Breast cancer screening has resulted in increased diagnosis of ductal carcinoma in situ (DCIS). Compared with other breast cancers, little is known about the cost of illness or quality of life burden associated with DCIS. METHODS: A structured literature search strategy was developed for identifying DCIS cost and QOL data in three publication databases (PubMed, EMBASE, and the Cochrane Library). Primary and secondary search criteria were “Carcinoma, Intraductal, Noninfiltrating” or “DCIS” and “Quality of life” or “Costs” or “Resource use”, respectively. Publications for review were restricted to those published between 2004 and 2014 inclusive. Abstract screening was performed by a single reviewer, with included results checked for protocol alignment by two further reviewers. RESULTS: In total, 585 articles were identified for review, of which 55 were duplicates between databases. Following abstract review, 111 articles were retained for analysis. The majority of excluded articles were not specific to DCIS or did not report cost or QOL data. DCIS does not directly affect QOL. Anxiety caused by DCIS diagnosis is a key decrement to QOL, although its impact can be transient. Longer term impacts on body image and role limitation were apparent following surgical intervention. Evidence of QOL detriments due to DCIS treatment were identified. Use of post‑surgical radiotherapy is increasing, and patients receiving lumpectomy plus radiotherapy had significantly lower ‘mental health’ (74.0 vs. 77.4) and ‘vitality’ (59.3 vs. 63.5) QOL than controls. There is little data on the cost burden of DCIS. Individual cost items were identified, with radiotherapy estimated at USD 10,700 to 34,900. CONCLUSIONS: Anxiety about tumour recurrence and body image and treatment side effects are the major factors influencing patient QOL in DCIS. Adverse events and costs associated with DCIS treatments makes the choice of treatment pathway important for both patients and healthcare providers.