DCIS size affect choice in lumpectomy+radiation or mastectomy

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a_nic_
a_nic_ Member Posts: 17
edited December 2021 in DCIS (Ductal Carcinoma In Situ)

Hey group! I was just recently diagnosed with DCIS grade 2. Met with the BS yesterday and the area she has to remove is 4.6cm. She seemed slightly concerned about the amount she’ll be removing but said since my breasts are slightly above average (D cup), she “thinks” she can make my breast look okay. I’m only 41. I want more than an “okay” looking breast. Does anyone have experience with similar DCIS and breast size? I’m so torn between my treatment options

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  • CarlyVirginia
    CarlyVirginia Member Posts: 2
    edited October 2021

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    Hi .I was diagnosed with Intermediate DCIS.Masectomy wasnt suggested but as I have large E/F breasts I assume this is why.I didnt ask though.I had two operations as first didnt have good margins.Second op had very very close margins so I then had whole breast radiation.Now five months since completion of Radiotherapy I have developed Lymphodema.I do wonder if I had gone for masectomy would I still have got lymphodema.


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  • MountainMia
    MountainMia Member Posts: 1,307
    edited October 2021

    Hi a_nic_. I can't answer your question specifically, but I understand your concern about looking good. One thing that helped for me after lumpectomy and radiation was to have reduction on my healthy breast to achieve symmetry. In fact now I'm more symmetrical than I ever was before bc, so I'm really pleased with the results. A breast specialist surgeon did the lumpectomy and a plastic surgeon did the reduction.

    I also wonder if a plastic surgeon needs to be consulted on how to achieve a pleasing result on your DCIS surgery. It's worth asking the BS about.

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  • Waves2Stars
    Waves2Stars Member Posts: 158
    edited October 2021

    What is the position they will remove the tissue from? I had idc estimated at 1.8 cm, but it was in the 9-10 o’clock position of the left breast. They said with margins, no matter what they did, i would be left with a “deformity,” even with fat grafting and G cups. Maybe because of how radiation would tighten the area? My breast surgeon, plastic surgeon and radiology oncologist all agreed the outcome would be poor. Maybe get a consult with a plastic surgeon!

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  • Waves2Stars
    Waves2Stars Member Posts: 158
    edited October 2021

    Carly, I’m sorry to hear about the lymphedema! Women who get mastectomies can get lymphedema, too! I hope you are seeing a good specialist

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  • a_nic_
    a_nic_ Member Posts: 17
    edited October 2021

    Thank you all for the feedback. In addition to the obvious worry from taking such a large amount, @Waves2Stars, its also right at the 3 o'clock position which the BS said was basically the worst area, as there is the least amount of tissue there anyway. On one had she went on and on about how she thinks she could get the margins the first time around and would do all she could to make it look okay but then talked about it being a bad location. Talk about making it harder to decide!

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited October 2021

    I agree - it would be good to consult with a plastic surgeon & hear all your options before making a decision.

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  • Jodig
    Jodig Member Posts: 1
    edited November 2021

    Hi All,

    I was recently diagnosed with stage 0 DCIS with a 2cm removal. But after MRI, they found a much smaller area inferior to the original area that “appears to have the same properties”. So she wanted to remove it all in one lump, which made it a 4cm removal. I’m a B cup. I’ve cancelled my surgery and am going to talk with an oncology plastic surgeon. I’m not sure how my breast could appear normal after this amount of removal. My DCIS is at about 9:00 on my right breast. My breasts may be too small for oncoplastic surgery but I hope to find out at my meeting w the new surgeon. Anyone else have a large removal on a small breast? I’m torn between a lumpectomy and BMX.

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  • Waves2Stars
    Waves2Stars Member Posts: 158
    edited November 2021

    Jodig, I’m sorry to hear your lump is now two lumps. Definitely hear out an oncoplastic surgeon! They will be honest with you about outcomes. Make sure you are clear about the cosmetic outcome you’re hoping for, communicate that well to the surgeon. Also, ask about alternate surgical scenarios, like how they would attempt to cosmetically fix the breast if the areas of DCIS were to be more extensive than shown on the MRI. Plastics can do wonders these days. Hugs to you

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  • Khakitag
    Khakitag Member Posts: 46
    edited December 2021

    I had a <1 cm area of DCIS in left breast and also was a size D (although not as full as before breast feeding). After the lumpectomy, I still have a small indention in my breast that is obvious to me. I can’t image an area the size you described not causing any abnormality. I’d get a second opinion

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