Mastectomy for DCIS

Zoe- I chose lumpectomy and rads as I didn't feel like I was ready to part with my breasts. I don't define myself by them but feel attached to them so wanted to keep them. If I have a recurrence though, I think I will be ready to part with them. I also feel for myself that to take both breasts off was too radical as there is a very good chance that there will be no recurrence. Best of luck to you with your decision, ask lots of questions and don't let anyone rush you or talk you into something you aren't sure of.

I had a lumpectomy first but the margins were not clear and, like baywatcher, the DCIS was extensive and grades 2 & 3. My surgeon strongly advised a mastectomy. I didn't want radiation either and am not on tamoxifen. I am nearly 3 years past dx and all is well.

Best wishes with your decision and I hope it all goes as smoothly as possible.

I had extensive DCIS, I also was not given a choice for lumpectomy.  In the end, it was a good decision FOR ME, as there was 8mm IDC in my pathology. 

Good luck with your decision, everyone is different, just as everyone's dx is different.

Trish

I had 3/4 margins after lump. still DCIS.  I felt if just maybe 1 margin might have tried again. I decided on bital Mx and had it 5/1.  I was told I woould have 30% chance of it recurring or 1% with Mx.....I did the math and the decision was easy.  My nodes were clear so no chemo and no radiation which was also a big part of the decision.

My path report after mx showed other areas of DCIS that had not been caught on MRI or mammogram so I know I made the call.  This is you choice with your body and do what is right for you. Everyone must make the call....this part of it is the worst!!!!The waiting until you what you are goig to do seems forever.  Breathe....

baywatcher --- I agree with you totally.  I was told my DCIS was multi-focal and I must have mastectomy.  So, I did.  It turned out that all of the DCIS was gotten with the stereotactic biopsy and I just had LCIS.  I wish I had made the doctor do a biopsy/lumpectomy against his advice.  If I had done this, I would have both my breasts, be taking Tamoxifin, and not have to deal with this extensive reconstruction.

I agree that this is such a personal choice and two women with exactly the same size and type of cancer can make two completely different decisions and still have it be the right choice for them.

That said, I personally do not plan to do a mastectomy unless my re-excision still cannot produce clean margins (so far, I had a lumpectomy with an 8cm x 7cm x 5cm chunk removed; 2/4 margins clear). 

Weirdly, even though my DCIS is a large area that pretty much covered half my breast, my surgeon has not suggested that I have a mastectomy. I'm sure he will if he's not able to get clear margins the second time. I *think* I'm emotionally okay with a mastectomy if he is able to do an areola-sparing one. (I'm okay with a flat chest and probably wouldn't even get implants, but a tattooed areola isn't for me... again, totally personal decision!)

I've already had a scare with my "good" breast... 7mm suspicious mass that was biopsied on Thursday. I am praying that it turns out benign or that it's something that can also be removed with lumpectomy. If it's benign, I absolutely wouldn't consider a prophylactic mastectomy. I've figured out WHY I got DCIS and have been making changes (that I will keep doing for the rest of my life) to prevent it from happening again. 

I just spoke to the surgeon's office and they told me my surgery would be Feb 5th. I was shocked about the wait because last time I saw the surgeon he had a sense of urgency.  She explained it is hard to get all the surgeons lined up together on the same day for that long of a procedure. At times I feel like I am a pingpong ball bounced between Dr's. 

Wow - you have been through the mill in the past few weeks. When did this second mass come up on the good breast?

desdemona, I had missed this -- and I've missed you! It's good to see your name here again! This mass was seen on my pre-surgery MRI.

I found out Thursday the 7mm mass is benign. Yehaa! But, I still have extensive microcalcifications so I'll have to do a mastectomy on the previously operated-on breast. My BS claims he absolutely can do it as nipple/areola-sparing, which as I had said before is my biggest concern, but it's good to know there's much they can do to make it look realistic. 

This is my 1st post.  I turn 35 this January.  I found a lump 4 weeks ago.  My husband insisted that I have it checked out.  Long story short, two masses behind my left nipple, DCIS, stage O.  Due the size of my breasts 36AA and the location of the lumps I am going with a masectomy, with reconstruction plus augmentation of the good side.  A lumpectomy on the two would leave me too disfigured. 

Surgery is scheduled for the 29th of Dec.   A new chapter in my life has begun.

I am 41 and was also diagnosed with DCIS, grade 3, estrogen +, and do not have the brca 1 or 2, based on testing about 2 years ago.  It was found on my mammogram Dec 10, stereostatic biopsy Dec 18, results Dec 21.  My mom had breast cancer at my same age.  Her sister also had breast cancer at about age 50.  I am opting for the double mx, but want the DIEP flap surgery.  In my area, there is only one surgeon who does the procedure bilaterally.  Unfortunately, we cannot coordinate my breast surgeon and the plastic in the same hospital, so I will have to do the procedure in two separate procedures.  Question about tissue expanders- is this necessary?  Since the plastic surgeon does not work in my breast surgeon's hospital, they cannot be put in at the time of the mx.  I am quite large breasted and dense, and had a reduction about 20 years ago.  Also, how much time should I realistically allow off work for both procedures?  As of now, it appears that it has not spread to they lymph nodes, and the surgeon will evaluate the sentinal nodes during the surgery.  Thanks...

My reasons for going with mastectomy:

I am only a B cup

My tumor was 5.3x.3.2cm in size with a high grade.

I had 3 positive nodes(found that at surgery)

I am small breasted so lumpectomies on me take a lot. I had one lumpect. but no clear margins so had the mast altho she offered another lump. Felt that I did not want lump. after lump.. Turned out good as there was much more DCIS than shown on mamms (MRi did pick it up tho)

Had MRI on both breasts to decide if I wanted bilateral. Lt one clean, so went for one mast on Rt. If it occurs in Lt, then I will get a mast on that side too.

Radiation makes it difficult to do reconstruction later.

Good luck!

I had DCIS on the right side.  I chose a bilateral mastectomy, mainly so I wouldn't have to worry about what might pop up later.  Plus, I tested positive for the BRCA1 gene mutation.  That solidified my decision!