Margins and Radiation

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percy4
percy4 Member Posts: 477
edited June 2014 in DCIS (Ductal Carcinoma In Situ)

Hi All - As most of you know, my lumpectomy for DCIS showed no invasive cancer, and no high-grade DCIS.  Felt path report incomplete, as it did not give dimensions of DCIS, assessment for necrosis, etc.  And only one margin (2 mm) was quoted to me (I presume this was the narrowest).  Have asked for 2nd opinion (within same HMO, but at a different facility) path report, and including all the details.  If that comes back with the other 3 margins wider, no necrosis, small area of DCIS, etc, I may forego rads.  Everyone in my family lives to be 95, so as I may live another 40 years, and I have a four-times -greater-than-average chance now of having a future BC, I don't think I want to use my once in a lifetime opportunity for rads up on this.  Still; the 2 mm isn't enough for me to feel secure.  Does anyone know if in re-excision only one margin can be widended,. or must it be all?  Also, asked them to look at my tissue for ADH, etc.  Does anyone know if rads can get rid of ADH, if it's there?  Do surgeons ever refuse to do a re-excision for a wider margin and just say "No, you'll just have to have rads"?  Thanks- P.

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  • Beesie
    Beesie Member Posts: 12,240
    edited December 2013


    I believe that the surgeon can target just the one specific margin, but I'm by no means an expert on this. I'm sure someone else will respond who has more knowledge on this.


    Why do you believe that you have a "four times -greater-than-average chance now of having a future BC"? Certainly having been diagnosed once, we are all higher risk to be diagnosed again, but four times the risk is very much at the high end of that risk. My oncologist told me that I had double the risk; in reading through the research and various websites, I've seen lower numbers and higher numbers. A lot of it depends on what other risk factors you have and your age at time of diagnosis; pre- or post-menopausal is a factor too. You are now higher risk than average but I seriously doubt that your risk is four times higher.


    As for ADH, I believe that rads are not thought to be particularly effective on ADH. But ADH doesn't need to be removed - normally it's excised only in order to ensure that nothing more serious is going on.

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  • percy4
    percy4 Member Posts: 477
    edited December 2013

    Thanks, Beesie.  I was given the 4-times-greater quote by three docs along the way (I think 2 surgeons and one MO), not specific to me,  but for anyone who's had DCIS.  I have no other risk factors.  Of course, all these docs are at one HMO, so maybe that's the general consensus and party line given by my particular place.

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  • percy4
    percy4 Member Posts: 477
    edited December 2013

    Interestingly, doing the Van Nuys Index on myself, based on my age and stating no necrosis and DCIS under 5/8 inch (if that turns out to be true), even with the one margin at 2mm, I'd be a 6, not necessarily recommended for rads even now.  But I'm just not comfortable with the 2 mm, anyway.

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  • ballet12
    ballet12 Member Posts: 981
    edited December 2013

    Hi Percy, I had re-excision (it was my second) for one narrow margin which was less than 1mm.  I was given a wide margin (the others were already).

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  • percy4
    percy4 Member Posts: 477
    edited December 2013

    Thanks, ballet.  I just want to get it right, so I can walk away and feel I've done the best for myself. xx

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