Newly diagnosed multifocal DCIS w/comedo - why 2nd opinion?

nesw, if you are uncertain about the MX and want to know if a lumpectomy is even a possibility, then it certainly makes sense to get a second opinion.  My situation was quite similar, except that I'd already had an excisional biopsy (a surgical biopsy) that uncovered high grade DCIS in two different areas of my breast, along with a microinvasion of IDC.  There were no clear margins anywhere around those two removed areas so obviously there was more DCIS left in my breast.  My first surgeon told me that a mastectomy was necessary. I wanted a second opinion on that, and I knew that if I were to have a MX, I wanted immediate reconstruction (which was not an option at my first hospital). So both those factors drove me to seek a 2nd opinion at a different hospital. The new hospital had their own lab go over my pathology slides so I got a second reading of the pathology through them - they confirmed everything from the original pathology report. I hadn't had an MRI up to that point and the 2nd surgeon sent me for one.  The MRI showed "stuff" throughout my breast. The surgeon explained that there was no way to know for sure if the "stuff" was more DCIS, but we both guessed that it was.  He too recommended a MX but understood that I would prefer to have a lumpectomy and offered to attempt one, just to see if he could get clear margins. However from the previous pathology and the MRI we both knew that the odds were really high that I'd still have DCIS in the margins, so at that point I agreed to the mastectomy. 

While the 2nd opinion didn't change my treatment plan, it did help me come to terms with it - I realized that a MX was the only reasonable option. I needed that extra time and the 2nd opinion to get me there. So for that reason, for me the 2nd opinion it was really valuable.  

It sounds like you too are struggling with the recommendation that you have the MX, so I think a 2nd opinion might be helpful. You never know, a different surgeon might be willing to attempt a lumpectomy. Once it's done, if you don't have clear margins, you'll know that the MX is your only choice. Or, if you do have clear margins, you'll be able to see how much the size and appearance of your breast has been affected and based on that, you can decide to move on to rads, or have a MX instead.

Hope that helps!

nesw,

Go for the second opinion, what can it hurt? You might get more information to help you make an educated decision. I started out with left side atypical cells, so had to have an excisional biopsy which is basically a lumpectomy and didn't get clear margins. BS sent me for an MRI found a spot on my right breast had a biopsy and it was B9. But after studying all of my test results he told me a simple mastectomy was my best option. He said the problem with DCIS is that it's hard to get it all, in his words, "it's like a dog chasing it's tail." He said his main concern was recurrence. Take your time and get the information you need to be OK with the decision you make.