DX DCIS Stage0-Close to the skin - Need treatment help

Lizperez

Hi everyone:

Recently diagnosed and wanted to get input from anyone with DCIS close to the skin. Mine was found where the bra underwire goes (.9cm but .4cm near the skin). I am opting for nipple-sparing double mastectomy because I don't want radiation. But, now I am worried about the closeness to the skin and the ability to get clear margins. All of my genetic testing came back negative and I am ER+. The surgeon said he is going to add a wire the day of the surgery where the lesion is to ensure they take everything out and skin may go with it.

What do you think about getting Tamoxiphen or Radiation?

Moderators

HI Lizperez,Welcome to the BCO community. We are sorry about your diagnosis but glad that you reached out. We notice that you have not received any timely responses to your post today. Can we suggest a few other forums where you might get your questions addressed about Tamoxifen and Radiation. Check out the Hormonal Therapies forum and/or the Radiation Forum for some other possible threads. You also may want to look at the Surgery Forum for threads that might relate to your concerns about getting clean margins. Let us know if you need help navigating around here. Keep us posted. The Mods

Annette47

I wouldn’t worry too much about the DCIS being near the skin - when they perform the lumpectomy, a section of the breast, including skin, is removed - it’s not like they peel back the skin and put it back over the hole ... they remove a chunk and pull the sides together. Edited to add - I didn’t realize when I first read this you are getting a nipple/skin sparing mastectomy. I would imagine that they would still remove the area of skin right around the cancer though I don’t know for sure ....

As for Tamoxifen and radiation - I did both with minimal problems, but you should discuss the advantages/disadvantages with your medical team.

MnEM1108

I can't speak perfectly to your situation, but there are similarities. I have IDC near my nipple/skin and DCIS/IDC further back in the breast. From what I've heard so far there's no need to do radiation unless my IDC is actually in the skin and even then it's not 100% guaranteed. They will be removing the nipple due to the invasion. So, I would assume that with an Mx you will be good and not need radiation. And you can always just ask them to remove the skin near the DCIS just to make sure you have great margins.

Regarding Tamox, I don't know what the recommendations are for DCIS ER+. Hopefully someone else can chime in on that!

It's a lot going on all at once. Hang in there!!

LAstar

Mine was also close to the skin. My MX path report cited a narrow (<1mm) margin on the anterior (skin) side, which made me very concerned. My BS told me that acceptable MX margins were different than acceptable LX margins and not too worry. When I had revisions, I had them remove a little more skin around the area and nothing was found. No one recommended tamoxifen or radiation to me since I had BMX and margins were fine.