Can I wait this long?

clarecy, particularly since you've had the excisional (surgical) biopsy, you are fine to wait.  With the excisional biopsy, most of the DCIS - maybe even all the DCIS - has already been removed.  I'm assuming that more surgery may be necessary because you have a close margin, but it's not a positive margin (i.e. there aren't DCIS cells right up to the edge).  You also have grade 1 DCIS, which is not aggressive at all.

Back when I was diagnosed, I had an excisional biopsy for two areas of concern.  Both came back with lots of grade 3 DCIS with comedonecrosis (the most aggressive DCIS there is) and all the margins around both areas were dirty (i.e. there were DCIS cells right up to the edge).  The pathology also uncovered a microinvasion of IDC, which meant that my DCIS was already starting to evolve to become invasive cancer.

After the excisional biopsy, I decided to get a 2nd opinion on the surgery options (I was hoping to avoid a mastectomy) and that lead to an MRI and another biopsy (of my other breast - that biopsy was benign).  From the MRI it was very clear that I needed the MX, so I had consults with the plastic surgeon and the PS and BS had to coordinate their schedules in order to operate.   All in all, it turned out that I waited 2 1/2 months between my excisional biopsy and my mastectomy surgery.  None of the doctors I dealt with where the slightest bit concerned.  And as it turned out, while my MX uncovered a lot more DCIS, there were no more areas of invasive cancer so there was obviously no progression during that the wait.

My situation was not unique.  I've been on these boards a long time, and I've seen lots of women wait 2 months or 3 months for their DCIS surgery.  So don't worry.  A few weeks and even a couple of months delay is nothing to be concerned about with DCIS, particularly since you've already had the excisional biopsy and the core of the DCIS has been removed.  And with grade 1 DCIS, most docs would say that a 6 month wait would be fine.

Do you have another doctor you can talk to about this? If you are in the situation Beesie described (clean margins following excisional biopsy), you're probably fine. But if not, you should be asking a doctor this question concerning your individual risk factors. Most women can wait, but we are all different. I was advised, in my case (high grade DCIS, large area, dirty margins, etc.), to go no more than six weeks from time of diagnosis to treatment.

Hi Clare, the 0.9 mm margin is close, and it will be addressed by surgery, or if in the unlikely event it can't be addressed by surgery near chest wall, then radiation boosts.  They do this all the time. Only three weeks now.  Best of luck to you!