Extensive DCIS - 4 cm - Mast. or Rad

I was diagnosed on Nov 19. DCIS stage 0 grade 3.  They thought it was a very small area from the mammograms, biopsy, and MRI. I had a clear plan - lumpectomy, radiation, tamoxifen.  I had my lumpectomy on Dec. 9 with no clear margins.  I had the reexcision on Dec. 21 and my margin is within a mm. My surgeon said it is obviously more interspersed  than they thought.  My immediate reaction was I want a bimx and she agreed. I look back and wish I had never done the reexcision because I was going back and forth at that point but what's done is done. It just seemed so drastic when you are diagnosed with stage 0.  I just talked to a friend last night who was stage 2 and she had chemo and radiation.  She said the radiation was ten times harder and the fatigue lasted many months after she was done. I know everyone is different, but I now know that I will have peace of mind.  I'm a worrier and I'm not sure I could ever settle down and believe it was really gone. I also talked to another friend who had the same diagnosis as us and she immediately wanted a bimx. When they did it, they found DCIS in the other breast and more in the diagnosed breast. It is definitely a personal decision. I have no history of any kind of cancer on either side of my family going way back. My BRAC test was negative. I go to the BS and PS on Jan.5 to get things set up for the surgery. I hope you are doing well and have a Happy New Year. Keep us posted and let me know if you have any other questions.

JillAnn, I was dx in 2007 with DCIS, I don't know what the extent was of my DCIS (how big it was), but I have a strong family history of breast/ovarian cancer (mother breast, aunt ovarian). I also have a personal history of abnormal mammo Jan 2005, biopsy with ADH (pre-cancer left breast), abnormal mammo Aug 2006 ADH (pre-cancer right), and third abnormal mammo Apr 2007 - DCIS right (same area as ADH 6 months earlier). My surgeon suggested I consider PBM after the 2nd dx of ADH. I was glad I had that 6 months to research my options before hearing the words, you have cancer. My decision was to do the bilat mast with recon with implants. My final path report showed more ADH in both breasts that didn't show up on the mammos. It is a very personal decision and you will hear pro-con for both procedures, you need to look inside yourself and make a decision that you are happy with and can live with.

Sheila

When I was dx'd in June, I went with what the surgeon suggested...lumpec & rads.  It was such a whirlwind, as I also went for my first mammo at 37, and there the bc was sitting there.  Because I didnt have one lump like some folks, but had DCIS/IDC in different spots, I just dont feel comfortable that all the cancer is gone (or ADH) or that I wouldnt have a reoccurance in the 50 more years I plan to live .  Also, the idea of going through mammos, biopsies, etc. every year did not excite me, so I decided to schedule a BMX and DIEP reconstruction for this February 18.  I believe my breast surgeon thought that because I was young, I would want to keep my boobs.  It did give me time to research my options while still getting treated, and now I KNOW I am doing the right thing for my peace of mind.  I dont know if I took them off in the beginning if I would have had regrets, but now I know I will not have regrets.

The bottom line for me was I didnt want to worry as much, didnt want to be squashed and stuck with needles, and wanted to feel that I had done everything possible to prevent a reoccurence.

I would have taken rads in a heart beat...thanks to a misdiagnosis 2 years before, I didn't get the choice.  However, I don't have any family history and (I'm sure this is completely illogical) I was weirdly reassured by the fact that my DCIS got as large as it did (>7cm 1st excision, >3cm residual in Mx) without ever turning invasive. LOL  I don't recommend you base your decision making around that.

MY advice to you is to take your time and discuss this fully with your surgeon...get a second opinion if you think another perspective will help.  I got a second opinion from another surgical team at the same hospital, my surgeon is a man and this other surgeon who is a woman (and breast owner LOL) had a different slant on things but ultimately her perspective helped me to arrive at the same place.  Good luck with your decision.