Deciding the treatment

in answer to your mastectomy question: mastectomy has lower recurrence rate than lumpectomy + rads, but they both have the same overall survival rate. Having mastectomy may mean you don’t have to do rads. You’ll need to check with your dr. It’s a very personal decision. Some women are good with hypervigilance with mammograms/ultrasound/mri every 6 months while others are not. Some just want to deal with it once vs doing lumpectomy now and doing mastectomy later if it comes back. My advice is to to do your own research and come with pro/con lists for each, research reconstruction options including before & after photos and opt for the path that leaves you with a feeling of peace. If you choose mastectomy, know thatReconstruction options are advanced today and include traditional implants as well as natural tissue reconstruction where they take excess tummy tissue or hip tissue and build new breasts out of it.

There is a lower recurrence rate if you have a mastectomy, but it can still happen. There will always be some breast tissue left behind. Overall survival rates are the same whatever you choose.

I chose a lumpectomy because I hated the idea of having no feeling in a reconstructed breast, and I would never have been happy going flat. I had to use a partial prosthetic for a while until I got reduction surgery to my good side, and I really hated removing the fake boob from my bra at night. But now I don't have to use one, I feel like my body is my own again.

Everyone is different, both in the way we feel about things, but also in the size and position of the DCIS relative to the size of your breast. Mine was in a fairly good location to give a good cosmetic outcome, but if it hadn't been, I would have had a mastectomy.

There are some really good threads about the pros and cons of mastectomy vs lumpectomy, different reconstruction options etc. In the end, you have to go with what feels right for you once you have all the information.

Hi. I also had DCIS grade 3. It was very small (3mm.) If was removed in January with clear margins. They want me to do 20 sessions of radiation and 5 years of Femera (I’m post menopause.) Has anyone out there not done the radiation and medication for a small DCIS and just checked (MRI and mammograms) every 6 months? I will be alternating between MRI’s and 3D mammograms. I’m suffering from a case of chronic fatigue syndrome and I know the treatments will be a set back for me. My bond density is not great either. Thanks girls.

Jill

Hi EatPlants,

I have been struggling with whether or not to have radiation. My DCIS was 4mm (2mm taken during biopsy and 2mm found in pathology following a lumpectomy, with clean margins). I am post menopausal, and will be meeting with a medical oncologist next week. I am pretty sure I will start on hormonal meds.

But I can’t decide about getting full breast radiation. I talked to the radiology oncologist about my doubts, so she is ordering an oncotype dcis test to analyze the tumor genetics. I’m wondering what kind of score would make me go one way or the other.

I’m leaning toward not having radiation because it seems to me that the long-term side affects of radiation may outweigh the reduced probability of recurrence, and I have been told that a mastectomy is the only option for local recurrence if you have had radiation in that breast.

I can keep you informed about my decision and wish you the best in whatever you decide

Hi Lew, and EatPlants, I am also seriously considering not doing radiation for small low grade DCIS after lumpectomy - age 65. It's left side so heart is a factor. Love to hear from anyone also not doing radiation or meds. thanks

I had similar- DCIs in past, and new calcification spots on last 4 mammos (so in past 2 years) but I haven't had a biopsy yet and am deciding what to do since my great surgeon moved...now have to find new dr who I am trust and is patient and kind- a must for me. I saw a female dr, fairly young, last week and she was rude and pushy- so I won't go back. it's amazing how a dr in this field wouldn't be compassionate!