radiation therapy - yes or no
is there anyone on this board who has not had radiation following lumpectomy for dcis? although i know the recommendation is for radiation, i am reluctant to have radiation as i had a small low grade dcis. i'm thinking that in the future i will have bilateral mastectomies and having radiation now, may make the reconstruction more difficult. cant have mastectomies now as contemplating a pregnancy and would like to breast feed if possible.
any thoughts would be helpful. thanks
Comments
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It is becoming more common for women who have a diagnosis of a small low grade DCIS to skip rads. That's not yet the standard of care, but it gaining momentum.
Do you know what your surgical margins were?
Here are some threads that talk about this issue:
Topic: DCIS lumpectomy without radiation?
Topic: Lumpectomy only
Why are you thinking about having a BMX in the future when your diagnosis was a small area of low grade DCIS?
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I was diagnosed with a tiny focus of DCIS in July 2008 and did NOT have radiation treatment. I had my diagnosis of DCIS -- left breast -- after a digital mamm which showed a cluster of microcalcifications followed by a lumpectomy/surgical excision. Mine was a very small focus area of DCIS (1.6 mm) with nothing identified as comedo (path report indicated solid & cribriform) NO necrosis present, considered intermediate grade, and I had clear margins after the surgical excision/lumpectomy. I have not had any additional treatment besides my excisional biopsy in July '08 which got that tiny area of DCIS out. At follow up appt. a week after that biopsy, a medical oncologist spoke with me and told me that my tumor was so tiny he thought there was a miniscule chance it would cause me problems down the road and he did not recommend radiation therapy or hormonal therapy with their associated risks and side effects for my particular situation. He actually told me I was not to lose sleep over this or worry about it and he never expected to see me again. I also met with a radiation oncologist who wavered a bit on his recommendation, (seems I was sort of in a 'gray' area on rad treatments mainly because of my age at that time - 46 - and one margin although clear was quite 'close' at 1.3 mm) but ultimately told me after we had a long discussion that I get a pass. Therefore, I decided against doing anything more except for close monitoring with mammograms and MRI's as needed.
I have had two additional biopsies since the initial diagnosis of that tiny area of DCIS. In summer of 2011 microcalc’s were again found in that same left breast and I endured another excisional biopsy which indicated all benign conditions. In July 2012 a small grouping of microcalc’s (less than ten) were again showing up in left breast on mamm and I had a stereotactic biopsy to remove the majority of them which also came back benign. So, while I don’t feel I am terribly far out from the initial DCIS diagnosis and have had to endure additional (thankfully benign) biopsies, so far so good even though I chose not to have radiation. I'm pretty much on the six month mammogram 'plan' with that left breast, but I am totally fine with being monitored closely and had another mammogram in January 2014 which I was told the stereotactic biopsy 'clip' site looked stable/unchanged and to come back in July. Not sure if that will help you in your decision making or that I can really suggest what YOU should do, but that’s my story at this point.
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thanks. am only 32 years old, with strong family history of breast cancer (negative brca for family). so that's why i'm thinking if even at this age i have dcis, i might need to consider bmx in the future. i'd like to preserve breasts right now for nursing, as i am yet to have any children. margins were good - one small focus of dcis, but intermediate grade. i will definitely be followed closely and am really leaning towards no radiation - but doctors are divided.
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can i ask how old you were at initial dx? i am 32. also was there a family history of breast cancer.
appreciate your help
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I had just turned 46 in 2008 when I was diagnosed with the 1.6mm of DCIS. Will be 52 this coming summer and so far, so good on no recurrences even without going the radiation route (crossing fingers that will continue to be the case, but there really seems to be no rhyme or reason to some diagnoses). I have no immediate family history of breast cancer (my grandmothers never had it, nor my mom, and not any of my three sisters either - we do have one paternal aunt that has had breast cancer). That might have totally changed my view on whether to do treatment or not if my Mom, a sibling, or Grandma's had battled it. You just have to weigh the pros/cons and risk factors and do what you, yourself, can be comfortable with. Good luck with your decisions.
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I was in my early 40s when a routine annual mammogram showed micro-calcifications and then a stereo. biopsy confirmed grade 2 dcis. Absolutely no known family history and tested negative for BRCA1+2. For better or for worse, my breast surgeon was pretty blunt and gave me one of two choices: lumpectomy with rads or mastectomy. If I didn't want rads, then mx. I chose the less aggressive surgery and was glad to have been given the choice.
That was nearly 4.5 years ago and have thankfully had no further problems or cautionary biopsies or call-backs. Just have annual diagnostic mammograms and ultrasounds. The thought of rads scared me tremendously back then so I appreciate your concerns! But I must say that I am glad I underwent the rads treatment because I do believe it's a good recurrence reducer (and cosmetically everything healed really well, no problems at all, and no physical problems that I know of). I'm also glad I opted out of tamoxifen, but each of us must weigh our risk aversion and statistics to find the treatment options we feel the most comfortable with (or without).
Wishing you good inner peace with whatever treatment(s) path you take.
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I was 49 when diagnosed with intermediate grade DCIS. I didn't do rads with the oncologist's blessing and my first check up a year later was fine. I certainly hope that continues. x
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