DCIS Recurrence-What is typical treatment plan?

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StellieB13
StellieB13 Member Posts: 9
edited July 2017 in Just Diagnosed

I am a 50 year old female and was diagnosed with DCIS, stage 0 7 years ago. I had a lumpectomy, 33 rounds of radiation and took tamoxifen for 4 years. I went in for my annual mammogram and had to go back for diagnostic mammo that shows cluster of calcifications behind the nipple, where my original site was back closer to the chest wall. The largest of the group is 1 cm. Same breast, obvisously.

I am having a biopsy tomorrow. Let's say this is DCIS again, what would the typical treatment options look like? 7 years ago we didn't go onco scores and all that. I am way out of the loop.

Thank you in advance for your help.


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  • Annette47
    Annette47 Member Posts: 957
    edited February 2017

    Most likely, a mastectomy would be recommended. It is not possible to radiate the same area twice, and since you've already had radiation to that breast, you would be unable to do it again. In rare cases, a lumpectomy alone might be suggested, but since you are on the younger side, and have already recurred despite aggressive treatment, most likely they would not recommend that. If it is DCIS, and if it is ER+ again, my guess is they might put you back on Tamoxifen or an AI (depending on whether your menopausal status), possibly for longer this time. If you did have a mastectomy that would primarily be to protect the other breast, and if you elected for double mastectomy, might be avoided. The mother of a friend of mine had a new primary 8 years after the first (IDC both times). She had previously done 5 years of an AI, and after the second cancer they told her she would be on it for life, as they felt it had helped while she was on it, but hers was not DCIS, so I'm not sure the recommendation would be the same. About Oncotype testing - most Oncotype testing is done on invasive cancer to determine the risk/benefit ratio of chemo. There is an Oncotype test for DCIS which has not yet been widely adopted, but that advises on the need for radiation after a lumpectomy. Since radiation is not an option for you, I doubt it would be offered in your case, although perhaps it could shed some light on whether a lumpectomy alone would be sufficient. Since this is the second cancer in the same breast though, I really doubt a lumpectomy alone would be recommended.

    Sorry you find yourself in this position! Hoping your biopsy yields benign results and this is all hypothetical.

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  • StellieB13
    StellieB13 Member Posts: 9
    edited February 2017

    Thank you for your input. I am hoping for benign results!

    I think if it is possible (because my surgeon is awesome and I trust her completely) I would like to see if she thinks she will be able to get clear margins and have another lumpectomy and go back on tamoxifen, rather than have a (double) mastectomy. That would be my ideal situation, but I know we will have to wait and see.

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  • obsolete
    obsolete Member Posts: 466
    edited March 2017

    Stellie, so sorry that your journey is bringing more reasons for you to be here. Please do not feel discouraged. You didn't mention your grade & variant of your prior DCIS. I originally began my BC journey with grade-III DCIS, which is often multi-centric and sometimes is not visible on MRI. After multiple biopsies and surgeries, a BMX was the best solution for me. My BMX without reconstruction was the easiest for me, and the BMX pathology found more DCIS and invasive BC. I wish you well with which ever path you take. Hugs.

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  • StellieB13
    StellieB13 Member Posts: 9
    edited February 2017

    Thank you for your response and for the hugs! I was feeling discouraged yesterday, but today much better. I am moreso just nervous about the pain that I will have tomorrow with the Stereotactic Biopsy. This will be my 4th one and it never gets any easier.

    Gosh, I should know the grade and variant right off the top of my head, but I am drawing a blank. I will find that out and get back to you. If I need to do more than a lumpectomy, then I feel confident that I will have a BMX no reconstruction.

    What is the recovery time for the BMX no reconstruction? I was just promoted, so even though I know that isn't the most important thing in the grand scheme of things, I am trying to figure out what life will bring in the next few months.

    Thank you!

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  • jacky0
    jacky0 Member Posts: 1
    edited September 2017

    Good luck, hope everything is okay.

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