Radiation a second time?

If you have already had radiation in the past and develop another DCIS or invasive mass and need a lumpectomy, can you have radiation again or would a mastectomy be required?

I am asking for my sister. She has just been diagnosed with DCIS and is wondering if she should follow up with radiation after the lumpectomy. If you follow up with rads, what happens a few years later if you develop a new DCIS or invasive mass?

Thanks.

My understanding too is that each breast can only go through radiation once. My husband asked two years ago if it wouldn't be better to save that treatment "in case it returns." My RO said the goal is not to have that happen. She also said it'll cut the probability of recurrence in half. That's all I needed to hear to be convinced.

I'm just curious - is it that your sister is really afraid of ever needing a mastectomy? I would say deal with the DCIS she has now, and worry about the mastectomy later if that ever becomes necessary.

After her surgery you will have more information on the characteristics of the DCIS. Sometimes adding tamoxifen can prevent new abnormal cells from developing, but that's only appropriate for some people.

I agree with what the Dr said though - the radiation is supposed to keep it from coming back. It's better to treat the cancer adequately the first time so you don't have to deal with it later!

To answer your original question though, yes - you would generally need a mastectomy if she had already had radiation. You could ask about SAVI radiation, which is only to part of the breast.

That's completely understandable - it's scary. But, the bright side is that your sister's disease is so treatable right now, and she won't have to go through some of the worst treatments.

When I'm afraid of treatment I remind myself that not treating the cancer, and allowing it to progress won't be good either. This disease truly puts us between a rock and a hard place.

Getting a second opinion can be helpful. Go to an NCI designated hospital if possible. Different doctors have different approaches, and if breast conservation is a top priority they may be able to find a way. Best wishes to you.