No more treatment after lumpectomy

Amain, I read where you had said this on another thread, and even though I didn't have clear margins, I'm considering taking that approach too. I DEFINITELY wouldn't do rads/drugs if I had such a tiny amount of DCIS that was removed with such large margins.

IMO, a good diet based on organic veggies, fruit, nuts, seeds, and minimal amounts of organic animal products, plus exercise, good sleep every night, and a low-stress life are better for staying cancer-free than all the rads/drugs in the world if you're eating junk food and live like a couch potato.

       Here is the van nuys prognostic indicator chart for DCIS? http://www.breastdiseases.com/dcispath.htm, there are other versions on the internet as well - so  a nice visual for you and those who might question your decision not to have radiation for DCIS of that size. With regards to why tamoxifen for someone who has had ER+ DCIS and no drugs for a colon polyp, I would think it is because tamoxifen has a proven track record for preventing ER+ breast cancer, and there is no similar preventative for colon cancer other than monitoring.  I am just providing an explanation for the difference in recommended treatment regimens, am not advocating that everyone ER+ take tamoxifen - since I am well aware of its unpleasant and sometimes dangerous side-effects!!!!  I agree that DCIS is the new in disease - the medical establishment is developing a great track record of finding/curing DCIS while not doing so well detecting and treating  young women with aggressive/invasive BC.

Jelson

Amain:
Just wondering what grade your DCIS was.......I put myself through torture until I finally decided to have the radiation and eliminate as much possibility of developing invasive cancer as possible. It was a very tough decision but since I had grade 3 comedonecrosis - which seemed the most likely type to recur as invasive -  I opted for radiation. I will always remain paranoid about what the rads may have done to me - but, then again, I would have lived with a different type of concern without it. Can't win! But congratulations on being firm in your resolve.

I should add, a friend of mine had Stage 1 about 7 years ago and opted for lumpectomy with no further treatment.  She is very rigorous about her diet and she is doing great!

Amain, I appreciate your perspective and I suspect that if my diagnosis had been the same as yours, I likely would have taken exactly the same approach that you did. 

Having said that, I think it's important to point out that all DCIS is not alike.  For a small amount of low grade DCIS, it is probably fair to say "an "in situ" diagnosis means just that, it's "in it's place" and probably won't become invasive. "  But many of the women who come to this website with DCIS don't have a small amount of low grade DCIS - they have larger amounts of high grade, aggressive DCIS (often with comedonecrosis).  The likelihood that an aggressive DCIS will become invasive is extremely high, and the timeframe for this could be quite short.  So to make a blanket statement about DCIS, suggesting that it's not serious and doesn't need any treatment beyond surgery, could lead someone with high grade DCIS to not take treatments that truly are necessary (radiation and/or Tamoxifen and/or a mastectomy), and that could very quickly lead to a diagnosis of invasive cancer.  In fact, it's been very well documented through many studies that 40% - 50% of all DCIS recurrences are not found until the DCIS has already progressed to become invasive cancer.

My wish is that eventually, once more is known about DCIS, DCIS will be divided into two different diagnoses, one being a pre-cancer, for those cases which are unlikely to ever become invasive or likely won't become invasive for many years, and another for those cases which are high risk and which must be treated just like any other cancer.  If that ever happens, we will hopefully be able to avoid some of the over-treatment that happens today when women are diagnosed with low risk DCIS (i.e. small amounts of low grade DCIS) while at the same time ensuring that those diagnosed with more serious cases of DCIS don't put themselves at risk by under-treating their cancer.   Until then, the best we can do is try to drive all women diagnosed with DCIS to make their treatment decisions based on their own specific pathology and not simply on the fact that they have been diagnosed with "DCIS". 

By the way, like many of the other women who have passed through here, my diagnosis changed as I went through the testing/diagnostic process.  My stereotactic biopsy showed only ADH; my excisional biopsy showed two areas of high grade DCIS w/ comedonecrosis along with a microinvasion of invasive cancer (meaning that my DCIS had in fact already started to become invasive) and my final surgery (a mastectomy) revealed a much greater area of high grade DCIS - basically the DCIS ran through the ductal system of my entire breast.  I mention this just to point out that breast cancer can be sneaky; what's initially seen on a mammo and found in a needle biopsy is not always all there is to it.  In approx. 15% of cases where DCIS is the initial diagnosis after a needle biopsy, the final diagnosis will be invasive cancer.

Again, all this isn't to suggest that those who have a small amount of low grade DCIS should worry or think that they have to undergo mastectomies or radiation or take Tamoxifen.  It's simply to point out that DCIS is not a single or simple diagnosis - some cases truly are low risk but many cases are not.  And what that means when it comes to treatment of DCIS is that One Size Does Not Fit All.