DCIS Remaining after Lumpectomy

I am not in your position because I didn't have IDC, just DCIS.  I did have close margins but was told that radiation with a boost would "sterilize" any DCIS left behind.  If I were you, I would talk to your oncologist and ask him/her about your concerns.  Margins are the most complicated part of DCIS decisions, and as hard as I tried I never really felt like I understood what was involved.  My oncologist said that the size of the margin is dependent on a number of things, including how the tissue was handled by the pathologist.  

I had one close margin and the BC surgeon put my case before the tumor board because she needed input from others. My cancer was DCIS but because it was grade 3, multi focal and multi quadrant, she just wasn't convinced that she got it all. She explained that with so many tumors it was just as likely there were additional tumors in the area she didn't touch. She booked me an MRI but before the appointment date the tumor board came back with their recommendation. Everyone on the the tumor board recommended a mastectomy. 

I did have the mastectomy and it turned out that there were no additional cancer cells . . . all cancer was infact removed by the lumpectomy.  So you can see that it is just as likely all cancer was removed during your lumpectomy. 

Discuss it with your BS further and have all the facts before making a decision as it all depends on which margins My posterior margin was 1mm and my anterior/subcutaneous margin had extensive IDC and DCIS involvement. My BS explained that he removed all the visible cancer and felt confident that Rads would clear the subcutaneous margin as it was just below the skin surface.The posterior margin is the one close to the chest wall and there was no more tissue to take. My Rad Onc said close margins are considered OK and Rads take care of them.

I have trust in my medical team who all agreed no mx was necessary in my case, approaching the 3 yr mark since dx and I'm great.

Good luck with your decision either way. 

Lou 

I was recently dx'd with DCIS in my left breast, stage 0, grade 3 but after a lumpectomy by BS told me that DCIS was found in 20 out of 22 slides so she definitely didn't get it all and doesn't see how it would be possible to get it all with another lumpectomy, so I am now facing the fact that I will have a mastectomy.  I have an appt with the PS next week and have lots of questions.  I am also worried about the "good" side since the DCIS was only found through the lumpectomy.  I did just have an MRI so I am hoping that will shed light on both breasts so I can decide whether to have a unilateral or bilateral mastectomy.  This is so consfusing and I am very nervous!  I think the MRI will be helpful and I will have both breasts removed if it means DCIS is in both bc I don't want to go through this twice if I can avoid it.  BIG DECISIONS TO MAKE!!