DCIS-MI

I had a micro-invasion and chose lumpectomy with sentinel node biopsy.   Prior to the surgery, they inject you with a radioactive dye.  Apparently this can be painful, but I was also injected with lidocaine at the same time and didn't find it painful at all.   During the surgery, they take the nodes that "light" up with the dye as this indicates they are first one(s) to capture anything leaving the breast.   How many they take depends on your anatomy - my mom had the same thing done and only one "lit up"; for me it was 3 that were clustered together.

I will be honest, I found the recovery from the sentinel node biopsy to be much more painful than from the lumpectomy, although neither were particularly onerous.  I had the two procedures done at the same time, so it wasn't always easy to separate which was causing what.   A bigger issue is having to be on guard against lymphedema, which is a lifetime possibility any time nodes are removed.   So far so good with no problems.   I mostly make sure to put neosporin on any minor cuts, hangnails and the like (even if I wouldn't have normally) and request blood draws and blood pressure to be done on the other arm ... not a big deal in the scheme of things.    As my doctor said - if you are awake and conscious, ask them to do it on the other arm, but if you are in a car accident or the like and unconscious, don't worry about it - you'd have bigger problems at that point.

Radiation is done to the breast only (unless your nodes are known to be affected), so would kill any cells that escaped the main tumor but remain in the breast.   In the very unlikely case that any have escaped the breast, they would not be affected by the radiation - in that case you might require chemo, but if your tumor is highly estrogen receptive, the anti-hormonals (Tamoxifen if you are pre-menopausal) might be just as effective and are certainly safer.

This site has some good information about what to ask, but I would certainly want to know about the margins (did they get good ones with the re-excision), the nodes (were they clear?  They'll get an initial idea during surgery, but the final results usually come a few days later), and what is the hormonal status of the tumor (ER, PR, and if large enough to test the micro-invasion, HER - HER does not matter as much for the DCIS portion, and if the micro is really small may not affect treatment either).