Tamoxifen, radiation, nothing ? What to choose ? DCIS

B-A-P

Yesterday was my first appointment with the oncologist. She was great and listened to everything I had to say which was comfoting. She talked to me about the option of starting tamoxifen , listed all the benefits and risks, and told me there was no urgency in starting right away. Next month I meet with the radiation Oncologist to see if radiation is the right way to go in my case. It's all very confusing. What option is my best chance? I'm only 30 so to go through the side effects of medication is daunting, as well as the risk of endometrial cancer, and radiation, as we all know isn't the healthiest. I know that benefits have to outweigh the risk. How likely will my DCIS or more, return with tx or without? that's the big thing. The bigger thing is waiting on more testing. I have to wait a couple months for an MRI to make sure there isn't more areas of concern, as well as genetics. This is all a huge waiting game. I feel like even though it is radical, i'd want a mastectomy to avoid the potentially danergous affects of meds and rads, and prevent recurrence that way. In my mind , it's like why did this happen at 30? did it start sooner than that ? what;s going on in my body to do this at this age?

I don't think mastectomy is on the table for my case at the moment ( unless genetics dictates high risk or more areas ). So if everything is clear, the choice is a lot harder. What do you choose? I obviously don't want it to recur, but i know that the treatments aren't 100% too.I'm rambling but it's a lot to think about and the waiting is killing me a little. THe oncologist told me it is completely fair to wait on making a decision until we get the whole picture, but i think it's a huge decision. It's the future of my life at stake. I know there is watchful waiting an monitoring which could also be beneficial. I guess the feedback i'm looking to get especially those with DCIS , is How did you choose your treatment ? what was your reasoning? How well did you tolerate it ?

Thanks for reading !

farmerlucy

If you were my daughter I would ask you to seriously consider the BMX. It avoids radiation and systemic hormone therapy. Thirty is really young for this stuff. You’ve got a long life ahead. Do you happen to know your breast density? Screening is not great with extremely dense tissue. Many might think the surgery is overkill, but it should get the whole BC monkey off your back. I was quite pragmatic about losing my breasts. As I saw it that was a better option than losing my life. While implants are not like the originals, they are fine, and I’ve 100 % adjusted to the new normal. I just would rather not have the risk of recurrence hanging over me. When I was doing the high risk screening I figured odds were good that something would be caught at DCIS. Nope. Wrong. Most women on these boards would jump at a chance for a do-over with just DCIS. Best wishes to you. Sounds like you are in good hands medically.

B-A-P

farmerlucy, thanks for your reply.

I am really leaning towards a BMX but they way everything came off, it seems like they aren't considering that for me unless my genetic testing or MRI comes up more concerning . That's why this has been a difficult thing for me, because I'd rather that then the potentially dangerous treatments offered. I don't see my surgeon until January, and I'm concerned she'd laugh off the whole idea. My DCIS was 6mm so fairly small in their opinion so a BMX would be too radical for their liking. I'm in Canada so we have universal coverage, and if the risk isn't high enough, it isn't covered. It's such a dilemma. I'd love to just separate myself from my breasts and be done with it. I feel like for the rest of my life, I'd me just waiting for it to return. They did mention close monitoring as an option to catch anything early. So it's all a big waiting game to see what the final options are. I just feel like besides MX, there isn't one right decision. It's tough .

As per your question about density. Yes, my breasts are dense which is why i'll be having an MRI instead of a mammo. She said they wouldn't be accurate for me which i agree.

farmerlucy

One of the things my doctor said would persuade my insurance company to pay for the preventive surgery was the fact that over just a few years the cost of screening would outweigh the cost of the surgery.