DCIS, BMX, rads?

howhm02l

I had an MRi on June 15 with large area that was suspicious 5 cm x 4 cm x 3 cm. Mammogram with biopsy was done 10 days later that showed "extensive" micro calcifications with largest measurement of 8 cm. Numerous samples taken for biopsy showed DCIS, grade 2 with central necrosis.



Due to the size of the lesion and my BRCA2+ status, I will have BMX on 8/16. I understand the treatment will ultimately depend on margins and whether the final pathology shows an IDC.



Just wondered if anyone who has had MX with DCIS diagnosis had to have radiation due to margin size?



Thanks,



Heather

BLinthedesert

If your DCIS was close to the chest wall then there is a possibility that the recommendation would be radiation after MX.  Usually though, good surgeons can get down to the facia of the chest wall and get good margins (my surgeon had to go pretty deep but was able to do it).  It is pretty rare to get radiation after MX for DCIS.

Good luck to you ... I hope your surgery goes well. 

howhm02l

Thank you - I was thinking that it was unusual with MX. My DIEP is currently scheduled for 2 weeks after BMX because PS wants to wait until after Final pathology to see whether radiation is necessary.



Just getting anxious . . .

BLinthedesert

I know -- the waiting is worse than the surgery/results/treatment (most of the time). 

Are you going to the Vanderbilt Breast Center?   They are top notch (I used to work for Vanderbilt and worked with many of the clinicians/pathologists/researchers in the Cancer Center - on campus).  

LAstar

I'm curious about this too.  I had BMX with hip-flap reconstruction in June but the superficial/anterior margin was only 1mm.  My BS thought this was fine, but my husband and I are concerned.  When I have Stage II surgery, I will have the area re-excised and hope for a clear margin.  The BS said that, if I didn't have a clear margin this time, it might be necessary to replace my flap and the skin (which is why waiting 2 weeks is such a great idea!).  My local BS wondered if radiation would be better.  I hope I don't need to make this decision.  Thanks for posting this interesting question!

howhm02l

BL - yes, I am going to Vanderbilt. I have had great experiences so far, and a not so great experience at Baptist on the ovarian testing side. Meszoely is my BS, and I have heard nothing but great things about her technical skill.



LAStar - I was initially bummed when the PS said he wanted time in between because that means two surgeries, two sets of drains, etc, but I think it will be the best long term result. He said he would not want to risk damage to the flap from radiation. As my surgery date gets closer, I am becoming more anxious about the pathology report.



Heather

LAstar

It's a long recovery regardless, and it may end up being easier to give your body a little time to recover from the BMX then deal with the reconstruction.  We have to keep our eyes on the long term with this stuff, and it will be worth it all.  I'm 7 weeks out and feeling worlds better about everything.  It was not a picnic, but doable and really nice to wake up with cleavage.  You'll be on the other side of this in no time.  I hope you are getting some fun in while you wait!  I was nervous about the path report too but nothing invasive was found and my 2 nodes were clear.  Best wishes!