DCIS, lumpectomy done and no Radiation needed?

It is unusual at your age (traditionally if you were under 70, radiation was standard), but I think it is becoming more and more common as people start to address the “over treatment” of DCIS. For peace of mind, ask them for their reasoning on recommending it vs. not recommending it.

I had DCIS in 2007 and radiation was not recommended. My DCIS was grade 1-2 with no necrosis and was about 4-5  millimeters . 

It was removed in biopsy and the lumpectomy was negative for any DCIS. 

It seems common now to have radiation not be recommended if your DCIS is under 5mm and have no necrosis. 

 Tamoxifen was optional but I took it for 5 years. It was not a big deal. 

Good luck  

I am 47 and was diagnosed with DCIS this year. I had a lumpectomy in Sept. Path report was good...it was small and big clean margins. Intermediate grade, no necrosis. We did Oncotype DX test and my score was very low (10). My RO said he wasn't recommending radiation based on 3 things: the size of the tumor being very small, the size of the margins being very large, and the low Oncotype score. I was comfortable skipping radiation based on this info. My surgeon had recommended doing rads, hormonal treatment, or both...not to just do nothing. My MO agreed and I began tamoxifen about 6 weeks ago. So far so good...no side effects at all. Hope this helps.

Hi Scsa, I'm glad to hear good news about your appt. I didn't have tamox so I can't answer your question. I do want to say that I also alternated MRI's with mammos every 6 months for about 7-8 years. I liked that extra bit of security that the MRI gave. The doctor who ordered that retired and then her replacement retired. The next doctor I saw didn't think the MRI was necessary, she said "you don't want all that radiation." Grrrrr . . . . . MRI's don't have radiation!!! Anyway, I now get a 3-D mammo once a year, hopefully that will be enough to catch anything. Again, great new you received

i just went for my 2nd opinion yesterday at Penn in Phila. Here is what I just wrote on another thread.

Annette47:

This is what my husband wants me to do. He wants me to try Lumpectomy first, get Pathology then go from there.

I guess I hesitating as I trying avoid more surgeries, stress & anxiety. If did Lumpectomy I think I will worry if something more growing. Even though I know that can happen with BMX too. 1st BS at MD Anderson also pointed out I had dense breasts too so monitoring after lumpectomy be harder. Penn Dr yesterday said that wouldnt be his reason not to do Lumpectomy. Penn seemed more eager for me to do Lumpectomy.

I just don't know!

Scsa:

You are very right & makes sense! I just hate not knowing that other area! He said it would then mean invasion & stage 1. I just want to hope it from the biopsy knowing MRI does pick up everything!

Worst case would be if it is invasion & Radiation is needed I then can do BMX.

It is so hard choosing what is the best choice for us individually! I know how stressed & worried I have been these past 2 months! I just want to be done with it.

Renee, my cancer was 1.3cm, invasive and Grade 2. Even before making my decision (which was first suggested by the radiologist who did my biopsy--she remarked “you’ll be able to keep your breast”) I decided I wanted the least invasive surgery that would be effective. Even before meeting with my bs, I did some research (Drs. Love’s and Port’s breast cancer “Bibles”) and decided that I could more easily handle an easy outpatient surgery with a faster recovery and then radiation than I could deal with a mastectomy, drains and possible reconstruction. (In my case, for symmetry’s sake it would likely have been bilateral). I was quickly disabused of the notion that mastectomies--even bilateral--absolutely prevented getting breast cancer again (especially in those of us already diagnosed). My bs had me participate in a Mayo Clinic decision tree study during which I would periodically watch videos and be surveyed about how they influenced my treatment plans. Though the video did show a 3% risk of recurrence with mx vs. 6% with lx and rads, the 15-year survival rate was exactly the same (without taking systemic therapy into account). Seeing as how I’ll be 65 in a month, that’d get me to 80, well into seniorhood and almost to my statistical non-cancer lifespan.

Radiation was more of an annoyance than an ordeal--the inconvenience of having to go every day (rearranging my schedule) and drive 20-30 min. each way was the worst part. I think that having been “under” for 7 hrs. getting breasts removed, abdomen sliced open to harvest tissue for reconstruction, and then dealing with much more pain, incision & drain care, and complications (or having to deal with tissue expanders and then going back for a second exchange-for-implants surgery)--plus the possibility of a less-than-optimal result--would’ve been far worse than a few days of moderate rest and then a few weeks of short daily radiation treatments. Neither option avoids the necessity for adjuvant systemic therapy anyway.

Surgery is no picnic. DH’s summer adventures in hemicolectomy-and-herniorrhaphy land proved that. And I’ve gone through two knee replacements, which are not exactly walks (limps?) in the park until fully rehabbed. When it comes to surgery, unless it’s a matter of life & death (like a Whipple for pancreatic cancer, multiple bypass for severe coronary occlusive disease, or debulking for advanced ovarian) my motto is “less is more.” I will add my voice to the chorus of those saying you can always go back in and cut out more, but you can’t reverse the process.

I was diagnosed with dcis in 2007 at the age of 34. I had a double mastectomy so I wouldn't have to hear the words "breast cancer" again. No radiation was recommended. In 2013 I felt something. The doctor couldn't even feel it. Had a biopsy.....It was triple negative breast cancer I feel like if I had radiation it wouldn't have came back. They said that one cancerous cell must have been released during the initial lumpectomy and logged in my skin. Lucky me. This only happens to 1 in 5 women. Good luck to you. Just keep checking your breast and let the doctor know if you feel anything.