Dcis with implants... Options if I don't want radiation

Nicwin

I was diagnosed with Dcis 4mm in my right breast 2 weeks ago after my first mammogram ever. I am 37 years old. I am swirling through the ton of doctor visits trying to make life altering decisions as most of you are.

I want to talk to people that have breast implants and Dcis. My biggest concern right now is I don't want the radiation! I am being told I have to remove the implants and it is doubtful or a long time before I can consider putting them back in if at all. Is my line of thinking totally crazy?

During the first biopsy they said they thought they got it all but due to the algorithm used by the radiation doctor they say I should get radiation therapy (I am young so they want to be aggressive). The surgeon and plastics guy think they can do a lumpectomy and get better maegins. Why can't I just do that and then check back every 6-12 months forgoing the radiation? Since there is no baseline mammogram how do we know this has not been there for a long time? I know I am being vain but I cannot lose my breasts right now. It is a decision I am willing to make down the line but right now I feel like I am cutting off my arm because I lost a finger.

Any advice?

Moderators

Hi Nicwin-

We know it's a difficult time, and we so sorry you find yourself here. But we hope you find this to be a supportive and informative community.

You may want to check out our Radiation forum, lots of great info there: https://community.breastcancer.org/forum/70. There are risks associated with radiation and implants, which is why your doctors may be suggesting their removal before radiation: http://www.breastcancer.org/treatment/surgery/reco....

You may also want to check out our DCIS forum, to see what other members have decided in terms of treatment: https://community.breastcancer.org/forum/68.

We hope some of this info helps!

The Mods

MinusTwo

Nicwin - I had a BMX for DCIS with expanders & reconstruction several month later.

1) radiation is often given with expanders in place before exchange surgery

2) i had a recurrence 2 years after my implants were installed & needed ALND surgery. The BS was able to skirt around the implant. The implants caused no problem at all to the radiologist

Sounds like you need to get a second opinion.

MTwoman

I agree with MinusTwo, get a second opinion. There are always differences between circumstances that make what is recommended for one person different from what is possible/recommended for someone else, but it never hurts to ask another expert for their opinion. If they make the same recommendations, that may feel different to you, or the second opinion could give you some other option that is preferable to you.

We all have 'lines' in the sand that we draw (what we will/can or won't/can't consider) and no one will consider you "vain" for being attached to any part of your self image. Right now everything is happening pretty rapidly and it is hard to imagine some of the twists and turns that could happen along the way of your carefully crafted treatment plan. For example, I had DCIS. Got a second opinion on my pathology after my lumpectomy as I was 38, triple negative, wanted to use breast conserving therapy, but had a close margin and didn't want to have any micro-invasions or tiny areas of idc missed. I used an expert in DCIS for that second opinion and he recommended a breast MRI as the architecture of my tumor frequently presents as multi-focal. I actually got that report the day before I was scheduled to go in and have my radiation mapping appointment. That was cancelled and an MRI scheduled. They found several other 'areas of concern' in another region of my breast, which led to more biopsies and more areas of DCIS (which were actually pathologically a bit worse than the first lump) which made the issue of close margins no longer important. The final recommendation was mx, instead of lx and radiation (lx in too many regions of the breast tends to have a less lovely cosmetic outcome). Mx is not typically followed by radiation in DCIS, and I had TN, which meant no further meds either. That is a long way of saying, prioritize what is important to you, find a team that works with you in a way you find supportive, competent and reassuring, make a plan, and then be prepared (if need be) to reassess as more information becomes available. Taking good care of yourself and relaxing as much as you can (music, warm baths, soothing massage, walks, candles etc) will also help you get through it. Good luck!

Nicwin

Thank you both for your post. I am definitely going to take your advice and go for that second opinion

tapwhite

I have implants and my rad onc said there is a fairly good chance the radiation could cause issues with the implant but it could also be fine. If you have decided to go with radiation just know that you MAY have to replace your implant...it is not a definite from what I am told. Definitely get a second opinion. Good luck!