert to deliver expert care while also conducting research to improve the understanding of the disease. 

Elizabeth Ann Mittendorf, MD, PhD

“DCIS is a distinctly different diagnosis than invasive breast cancer,” said Elizabeth Mittendorf, MD, PhD, Co-Director of the Breast Cancer Clinical Research Program at Dana-Farber Brigham Cancer Center and Co-Director of the new DCIS program. “The good news is that we have highly effective and curative treatment options to offer patients with this disease. The concern is that we might be overtreating a number of women with this diagnosis. Surprisingly little is known about why DCIS arises in the first place and which cases are likely to progress to invasive disease. Our new program will provide women with outstanding, state-of-the-art care while facilitating research that will help improve our understanding of the underlying biology of DCIS which in turn may provide insight into better ways to treat these patients.”

Treatment for DCIS is currently driven by a patient’s specific biopsy results and the characteristics of their disease. Patients diagnosed with DCIS may undergo a lumpectomy, also known as breast-conserving surgery, with or without radiation. In some instances, a mastectomy may be recommended if the area of DCIS is extensive or there is more than one area of DCIS in the breast. Endocrine or hormonal therapy may be recommended for patients with hormone receptive positive disease. While a diagnosis of DCIS carries with it an excellent prognosis, having DCIS can increase a woman’s risk of developing an invasive breast cancer in the future. 

Tari A. King, MD

In addition to offering integrated, patient-centered, high-quality care to women with DCIS, patients participating in the program will also have access to DCIS specific clinical trials. One such trial, the COMET trial, will examine the likelihood of progression from DCIS to invasive breast cancer in women with low-risk DCIS who either undergo watchful waiting or standard surgical care. The PROMISE clinical trial will test if an oral drug can reduce the risk of developing breast cancer in women with DCIS.

“Currently, there’s no good way for doctors to know which DCIS cases will become invasive cancer and which ones won’t, and there may even be some women who could safely avoid treatment for DCIS altogether,” said Tari King, MD, Chief, Division of Breast Surgery at Dana-Farber Brigham Cancer Center and Co-Director of the new DCIS program. “Our physician scientists in the DCIS program are engaged in multiple research studies to better understand the risk of progression to invasive disease and to better tailor treatment options to meet the needs of patients with DCIS.”

Patients wishing to visit the DCIS program, participate in a clinical trial or learn more about the program can visit: https://www.dana-farber.org/ductal-carcinoma-in-situ-program/