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DCIS — SCE Medical Oncology MCQ

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ModerateBreast CancerDCISSCE Medical Oncology

A 50-year-old woman with DCIS (ductal carcinoma in situ) undergoes wide local excision with 2 mm clear margins. The DCIS is high-grade, 30 mm, ER-positive. What adjuvant treatment is recommended?

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Correct answer: A — Whole breast radiotherapy followed by 5 years of tamoxifen or AI

For DCIS treated with BCS, whole breast radiotherapy reduces ipsilateral recurrence by approximately 50% (EBCTCG meta-analysis). Adjuvant endocrine therapy (tamoxifen for premenopausal, AI or tamoxifen for postmenopausal) further reduces ipsilateral and contralateral breast events in ER-positive DCIS (NSABP B-24, IBIS-II DCIS trials). High-grade, large, ER-positive DCIS benefits from both RT and endocrine therapy. NICE NG101 recommends discussing these options.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer