Updates on DCIS decisions after lumpectomy needed

Hi Kim,

I'm just finishing up 16 radiation treatments on Thursday. My DCIS was high grade and it took 3 surgeries/lumpectomies/incisions to get it all out. I opted to go ahead with radiation because it was an aggressive type of DCIS and I ended up with a close margin of 1.7 mm instead of the ideal 2 mm. An Oncotype test wasn't offered to me.

Mine was also on the left side, so I've had to do the breathing technique for treatments to protect my heart. Took some getting used to, and I won't miss it, but it's been OK. My side effects have been fine - some redness and itchiness over the breast area and a bit in my armpit. No real fatigue that's been noticeable. I've kept up a steady regimen of exercise, cold compresses after treatment, and skin care and my integrative doc. had me up my protein intake to 60g/day to help ward off fatigue. So, mine's been an easy time overall.

I was originally scheduled for 21 treatments, but the cavity created by my lumpectomies was larger than my radiologist expected, so he cut it back by a week so I have less toxicity.

Not an easy decision for sure. I'm 51 and am also perimenopausal. I'm due to have the Tamoxifen conversation with my medical oncologist this Friday. Ugh.

Hope this provides a bit of insight for you.

Take care!

Kim0215 - I am one who chose to only have lumpectomy with no additional treatment - Here is my DCIS 'story' - I had my diagnosis of DCIS back in July, 2008 -- left breast -- after a digital mamm which showed a cluster of microcalcifications followed by a lumpectomy/surgical excision. Mine was a very small focus area of DCIS (1.6 mm) with nothing identified as comedo (path report indicated solid & cribriform) NO necrosis present, considered intermediate grade, and I had clear margins after the surgical excision/lumpectomy. I have not had any additional treatment besides my excisional biopsy/surgical excision in July '08. At follow up appt. a medical oncologist spoke with me and told me that my tumor was so tiny he thought there was a miniscule chance it would cause me problems down the road and he did not recommend radiation therapy or hormonal therapy with their associated risks and side effects for my particular situation. I also met with a radiation oncologist who wavered a bit on his recommendation, (seems I was sort of in a 'gray' area on rad treatments mainly because of my age at that time - 46 - and one margin although clear was quite 'close' at 1.3 mm) but ultimately told me after we had a long discussion that I get a 'pass'. Therefore, I decided against doing anything more except for close monitoring with mammograms and MRI's as needed.I have had two additional biopsies since the initial diagnosis of that tiny area of DCIS. In summer of 2011 microcalc's were again found in that same left breast and I endured another excisional biopsy which indicated all benign conditions. In July 2012 a small grouping of microcalc's (less than ten) were again showing up in left breast on mamm and I had a stereotactic biopsy to remove the majority of them which also came back benign. They put a 'marker' in at the time of stereo biopsy and I have had follow up mamm's since then which thankfully continue to be 'stable' in that area. I am at the point now over twelve years out from the lumpectomy/surgical excision, of being back to annual checks/mamm's. My DCIS was a very, very tiny area, but I did not choose to have any additional treatment beyond lumpectomy. I am due for annual mammogram in August and do I still 'worry' a bit each time I go - sure - but 'so far so good' in my particular case.

I was Dx with DCIS In Dec 2019. Because of my age, and the importance of good quality of life, after my Drs agreement, decided not to treat with anything other than lumpectomy and close surveillance. I am now a year out, and have had two clear MRIs and no issues. My chances of recurrence according to the tool I used is close to 20% lifetime, but to me the gamble is worth it. I am extremely active and eat healthy and maintain a healthy weight. After my initial stress and worry about recurrence, I’ve put the whole thing out of my mind and hardly think of it at all.