Margins with BMX and question about tomoxifen...

I had a BMX for DCIS in Aug of last year. I am also being treated by a military BS but a civilian Oncologist. Apparently at my tumor board it was suggested that I at least discuss tamoxifen with the oncologist. My BS said he never recommends Tamoxifen after BMX. Oncologist said the same thing. She said the benefits were so small compared to the side effects

Unfortunately, my films showed very little DCIS, even my MRI but when we started surgeries it proved to be extensive. BS had to take quite a bit of skin to achieve a clear margin and I believe my deep margin was like 6 mm from the chest wall. They consider that "clear". Blows my mind because that is not much. Anyway, they also determined no Rads for me.

Interesting the one dr take. My BS kept reassuring me that if my diagnoses remained strictly DCIS there was very little concern with it "traveling". Thankfully that was my cas

Can’t answer about the margins, but there are two reasons to take Tamoxifen. First, to prevent distant spread (metastases) which if your diagnosis remains pure DCIS after your surgery is not a concern. The other reason is to prevent either a local recurrence or new primary. While both of those are possible after a BMX, the chances are so low that Tamoxifen is not usually recommended in cases of pure DCIS as the risks of side effects may be greater than the risks of cancer.

Have you had surgery or are you scheduled for surgery?

I had a uni MX and am on Tamoxifen to protect the remaining breast.

As for the margin question, in the MX your surgeon should take the fascia off the pectoral muscle. This gives you a clean separation even if the margin is very close. My chest wall margin was 1mm but since she removed the fascia she was not worried at all about it. No Radiation required either, and my case was reviewed by the tumor board at my request. Hope that info helps.

The new accepted belief is that any margin is clear. No matter how small. Fascia comes away naturally and in fact is very difficult to leave intact.

So you should be just fine. My oncologist stated that he never recommends tamox any more for pure DCIS. But we all have a tolerance that differs about risk factors and SE's differ for everyone also. Your treatment plan should be customized to you.