Welcome to the DCIS decision support tool

DCIS stands for ductal carcinoma in situ. DCIS is when the breast duct has abnormal cells in its lining. These abnormal cells have usually not spread outside the duct to other tissues of the breast. Research shows some types of DCIS may never harm your health during your lifetime.

The COMET interactive decision support tool helps you answer some questions:

• What are my options for treatment of DCIS?
• Does my choice of treatment affect my chance of getting a later diagnosis of DCIS or invasive breast cancer?
• How will my choice of treatment impact the chance I will be alive in 10 years? Of 100 women treated for DCIS, the chance of dying from breast cancer is very small. Doctors consider fewer treatments or no treatment for some DCIS patients.

This decision support tool should not replace consultation with a doctor.

What is uncertainty?

Uncertainty is when outcomes are not known. For example, no one knows if some types of DCIS result in future cancer.

What are risk estimates?

Risk estimates show how likely it is that a future condition will happen. They tell you if a future DCIS or cancer might return to the breast within a certain time after treatment.

All risk estimates given in this tool are absolute risks.

Learn how types of risks and risk estimates are created.

Why use a decision support tool?

A decision support tool helps patients and caregivers make decisions. It can help them understand each treatment choice and what may happen with each choice.

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

The decision support tool estimates your chances of having certain health conditions at 10 years. If you know your DCIS is low-risk (low or intermediate grade), check the low-risk box. If you know your DCIS is high-risk (high grade or estrogen-receptor negative), check the high-risk box. If you don’t know, check the don’t know box and you’ll get an average of the estimated numbers.

The risk estimates in the decision support tool only apply to women who have surgery.

Learn about choosing no surgery for DCIS and active surveillance.

What about no surgery for DCIS and active surveillance?

Some women with low-risk DCIS may not have a future invasive breast cancer. These women could use active surveillance. Surgery is recommended only if tests find invasive cancer.

Active surveillance does not mean patients are doing nothing. The patient and her healthcare provider watch the DCIS. A few studies show that surgery for low-risk DCIS may not affect a woman’s survival. Read about a study that tests active surveillance.

Note: Use the decision support tool in consultation with a doctor.

What are some things to keep in mind while using the tool?

Use the decision support tool menu to find the absolute risks for each treatment type.

Risk estimates are one piece of information that can help you make a decision. There are other things to consider:

• What else is important to you?
• What are short and long-term side effects?
• What happens to my family and work responsibilities?
• What kind of time commitments are there?
• What will cost more?
• Will this help my 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 and your health.

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