Radiation or mastectomy

I was dianosed last July, one month shy of 32nd birthday, with stage 1a IDC, oncotype of 12. I had always thought that if something like this happened to me, I would have a mastectomy, but when it really did happen to me, I just couldn't do it. I went ahead and had a lumpectomy and radiation. If it was my left breast, I may have thought harder about the mastectomy, since it is closer to my heart. I had no problems with the radiation, other than some skin issues, and driving 45 minutes one one to get to the center. It's a big decision, that we shouldn't even have to be thinking about. 

Nay84:  I agree with Ruthbru.  I would seek a second opinion.  I understand how difficult a decision this is.  I had to have a mx, due to size of my dcis, but radiation was optional.  I stressed myself sick over the decision.  But with all the research I did (and trust me I even amazed my RO) I discovered that radiation is so much more efficient now at hitting the precise spot and not damaging surrounding areas.  It is not without risks as is everything, but the risk is so small.  Of course with your young age, you will have more time to develop a secondary cancer, but that goes with aging period! This is such a difficult time for you, but know that you have choices and getting a second opinion may be just what you need.  ((((hug))))  And just as in my situation, a mx does not guarantee no radiation.

Don't let them rush you into something you aren't comfortable with. You could always have a mastectomy later, but once your breasts are gone....they are gone forever. They should have a specific reason if that is what they are recommending, not a 'it could come back'. DUH, as long as we are alive, it could come back." So push them. Go in with a notebook and write down everything they say. Be your own advocate!

You say you have a family history, and you yourself are also very young....have you had genetic counselling and/or genetic testing?  For example, if you are BRCA+, you are at a much higher risk of a new primary in next few years than the "average" women who has had a breast cancer diagnosis, and so many BRCA+ women diagnosed with breast cancer choose mastectomy/bilateral mastectomy, to not only reduce risk of new primary but to also consider fact they would not be able to get radiation again, etc.

Whether you have mastectomy or lumpectomy and rads really does not affect distant recurrence at all, either way. If the cancer cells have escaped, they have escaped, so the concern for you is reducing risk of local recurrence (like in chest wall, etc) or a new primary.  The risk of local recurrence depends a lot on margins, etc. Both lumpectomy + rads and mastectomy can be effective in this area, though a mastectomy generally allows for very large margins and removes a lot of breast tissue where local recurrences could otherwise occur (and also reduce breast tissue where new primaries could recur, but as you know it is not  a 100% guarantee). 

Ultimately, you need to make the choice that is right for you, as you are the one that needs to live with that choice, but I certainly would ask for a referral for genetic counselling if you have a family history as that appointment, or any testing, will provide more information as you make your decision.

Also, I am a bit unclear as to your diagnosis as you said you have DCIS, but then said you have Stage 1. DCIS would be Stage 0, unless you are saying they found an invasive component after surgery?