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Radiation and Tamoxifen for DCIS

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Lawrence J. Solin, MD, FACR
Last Modified: January 6, 2002

Dear OncoLink "Ask The Experts,"

In August, I was diagnosed with ductal carcinoma in situ. I had a lumpectomy and am currently going through 38 days of radiation. Will the radiation make less the chances of it recurring? And would tamoxifen make a difference? I am currently 43 years old I have been told that I would not be a good candidate with a history of blood clotting in my family.

Lawrence J. Solin, MD, FACR, Professor of Radiation Oncology at the University of Pennsylvania, responds:

Ductal carcinoma in situ (DCIS) is a form of very early breast disease that involves the ducts of the breast, but does not invade (or infiltrate) beyond the ducts. Since this type of problem is not invasive, treatment is typically designed mainly to treat the breast. Randomized studies have shown that adding radiation treatment after lumpectomy increases the likelihood that the disease will be controlled and not recur in the breast. Randomized studies are considered to be one of the strongest forms of evidence that a treatment (in this case radiation treatment) is effective.

With regards to tamoxifen, one randomized trial has shown that tamoxifen is effective in increasing the likelihood that the disease will not recur. However, as with any drug, there are some potential side effects that might preclude its use in an individual patient, and clotting disorders are one such potential side effect of tamoxifen. Each individual patient needs to discuss these issues with her doctor.