anyone with low grade dcis not having radiation

ballet12

Hi MMulder,  your risk is probably slightly higher than the individuals Beesie is referring to, if only because you had intermediate grade DCIS.  Everything else holds true for you: very, very small size and wide (ocean-wide, actually) margins. I would have probably done the same thing you did, but the only thing I had going for me was the wide margins. The first thing the surgeon said to me was, well..., you now have wide margins (after three lumpectomies), but you really need radiation (multifocal, comedonecrosis, high grade).  It's quite possible that they were radiating normal tissue, not stray DCIS, but we'll never know. 

Beesie

ballet12, I would argue that with MMulder's margins, her risk of recurrence is probably lower than the hypothetical person in my example, despite the higher grade of her DCIS. 

A recurrence happens when cancer cells from the original cancer are left in the breast after surgery, survive and redevelop into an area of cancer.  If someone has a single focus of DCIS that is 3mm in size and if the smallest surgical margin is 4cm, do you think there is even a 2% chance that some cancer cells from that original 3mm mass might be left somewhere in the breast, beyond that 4cm margin?  I would think that's closer to a 1 in a 1,000 chance.  Might there be an other separate area of DCIS?  Possibly, but as MMulder said, that would be a new/separate primary, not a recurrence.  And every one has that risk.

I know that there is more to recurrence risk than margins but no matter how aggressive the DCIS, at some point if the margins are huge, it's just illogical that any cells from that original mass might still be in the breast.  At least that's how I see it.

ballet12

I see your point. Makes me feel better, also, because I had wide margins, as well (not that wide though).