Lumpectomy and Tamoxifen but no radiation?

Hi Shira   I had a lumpectomy with no rads, mainly because my RO talked me out of radiation. I was totally prepared to be told it was necessary, but he spent 3 hours giving me statistics on older women -- I'm 66-- with early stage BC doing just as well without rads, and warning me about the long term risks pertaining to my individual situation. My onc was not pleased, but my BS understood. I am taking Tamoxifen for at least two years due to osteoporosis. My decision probably would have been different if I had been younger. I'm sure my age had a lot to do with his recommendations.

Shira, I was 49 when I was diagnosed the first time. It was a very small area of DCIS (7mm). All my docs are female and I asked each of them, "would you do radiation if this happened to you?" They each said no. I had a lumpectomy and Tamoxifen. I don't know if the type (DCIS) and size (7mm) played a big part in their answers, but I suspect it did.

I was diagnosed with a second primary a year ago. Radiation wouldn't have affected that outcome one bit, and my surgeon said my mastectomy turned out better because the skin hadn't been radiated.

Yes, the standard of care for DCIS is typically lumpectomy followed by radiation and a hormonal (tamoxifen, arimidex, etc). My area of DCIS was tiny and it was moderate grade. The way I understand it, radiation is used to "clean up" any stray areas that might've been left behind and/or to "clean up" close or dirty margins. My DCIS was completely removed during biopsy - the entire specimen from the lumpectomy was benign. That added to the thinking that radiation wasn't necessary.

The second occurrence of DCIS had a different signature (ER-/PR- and Grade 3) so was not a recurrence of what I had before which was ER+/PR+, but rather a new primary cancer. It was scattered over a huge area (6+cm) of my rather small breast, so another lumpectomy wouldn't have left me with much breast tissue anyway. That's why I chose mastectomy for that breast. Having had DCIS twice, I decided to remove the other breast as well. I figured my body had the capability to turn perfectly healthy breast tissue to cancer and the other breast was a ticking time bomb. I also wanted some symmetry with reconstruction and I for BMX. My IDC was a surprise finding. I had Mammaprint testing on the IDC with the results being "low risk of recurrence." At 1.1cm, I was borderline for needing chemo. My oncologist staged me at Stage 1a, which is about as good as it gets with IDC and with the Mammaprint results, thought chemo would be overkill. As it turned out, the "healthy" breast was filled with ADH so it was a good decision to remove it.