Has anyone decided not to have rads after lumpectomy for dcis
wondering if there are any sucess storys for anyone who had lumpectomy for dcis and chose not to have rads. I have health factors that i fear would only get worse through rads, have diabetes, high blood pressure, i am at risk for heart diesease now,afraid of long term effects from rads. Going back to see RO next week
Comments
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You might want to send your slides to Dr. Michael Lagios to find out what he thinks. He feels that some women can go without rads and still be ok with DCIS. His website is here:
http://www.breastcancerconsultdr.com/
I am sending him my path slides because I want a second opinion although not about rads. I have decided to do that regardless of his thoughts. I am worried about Tamoxifen and or an AI more than rads. He is one of the doctors that developed the Van Nuys Prognostic Index where you put in your stats and it tells you what your number is and the lower the number, the less likely you have to have a recurrence. Here is the index and you can see where you stand.
https://sites.google.com/site/dciswithoutrads/van-nuys-prognostic-index
I wish you the best of luck with whatever tx you decide to have.
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I had a very small (3 mm) DCIS in 2005 and all of my docs felt that no radiation was needed. In October last year, I had two new primaries. One was DCIS and one was IDC. Neither was considered a recurrence as they were in different parts of the breast. I very much doubt radiation would've prevented them as it wouldve targeted the area of the first DCIS.
Unfortunately, there are just no guarantees one way or another. -
http://jnci.oxfordjournals.org/content/96/12/906.full
This is one of the best articles I have read to date about forgoing rads and/or tamoxifen. The fact of the matter is they just don't know all that much about DCIS although they are finding more every single day. What they have right now still shows a huge benefit of rads in recurrence rates (50%) no matter what study they use. I am leaning toward doing them. Tamoxifen is a different story and I may opt out.
Hope this helps you in some way. Warning: It is long and detailed but worth a read
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I think there is a lot of evolution of thought in this area...from what I can gather, and from what both the RO at my breast center and Dr. Lagios (from whom I sought another opinion) told me, is that much depends on the size of the DCIS, the grade and the surgical margins. I was fortunate that mine was small, low grade and wide margins (9mm) were acheived, so it was not recommended that I do rads.
I am still trying to work through the Tamox decision, though. I am having an MRI in a week becasue they also found some ADH in my other (left) breast during teh stereotactic biopsy, and my surgeon wants to take that out as well to make sure there isn't anything more/worse. If it is truns out to be DCIS, I might be inclined to give the Tamox a try to see how I tolerate the SE's.
The link tyhat April provided has very good info. Good luck, sorry that you received this diagnosis.
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After I had a lumpectomy in 2007 for DCIS, I consulted with Dr.Lagios. He used the Van Nuys Prognostic Index (VNPI) and calculated my risk of recurrence as only 4 percent without radiation. Because my risk was so low, I opted out of radiation, mainly because the 50 percent risk reduction that radiation provides would have only been 2 percent for me.
If your risk is also low and you feel comfortable opting out of radiation, you may well be able to also skip it too. However, if your actual risk is higher, it might make sense for you to have radiation. Since you can only have it once, you will want to carefully consider your risk without it vs. the benefits and risks of radiation.
Please feel free to PM or email me at lovetennis60@aol.com if you have questions. You can also read more of my story if you like at http://dciswithoutrads.com/.
Best,
Sandie
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Hello,
I had DCIS stage 0 grade 2. 2 lumpectomys and no radiation....I decided not to take tamoxifen because I did not want to deal with the side effects. I see you did take tamoxifen, are you glad you did? How are you doing now? I am 47 soon 48.
Julie
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I would like to know how you are doing littlejukie?I had lumpectomy..A year later I decided to got with the tamoxifen with no radiation..My dx was just about the same as yours...DCIS stage 0 intermediate grade..(I just started tx 5days into it)
Thank you
Barbi811
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Barb, i am doing fine with no tx at all,iam just going to be closely moniterd,get another mammo next month, i will post my progress.
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traze2222, I'm glad you checked in to let us know what you decided to do and how you are doing. Good luck with the mammo next month!
More and more, I'm seeing women come to the board wondering if it makes sense to pass on Tamoxifen and/or radiation after a lumpectomy for DCIS. Of course every DCIS diagnosis is different, ranging from a tiny single focus of low grade DCIS to a large area of high grade DCIS that is multi-focal. Surgical margins differ as well. "Clear" margins might be 2mm in one case and 2cm in another case.
For others who are considering making the same decision you've made, do you mind sharing the specifics on your diagnosis and margins? How large was your area of DCIS, what grade and what were the margins?
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Hi Beesie
Mine was 9mm of intermediate grade DCIS - closest margin was 3mm. Only a lumpectomy, no rads and no tamoxifen.
I've got my one year check up coming up next Weds - fingers and toes firmly crossed. xx
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Janet, good luck on Wednesday. My fingers and toes will be crossed for you too!
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I did not have rads or take tamoxifen after my DCIS diagnosis. It has been almost a year since my lumpectomy and I had my second 6 month mamo today and everything looked good. Sometimes I have pain in that breast so my mind will go to the valley of what if's. But the doc said the key is sometimes and it's nothing to worry about. A year ago when I was diagnosed I couldn't think of anything else. I thought I would never be free from that fear. But it's now not something I think about constantly. However a few days before I was to have the mamo I became anxious. But the Lord helped me through.
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