Radiation...do it or not

ValerieI

In July I went for annual mammogram. A lump was discovered, flash forward I was told I have DCIS. October 6th I had a lumpectomy with lymphnods. Pathology says the tumor was completely removed, no signs of further cancer, markers are ok.

Now for radiation..My appt with radiologist oncologist is this Monday. I will have to travel 70miles each way, through a mountain pass Monday-friday for 4-6 weeks. I'm primary cars taker for my mom who has dementia and there is a 20% copay for treatments which are 10minutes. I'm stressing that leaving my mom alone 3hours a day and the low risk for reoccurring. They already started me on cancer drug.

Any opinions? Any questions I should ask the radiologist? Am I stressing for wrong reasons? Im not looking for "what would you do" , but credible information from those who have gone through treatment who can share thoughts of how they made the decision to proceed

moth

You should ask what percent benefit the RO expects from the radiation treatment.
There is a radiation benefit for breast cancer calculator but the site seems down for me right now https://www.tuftsmedicalcenter.org/ibtr/

You can also ask if you qualify for something which is sometimes called the Canadian protocol - it's radiation for fewer treatments.

Radiation appts are very quick in & out but radiation is a powerful treatment.

Cowgirl13

Definitely ask about the Canadian protocol which is about 19 rounds. I had it and it was very easy.

Beesie

Valerie, did you have a needle biopsy first that provided the DCIS diagnosis? Do you have the pathology report from the biopsy? And do you have the pathology report from the surgery?

DCIS doesn't usually form as a palpable lump - that only happens in about 10% of cases - and usually lymph nodes are not removed when someone has a lumpectomy for DCIS.

DCIS is also always Stage 0 and not Stage I, and you are posting in the Stage I forum so I'm guessing you may have been told that you are Stage I.

Are you certain that you did not have some invasive ductal carcinoma (IDC) along with the DCIS? The two are often found together, but when that happens, the diagnosis is IDC, not DCIS, because IDC is the more serious condition.

As for radiation, if you have pure Stage 0 DCIS, and it is only a small amount and it is low grade, and you have good surgical margins (all things that are on the surgical pathology report) you might be able to skip rads with relatively low risk. But if your DCIS is high grade or if the surgical margins are small, then you would face a significant risk of recurrence if you passed on radiation.

If your diagnosis is in fact Stage I invasive cancer, it is much riskier to skip rads. Here again, if you have only a tiny IDC (not likely if you had a palpable lump) and it's grade 1 and you had wide surgical margins, then your recurrence risk without radiation might be acceptable to you. But with any other pathology, your recurrence risk could be quite high.

So, in terms of questions, first, you need to get your pathology reports, or talk to your surgeon or Radiation Oncologist or Medical Oncologist, so that you are clear about your diagnosis, the type of cancer, size of the cancer, the grade of the cancer, and the surgical margins. With this information, the RO or MO should be able to provide you with an estimate of your recurrence risk, both without radiation and if you have radiation. Then you can decide if the recurrence risk without radiation is something you can live with. If it's not, then the Canadian radiation protocol might be a good option for you.