Radiation Treatment

Debwa100

Hi All, recently diagnosed with DCIS (stage 0).  I had a surgical biopsy,  two weeks ago Tues, and I am going back to "have the margins cleaned up".  I am told I will need some time to heal, then I will get 5 weeks of radiation.  I am getting a lot of unsolicited advice (well intentioned).  My sister called me today, telling me not to get the radiation, because her friends son is a doctor and told her you can only have it one time.  If ther cancer comes back, it cannot be repeated.  Is this true? 

YramAL

Yes, that is true. You can only have radiation treatment to the same breast one time. But if you do have the radiation treatment, the chances are better that the cancer would not come back to that breast than if you had not. Why wait for it to come back?

Mary

SJW1

Deb,

Your sister is correct about having radiation only once. Since DCIS is a non-invasive pre-cancer it is a tough decision, because radiation can have side effects.

What you will need to find out is what are your chances of recurrences with and without radiation. If your risk is low, say 5-10 percent or less you might elect to skip radiation, since you might decide that the approximately 50 percent reduction from radiation is not worth it for you.

The Van Nuys Prognostic Index (VNPI) is a good tool to estimate your risks. It is based on your age, size and grade of your DCIS and the size of your margins. If your score is from 4-6 points, generally radiation will not be of much benefit for a DCIS patient.

If you would like assistance in scoring yourself using the VNPI, you can consult with Dr. Michael Lagios. After years of research he and Dr. Mel Silverstein developed this diagnostic tool. Dr. Lagios is a world renowned DCIS expert and pathologist. He has a breast consult service that anyone can use. You can find it at this website: http://www.breastcancerconsultdr.com/ .

When I was diagnosed with DCIS in 2007, I consulted with him several times. Because of his expertise, I was able to avoid not only a mastectomy, but also radiation and tamoxifen.

If you need more info, please feel free to send me a private message.

Best wishes and blessings as you make this difficult decision,

Sandie

Cowgirl13

Is your friend's son a breast surgeon or an oncology doc"?  Has he seen your path report?

My sister had her doc look at my pathology report and he said that I didn't need to do chemo.  He was totally wrong--my chances of  having a recurrence were at least 50% so i'm glad i didn't listen to him.

You will find so much help and such kind people here.  Good luck with your decision.  I also agree with an earlier post which advised radiation now- before it is a recurrence or has spread. 

sweatyspice

My rad onc is a rebel.  She told me that she's radiated people a second time, if there was a recurrence.  However, I hope to never consult her about a second go at this!

Or maybe she was lying to get me more comfortable with radiation....but I think she really IS a rebel and was telling the truth.

dsj

I think in general they do not radiate the same area more than once.  So yes, radiation is a one-shot deal for almost all of us.  However, radiation can decrease your chance of a recurrence by 50%.  And since half of recurrences come back as invasive, this can be a serious consideration. 

 The decision whether or not to have radiation is based not only on your margin status, but also your age and the grade and size of your DCIS.  You need to talk these through very carefully with your physicians (breast surgeon and radiation oncologist) and find out exactly what your risk of recurrence is before you make any decisions.   Good luck. 

lh88

After I had started already, my GP looked it up online and said the rads for DCIS decrease recurrence only a few percent, statistically meaningless.

Personally, I wish I had opted for no rads in 2007. I was DXed in March with a recurrence, 3 years after a lumpectomy and 33 radiation treatments. I'm waiting for my consult with my new BS to see what she thinks. My last BS recommended a single mast, TE, reconstruction, and implants in both. We'll see. I meet her on May 6.

Every case is different, seems like there are other tools for assessing risk now. And, it has to do with your personal tolerance for risk. I didn't want them to take more than necessary at the time. Still feel that way!

kittycat

Usually it is recommended that you do a lumpectomy with rads or a mastectomy with DCIS.  I chose a bilateral mastectomy because I tested positive for the BRCA1 gene.  There are no guarantees of recurrence, but the likelyhood is much less for DCIS. 

Good Luck!