Diagnosed with Ductal Carcinoma In Situ

regina3583

Hello to all! How are you? Hope all is well.

I am diagnosed with Ductal Carcinoma InSitu (left breast). I went yesterday to a Surgical Oncology Specialist to check on my case and will give me options for treatments. He gave me 2 options: 1st - Mastectomy (with implant) , 2nd - Lumpectomy with radiation. As he was discussing with the treatments, he somehow ended up with the 1st option (with the possibility of doing double). I mentioned to him the option of doing Lumpectomy + pills, instead of lumpectomy+radiation, due to the following reasons: - heart is located in the left side, 2nd- side effects of radiation to my health. He sounded like he was not in favor of that option. I am right now confused of what treatment to choose. I am anxious. I need some guidance, I need to hear some opinions. I am 38 y/o, divorced w/ no kids. I still want to have my own family. Thank you. Inputs, wisdoms are much appreciated.

*note: Lumpectomy + Pills was suggested with my Primary Doctor.

Breast Cancer Biopsy Summary:

• Specimen Type: Core Needle Biopsy
• Breast Laterality: Left
• Invasive Carcinoma present?: No
• DCIS Present? : YES
• -Extent : measures up to 0.9 cm
• -NUclear grade: 3
• -Necrosis: Present, comedo type
• - Architectural pattern: Solid and micropapillary

LivinLife

Welcome regina! You're obviously not comfortable with the surgeon and the decision HE reached FOR you.... I'd encourage you to get a 2nd opinion with the goal of being able to have a discussion of options so YOU can reach a decision YOU are comfortable with. This is one of the few surgeries where we get to make a choice though that is many surgeons, not all operate that way (literally). It's important you gather more information, including recurrence types of stats, for each surgery as well. Make a list of concerns and positives you have for each option as well. You'll be able to see a lot of fact-based and statistically information on this site, esp. referenced by Beesie....

I had DCIS and had to have at least a mastectomy. I have scleroderma and so could not have radiation. I opted for bilateral due to not wanting reconstruction due to healing issues, not wanting to be left with one large breast, several call backs and two biopsies on the non-DCIS breast, etc. I have no regrets mastectomy and bilateral mastectomy are decisions others would be very uncomfortable with. Thus it's important you do your research, ask questions, see what you're comfortable with, get a 2nd opinion, etc. Hopefully others will weigh in too....

Moderators

Hi regina3583, and we're sorry you find yourself here. What has the doctor(s) told you about your diagnosis? Have you done any genetic testing? Here is some information that you may find helpful: Your breast cancer diagnosis, Fertility issues to discuss before treatment, Treatment and Side Effects, Mastectomy vs. Lumpectomy.

Also, if you feel it is helpful, many people seek a second opinion. Hoping others chime in. You may also want to join the DCIS Forum.

And consider signing up for our WEBINAR: Breast Cancer Surgery: How to Make an Informed Decision.

When: Jun 24, 2021 04:00 PM in Eastern Time (US and Canada)

Register HERE

Warmly, The Mods

cgifford7

Hi Regina. I was diagnosed May 12 with DCIS, grade 2, 5 cm (basically runs from my nipple to chest wall in my tiny breast). Based on all the research I've done for myself, the two options he gave you are the two standard options for most, barring other circumstances. Lumpectomy was not an option for me because mine is multifocal and too much breast tissue would have to be removed to save the breast. My understanding is that in a lumpectomy without radiation the chance of recurrence is much higher than with radiation. I have not read at all about lumpectomy plus hormone therapy (if that is what you meant by pills) and no radiation being a standard of care option. No doctor can make you do anything, but they will tell you if they think a choice has higher risk associated with it.

Keep in mind that you have time to get a second opinion, and even a third opinion of you want, and you definitely should not stay with a doctor who tries to steer you into what they want as opposed to providing you all the information necessary to figure out what is best for you. I took about two weeks to decide between a single or a double mastectomy. I ended up deciding on a double (surgery on July 7). Even though things feel overwhelming and scary, DCIS is not a crisis situation, you really do have time to get your feet under you, do your own research, meet other doctors, and figure out what is best for you.

Salamandra

I totally agree with LivinLife about seeking a second opinion.

I would say not to count on being able to do pills though - not everyone tolerates it. If you decided to forego radiation, just do it with the knowledge that you might be left with surgery alone.

Also the pills cannot be taken during pregnancy and breastfeeding.

LivinLife

regina it would be helpful if you include the Grade, size, ER and PR percentage too. If you would go into your profile (I think that's the area??) and make this public it will help others respond more accurately too.... For example there's a big difference between a .5 cm area of Grade 1 DCIS that is 40% ER positive and 50% PR positive than a large area (e.g., 5 cm) of Grade 3 with comedo necrosis.... Lumpectomy and no radiation with the latter would likely be much riskier than the former with really good margins.... Just an example of other important considerations....

regina3583

hello! thank you for your inputs, I really appreciate it. I was diagnosed last month as well. Yes, it's lumpectomy + hormone therapy. I will make an appointment for second opinion. Praying for your successful surgery and healing. hugs.

regina3583

hello! thank you cgifford7 I really appreciate it. I was diagnosed last month as well. Yes, it's lumpectomy + hormone therapy. I will make an appointment for second opinion. Praying for your successful surgery and healing. hugs.

regina3583

Thank you @LivinLife, @Salamandra for your inputs. I appreciate it. I am getting an appointment for second opinion. Yes I will post here some details of my diagnosis. Thank you ladies. ❤❤

DelMar2021

Hello Regina, I too have been recently diagnosed with DCIS in both my left and right breast. For the moment the surgical oncologist has given me the two options as well (she seems to lean towards lumpectomy on both), unless my Gene test comes back positive and/or my MRI results show other areas of concern, would she then make a stronger suggestion of what will be best for me. So far your results are very similar to my. I share your concerns about radiation, and I am also very concerned of the hormonal pill and it's side effects, at the same time a mastectomy is not something I would like to have done. It almost seems impossible to believe, a few weeks ago I was feeling just fine.

Prayers my friend 🙏

Moderators

Dear DelMar2021,

Welcome to the BCO community. We are sorry for your diagnosis. We are glad that you reached out to share your story with others. You will find a great deal of support and helpful information here as you move along and make decisions and being treatment. Keep us posted and let us the Mods know if you need any help finding your way around here.

The Mods

LivinLife

I want to welcome you too DelMar!!!

regina3583

Thank you all for those who reached out and gave opinions on my query. Just an update, yes I did took the advise of getting a second opinion and it still turned out to be the same diagnosis.

I had my Mastectomy (left breast only) last August 25. Recovering now and is back to work. I have to undergo chemotherapy treatments but I did not schedule yet because I am still anxious.

But maybe next month or so i will schedule it. i am just worried about the side effects of the first treatment.

Thank you all for your prayers and encouragement. Much appreciated.

love, regina

Beesie

regina, did your diagnosis change with the final pathology? You mentioned chemotherapy and that treatment isn't given for pure DCIS so I'm guessing that some invasive cancer was found?