stage 0 dcis after lumpectomy
is radiation necesary if so what is the best type. what types of radiation are available
Comments
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It depends. In some situations radiation is strongly recommended. In other situations radiation isn't recommended. Most cases fall somewhere in between.
There are a number of factors that come into play in determining whether radiation will be recommended and how much benefit each individual patient will get from radiation. The factors include:
- the size of the area of DCIS
- whether the DCIS was in a single focus or whether it was multi-focal
- the grade of the DCIS
- whether there was comedonecrosis
- the size of the surgical margins
The age of the patient can also play into the decision since some studies have suggested that breast cancer tends to be more aggressive in younger women.
What has to be determined is the recurrence risk that you face if you don't have radiation, and the recurrence risk that you would face if you do have radiation. Then you can decide if radiation makes sense for you. For those who have a very favorable pathology and good surgical margins, even without radiation the recurrence risk could be as low as 4% - 5%. But for those who have a very aggressive pathology and poor surgical margins, the recurrence could be as high as 40% - 60% without radiation. On average, radiation reduces recurrence risk by about 50%. So whether radiation is necessary or not depends on an assessment of your particular case - the answer is different for each of us..
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The major types of radiation are Whole Breast external Irradiation (WBI), Partial Breast internal Irradiation (PBI), and Intraoperative Radiation Therapy (IORT). Within those types there are a variety of options and protocols.
Your choices for radiation depend on many factors, including your age and the size of your tumor, as Beesie said above. If you've had a biopsy and can post the pathology information from that, the women here can give you their thoughts about the various kinds of radiation you might be offered.
Or, have one or more kinds of radiation been suggested to you already?
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There is also an accelerated version of radiation. you go five days, twice a day and that's it. I was going to be in a study for it, but because I was HER2 i was a little uneasy about it. I think data is only 5-7 years if that. My RO was doing the study.
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