Thinking ahead: pregnancy after DCIS?

Hi, Sunshinegal - first of all, that is great that you didn't have any microinvasions! WOOHOO!!!

I am in a similar situation as you, with a few differences. My DCIS was very extensive (I had a 4.5cm palpable lump but the DCIS extended a lot further), I am strongly ER+/PR+, and I am in my late 30's and hoping for a baby (or two!).

Here is the course of action I'm taking, with my thought process behind it:

• I'm NOT doing Tamoxifen in spite of the strong ER+ status. First of all, I'm three years older than you so I don't have as much time. I can't afford to lose even two years by taking Tamoxifen. Plus, I am a big believer in balancing my hormones naturally with diet/lifestyle (which has worked in the past for me, much better than drugs).
• I personally won't consider a prophylactic mx because I want to breast-feed. (BTW, giving birth then breast-feeding itself lowers breast cancer risk... obviously not for all women, but statistically speaking it does lower the risk.)
• My original fertility plan was going to have injectables (and if that didn't work, IVF). Now that I've had DCIS, my fertility specialist does NOT want me taking injectables/gonadotropins because of the increased cancer risk. So I will be doing a Femara cycle instead (for fertility patients, it works similar to Clomid but without the negative side effects, and it's more effective). Femara doesn't increase cancer risk; in fact it's a breast cancer treatment!
• If I end up having to do IVF (which I might, at my age), I will do low-stimulation IVF which is safer for BC patients. I know you didn't mention IVF and you're young enough that you'll probably have no problems conceiving naturally, but I wanted to mention it in case you consider IVF in the future.
• In the meantime, I am taking high doses of iodine. Iodine can clear up fibrocystic disease and ADH, and there's evidence it may be a breast cancer preventative (and deficiency may be a breast cancer risk factor). Iodine deficiency can also cause infertility, miscarriage, and birth defects. I now think that my DCIS and six miscarriages are largely due to the fact that I was very iodine-deficient and didn't know it. So, taking iodine (along with many other diet/lifestyle changes) gives me the confidence most women get from Tamoxifen that I won't get a recurrence.

Thanks for updating... so happy for you that you're going to try for a baby soon (so are we)! Why are you doing radiation -- I assume because you had some close margins?

I would definitely get tested for clotting disorders... I tested negative but my fertility specialist wanted me on baby aspirin anyway (thins the blood). I did baby aspirin for a while but am now eating foods that are anticoagulant instead (flax oil etc.).

None of my docs so far have talked at all about the role of diet or supplements in recurrance prevention.

This is one of my biggest frustrations with doctors!! None of my OB/GYN's/fertility specialists told me about the role of diet/lifestyle in fertility, either. Diet and lifestyle are SO FREAKING IMPORTANT for both cancer prevention and healthy conception. I hope you'll check out two places: the alternative/complementary board here at BC.org, and the alternative forum at www.ovusoft.com. You will learn so much there that I can't possibly explain in one post. (The awesome thing is that the foods, lifestyle choices, etc. that prevent cancer are the same ones to boost fertility!)

As for iodine, you can be tested through your doctor (if you can talk him/her into it) or a naturopath. You can take it as a tablet (Iodoral) or liquid drops (Lugol's - either of which you can buy through Amazon.com or health food stores). If you're hyperthyroid, you shouldn't take it, but for the vast majority of modern-day Americans who are likely deficient, there's not a downside unless you massively OD on it. 

I also have just finished my DCIS treatment as well, had genetic tests come back all negative and went to Onc. yesterday as we to wanted to discuss our future of having a family since I am 38, she felt it can lower my risk of future breast cancers and that while pregnant and breast feeding our ER levels normally lower which is good also she said after I have a child we may consider putting me on hormone meds, I guess since I had no invasive cancer this is still an option, I thought that was great that I will still have that option in 3 or so years and that will also help reduce my risk in the future since I am young. I am so happy that this did not stop my future with having a family.