Dr Bajaj in Oklahoma City for DIEP

Radiation is “local" therapy, and most women with DCIS who have mastectomies can avoid it because there isn’t any breast left to radiate. But anti-estrogen therapy is “systemic,” which is meant to kill any micromets (microscopic tumor cells) that may have escaped detection and might be harbored anywhere in the body (“killing” them by starving them of the estrogen they need to survive). Opting for mastectomy (single or bilateral) over lumpectomy does not eliminate the need for anti-estrogen (endocrine or “hormone”) therapy. Even though DCIS is by its very nature non-invasive and is not supposed to spread, sometimes a stray cell can mutate into IDC, and might have sent out micromets. However, it’s often common for DCIS to be ER/PR- and HER2+, a combination that requires chemo and targeted biologic therapy in IDC patients. But because of DCIS’ non-invasive nature, chemo and targeted therapy isn’t given due to its risks outweighing its benefit. But endocrine therapy, while not devoid of side effects, is considered to have its benefits considerably outweigh its risks in patients whose tumors, even if DCIS, were ER/PR+.