Newly diagnosed DCIS

Miranda5579

Newly diagnosed left breast DCIS (4mm, grade 3, necrosis present) ER weakly positive, 2%, after excisional biopsy. Core needle biopsy revealed ATypical Apocrine Adenosis (rare, high risk benign breast lesion), which is what prompted the excisional biopsy.

I'm healthy. Just turned 40 years old in May. Strong family history. (Maternal aunt, grandmother, first cousin). Meeting with genetic counseling on Monday. I anticipate a negative BRCA.

Treatment options A) re-excision to "clean up my margins", radiation and possibly Tamoxifen. unilateral mastectomy

I am an Oncology RN. On strong recommendation from coworkers, my medical oncologist I work with, they recommend a BMX. (Based on family history, the DCIS, and the extensive atypia noted in my pathology report). Met with my breast surgeon today, she will support me, but is not 100% on board with removing the healthy breast.

I do realize the cancer is small, treatable. But I'm looking long term. I'm young. I don't want radiation and I don't want hormone therapy. Has anyone had a similar story and opted for the more aggressive approach despite backlash from surgery?

Thoughts? Opinions?