Did your RO recommend a boost for pure DCIS?

dl1129
dl1129 Member Posts: 19
edited March 2019 in Radiation Therapy - Before, During, and After

I have my CAT scan coming up next Monday, so likely will start treatment in 1.5 weeks.

My RO is recommending a 4-session boost after 15 sessions of whole breast because I had one close margin (1 mm, it was at the skin -- my surgeon removed everything but the skin on that side), the rest were clear. She is open to doing just the 3 weeks, which is what I am leaning strongly towards.

There is very good evidence for a boost in some cases - positive margins, and comedonecrosis. I had a little bit of focal necrosis, but my surgeon tells me that is common and NOT comedonecrosis (the RO seemed to include the presence of necrosis as factoring in to her thought process...)

I was diagnosed at 49 which lumps me in with the "younger" group of treatment recommendations (and younger patients *generally* receive more radiation), and because I am very healthy overall RO says the boost makes sense because I can handle it.

I am paraphrasing, but that was the gist. Curious about others' experiences?



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  • AliceBastable
    AliceBastable Member Posts: 3,461
    edited March 2019

    The boost isn't stronger, it's just focussed on one area. I had the long course of rads, and the boosts at the end were the easiest and quickest part. It's just a little insurance against recurrence. I think it's pretty routine for most rad courses, not just close margins.

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  • Jelson
    Jelson Member Posts: 1,535
    edited March 2019

    at 59, I had boosts after longer course of Rads due to close margin at skin - 1.5mm and had no problem at all. I never had a CAT scan

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  • Beaverntx
    Beaverntx Member Posts: 3,183
    edited March 2019

    At 77, I had extra boosts due to the RO's concern that the margins on the DCIS found during surgery were not wide enough. BS disagreed about the adequacy of those margins but I figured I was there anyway and felt the extra boosts might be beneficial. As Alice said the boosts are similar to the whole breast radiation but are more targeted.

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  • Ingerp
    Ingerp Member Posts: 2,624
    edited March 2019

    I've honestly never heard of anyone getting rads who *didn't* get boosts at the end. I didn't get clean margins in 2016, had another surgery, and still had boosts. Last year my margins were fine the first time around and I still got boosts.

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  • dl1129
    dl1129 Member Posts: 19
    edited March 2019

    I think for low and intermediate grade pure DCIS a boost isn't necessarily standard. A friend of mine was diagnosed with stage 1 BC, after chemo and surgery she had whole breast radiation without a boost.

    I think my comment about age made it seem like I was focused on that in relation to radiation, but it was more an incidental comment in that I (and anyone diagnosed around age 50) fall right on the border for any treatment recommendations in relation to age (50 is the "magic" number).

    My close border being next to the skin meant that he couldn't take any more tissue unless he took skin, which would create many new potential problems (plus, as my RO pointed out, they wouldn't know what skin to take since there was no visible tumor).

    Thanks to all for your feedback.

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