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Decision Support Tool

Welcome to the DCIS decision support tool

DCIS stands for ductal carcinoma in situ. It is a condition in which abnormal cells are found in the lining of the breast duct. In most cases of DCIS, these abnormal cells have not spread outside the duct to other tissues of the breast. Current research suggests that some types of DCIS may never become harmful to health within a woman’s natural life time.

The purpose of this interactive decision support tool is to help you and your doctor make a personalized treatment decision that is right for you. In particular, we will try to help you answer the following questions:

This decision support tool is designed to be used in consultation with a doctor.

What is uncertainty?

Uncertainty is when outcomes are not known. For example, it is uncertain if some types of DCIS will be associated with a future cancer.

What are risk estimates?

Risk estimates approximate how likely it is that a future condition will happen. For example, recurrence risk estimates give an indication of how likely it is that a future DCIS or cancer will be experienced in the breast within a certain time after treatment.

All risk estimates given in this tool are absolute risks.

Read about types of risks and how risk estimates are determined on the Making Decisions/Understanding Risk page of this website.

Why use a decision support tool?

A decision support tool may be beneficial for patients and caregivers who are making decisions that come with uncertainty. It can help them understand each treatment choice and what may happen with each choice.

What information do I need to use the decision support tool?

This decision support tool is designed to provide estimates for your chances of having certain health conditions at 10 years. If you have information that your DCIS is low risk (low or intermediate grade), then you can tap the “low-risk” box. If you have information that your DCIS is high risk, then you can tap the “high-risk” box. If you don’t know, you can tap the "don’t know" box and get an average of the estimated numbers.

The risk estimates described in this decision support tool are only for those women who have surgery. Learn more about having no surgery for DCIS or doing active surveillance on the About DCIS / Active Surveillance page of this website.

No surgery for DCIS and doing active surveillance

Some women with low-risk DCIS are thought to be unlikely to have a future invasive breast cancer. These women could be followed closely instead in a type of management called “active surveillance.” Surgery would only be performed if invasive cancer is detected at a later date. Active surveillance does not mean patients are “doing nothing,” it requires that the patient and her healthcare provider closely monitor the DCIS. This management strategy is based on results from limited studies showing that surgery for low-risk DCIS may not affect a woman’s survival. There are ongoing studies to evaluate active surveillance further. Read about one available study on the COMET Study page of this website.

If you are interested in learning more about active surveillance for some women with low-risk DCIS, please refer to the links below.

Note: This decision support tool is designed to be used in consultation with a doctor.

Things to keep in mind while using the tool

Use the decision support tool menu to navigate to the absolute risks for each treatment type you are interested in.

Risk estimates are one piece of information that can help you make a decision. You may also want to consider what else is important to you such as short and long-term side effects, family, time commitments, financial concerns, work responsibilities and quality of life.

There is no right or wrong answer when it comes to your treatment decision. It is important to choose a treatment that is right for you based on your circumstances and what you value most about your health.

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