DCIS- Surgeon Recommend 2nd Surgrey!

Regina -

You have to make the decision on the mastecomy yourself.  However, here are just some of my thoughts that may help you. 

I had a re-excision of mine also.  I have clean margin of 1/2 cm.  My DCIS was 4.5 cm, but I have large breasts to begin with (DD).  I will eventually have a reduction in my left breast because the right shrunk so much.  Even though my DCIS is not as extensive as yours, I opted to do the radiation treatments instead of the mastecomy. Again, this was a personal decision.

Do you have a med oncologist yet?  If so, I would speak to that Dr. before deciding on what to do. If you do not, then sit down with your BS and talk in depth on this subject. What my BS said was that if my DCIS was over 5cm, they would recommend the mastectomy.

Make sure you have all of the facts before deciding anything.  You do not have to rush into a decision right away.  Get a second opinion from another BS if you need to.

Good luck in your decision.  I hope I have helped a little.

Good luck tomorrow Regina!  I have to go for re-excision also, on Jan 11th.  Let's hope for nice, clear margins!!!

Regina,

I agree that it is a totally personal decision, but I would base it on several things.  You don't mention whether your DCIS is low, intermediate or high grade (Grade 1,2 or3). If you don't know, find out.  If you were not given one, get a copy of your pathology report.  You are entitled to see all of your medical records, but the path report and perhaps the operative report will give you additional information.  Do you know what your Van Nuys score is?  (See http://www.theeffectivetruth.info/brcavnpi.html)  If not, ask for the pathologist to amend his report to include one.  Once you know those things, I would see a second surgeon for a second opinion.  With those things, you will be making a decision based on information rather than emotion and fear. 

I had more than 10 cm. of intermediate/mostly high grade DCIS.  Two lumpectomies failed to get clean margins and my Van Nuys score was 11 out of 12.  Multiple surgeons and oncologists recommended MX.  I fought it for minths, but finally gave in and had a unilateral MX/immediate DIEP.  They found even more DCIS than was seen in MRI, but I had no microinvasion and no nodal involvement.  There are no guarentees, but now that it is behind me, I have no doubt that I made the decision that "guarentees" me the lowest future risks.

Good luck. 

Regina the Van Nuys score is very helpful reading.  I hadn't heard of the scale but my drs did explain all the elements of the decision to me, so it was no surprise a couple of weeks ago when i went thru the score and found myself sitting on 11.

In my case, the original WLE (partial mastectomy) removed a piece of tissue that was an inch deep, 3 inches long and 2.5 inches wide (7cm tumour). When none of the margins came out clean, the surgeon felt removing any more tissue would severely compromise the shape and size of my breast AND a mast with reconstruction would give me a better result.  Plus he wasn't confident a re-excision would even get it all ...meaning they would have to do a Mast anyway, but with the trauma of an extra surgery and therefore a longer recovery.

As it was they found an extra 3 cm worth of tumour in there from the Mast so I'm happy I made the right decision...BUT...if my surgeon had recommended a re-excision I would've taken it in a flash.  Once that breast is gone it's gone, and no amount of wishing will give you your nipple sensation back. ((hugs)) All the very best for making a decision which is right for you.