Radiation for DCIS
I was recently diagnosed with DCIS with ER/PR positive in my left breast. I had a total of 5 biopsies locating two DCIS areas as well as precancerous conditions ADH, ALH, and LCIS. I had a lumpectomy two weeks ago with clear margins. I see an oncologist this week and anticipate that I will be prescribed with Arimidex.
My question is regarding radiation. I saw a radiology oncologist yesterday and he said my risk was so low that I could skip radiation. I am 67 years old, healthy and fit. He said if I wanted to get radiation to reduce an already low risk, he would do it. It was up to me. He would give me radiation 5 days a week for three weeks. I don’t know what to do. After 5 biopsies, I was thinking that there must be a lot going on in my breast. He thinks the Arimidex would take care of future risk factors. It may seem like good news but it has brought me no comfort, just questions and anxiety.
Feedback please. Has anyone had this experience?
Comments
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What grade was your DCIS? I had grade 3 and my RO and BS both highly recommended rads.
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Hi Kathy, and welcome to Breastcancer.org!
Have you asked your doctor about the Oncotype DX DCIS test? This is a test that gives a Recurrence Score, which indicates how beneficial radiation therapy would be for you. You can read more on the Treatment for DCIS page and the Oncotype DX page (scroll down to the Oncotpye DCIS test section)
We hope this helps and we look forward to hearing more from you soon!
--The Mods
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I was grade 1
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I know this is a tough decision. I was grade 3 and really struggled with whether to have radiation at 61 years old. I did allot of research and talked to allot of people and decided to do radiation since it was a high grade and I did not have clear margins. Radiation wasn’t so bad for me and I only ended up with fatigue and a frozen shoulder. I do worry about potential damage to my heart and lungs which I may not know for years. I think you have to make a decision that you are comfortable with and don’t second guess your decision after. That can drive you crazy. There is new research on DCIS grades 1 and 2 that would suggestthat radiation may not be necessary . But again, make a decision based on what is most comfortable for you. You may also want to get a second opinion. Good luck with your decision.
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Have you asked about getting the Oncotype DX for DCIS test done? It is a well respected indicator of your risk of recurrence, and whether you will benefit from radiation treatment. My dcis was grade 3 and all 3 of my doctors recommended radiation. But my dcis was small, only 4mm, no palpable lump and was completely removed by the biopsy. So no cancer in the tissue after lumpectomy. So I asked for the Oncotype test to help me decide about radiation. My score came back as high risk, so I had the three week course, which is now the protocol instead of the longer course. I sailed through it with no side effects except a small area of tiny rash which resolved quickly. Good Luck.
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Johns-Hopkins says this on 6/22 re scenarios with DCIS:
http://www.hopkinsbreastcenter.org/services/ask_ex...6/22/2018 Below are the chances of DCIS turning into invasive ductal cancer (IDC), meaning it has broken through the milk duct:
DCIS risk for Invasive Ductal Cancer within 10 years:
• Do nothing = 30-50% risk of IDC
• Lumpectomy = 14% risk of IDC
• Lumpectomy/Radiation = 7% risk of IDC
• Lumpectomy/Radiation/Tamoxifen = 4% risk of IDC
• Mastectomy = 1% risk of IDC -
I am 4 days post op for lumpectomy they also removed 2 nodes and will get my test results on Tuesday next week I have no idea if I am doing radiation or doing the pill.
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I am 71, have DCIS, high grade solid and micropapillary type, ER/PR positive, tumor is about 1 cm. I am scheduled for my surgery on 8/1/2018. The doctor, who will perform the surgery said that Oncotype DX and HER2 tests were not needed for me and the oncologist/radiologist will decide about the treatment after the surgery. Surgeon's decision about not having those tests (especially Oncotype) done makes me nervous. Does it have anything to do with my age?
Thanks for your input.
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I’m 47 and I did not have Oncotype or HER2 tests for my DCIS. They don’t use Herceptin for DCIS so they don’t test for HER 2 status. My Radiologist recommended Radiation based on the grade and presence of comedo necrosis. If there was a question about whether or not to do Radiation then he said it was an option but in my case he strongly recommended it.
I would definitely ask your radiologist and oncologist about this because they may have a different opinion.
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Twelve years ago, I had breast cancer that had metastasized within my left breast. I turned 71 the day before my first chemo treatment. This past summer, I had another small cancer in my right breast. I have a very strong family history of breast cancer. I am nearing my 83rd birthday. My heart doctor said I could take radiation, but my oncologist said no. I am still in shock. Instead, he insisted I take femora over my objections because I had been told by two women that they were in intense pain. One stopped taking it. I have back pain and arthritis. This doctor had obviosly not read any of the five pages I had fiilled out.
I hope my primary care doctor will get me another oncologist for a second opinion.
Yes. I think it's all about age now. And maybe saving Medicare some money?
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