Radiation necessary in an early stage cancer

I had a sentinnel biopsy and additional breast tissue removed two days ago.  As of last night I had decided not to do rad.  My tumor was 1cm, node neg, est + , prog-, HER2-.   My surgeon called today to say that the margins were not clear.  This has radically shifted my thinking.  I am 36 years old and my thought at the moment is that I need to be sure that the cancer is GONE from my breast, even though I know that there is no guarantee that it won't come back.  I almost can't bear the thought of them doing surgery for a 3rd time on the same area with no guarantee that they will get all of the tissue. I also realized after speaking with my husband that although he supported me 100% when I said that I didn't want to do rad, he is very scared.  I'm still on the fence, but now leaning toward radiation.  I am thankful that this discussion is out there though.

Yeah, I feel great with my all clear mammo! And without ever having to subject my body to any of these other "treatments." With all of their horrible, side effects.

Although, I'm not, stupid. I'm going to continue with mammograms and MRIs for the forseeable future. On a frequent basis. And if the breast cancer, comes back, I'll deal with it, surgically, again. 

There ARE a lot, of unknowns. But when I finally delved in, to the numbers in the "real" studies the docs were quoting, to me, as "proof" that I "needed" this radiation, it wasn't compelling, to me.  For one thing, most of these studies, were thirty years old. And nowadays, Digital Mammography can reveal the tiniest cancer. Or pre-cancer. 

Yet, they won't do any more studies comparing Lumpectomy alone, or Lumpectomy with radiation. In the US, they haven't done one, in 30 years.  Because it was "so proven" to be effective.

Ha, so "proven" to be a $MoneyMaker. 

In 2006, I found this Austrian study, on the benefit of radiation after lumpectomy vs none, right here on breastcancer.org. For 1cm cancers, HR/PR+, HER-, negative nodes. If you look around, you can find it. And that study said, I don't have the exact quotes, but something like if you have the radiation, in absolute terms, there's a 2% chance the breast cancer, will return. If you don't, it's 4%. 

Although, in the popular media, the headline would read, "50% decrease in breast cancer recurrence, with radiation therapy." 

And that's all most people, read. 

Hey, any of you women out there, questioning, radiation therapy?  Again, with small cancers, in my view, 2CM or less IDC, ER/PR+/HER-, negative nodes. That's the only thing I can speak to, because it is what I had. 

If you're in that boat? DO NOT do, the radiation. And DO NOT do, the Tamoxifen. 

It's NOT worth it. 

I know, there's a LOT of women, in a lot of other boats. Triple negative, whatever. You do, what you need to do. 

I'm just speaking to the women, like me. Don't do it. 

I genuinely appreciate the voices of caution (and "adamant opposition" to) radiation, to be honest.  At the very least, they prompted me to ask (and I will continue to ask) questions of my doctors that I wouldn't necessarily have asked otherwise and put them on notice that "I'm not going to buy or do everything you say just because you're a doctor. I'm the one who will have to live with my decisions."

bfkh2t -- As the former chair of a grad program, I have known of many cases where a grad program would defer your admission + tuition/stipend under these circumstances (whether to January or to the following fall). Don't rule out asking them.  Depending on how much you want them to know, you might direct your request to either the dean of the grad program, or the director of grad studies for your particular program.

Also, while I hope it wouldn't be necessary, I have requested & received unpaid leaves of absence for my students who have experienced a serious medical problem (e.g., they don't have to pay a matriculation fee).

Just something to think about. CONGRATULATIONS! 

We all need to follow our instincts as far as our treatment goes. I blindly followed my doctors advice and had rads, even though I kept questioning it throughout. I had clear margins and nodes and I just did not see the point. I don't even feel a sense of comfort that the rads did me any good because I really feel that the diet and exercise program that I am on has helped me the most. I have not seen any of my doctors for a follow up and will not go back to my onc, ever. I just did not feel supported enough by them. I found a great holistic doctor (chiro) who is helping me naturally regulate my estrogen and I did a thermograph instead of another mammo because I am so afraid of even more radiation. This has to be decision that we make from our hearts and unfortunately, that doesn't hold any merit in the AMA.

Hi gals, I think, just think, don't know for sure, that the rad oncs either do not know what can happen, or don't want to scare you away from a treatment that can save you a recurrence.

Some women have rads and not one single side effect.  I did not burn at all, just got brown, BUT, I ended up with rib problems.  So this is the reason it is so hard to know what to do.  The benefits are pretty well proven, they just need some way to be able to tell who will have lung damage, heart damage, rib damage, etc.  One thing I tried to do and would INSIST on now (after the rib damage) is make them give me an apron to slide under my breast and covering my abdomen and heart, and, most of the lung.

They insisted that "nothing goes anywhere except the breast", and they were wrong.  I asked for the apron, if I knew then what I know now, I would MAKE them let me have one.  If it doesn't matter, what can it hurt?

Sheesh, I love medicine.

Hugs, Shirlann

Shirlann,

After reading all I've read thus far on the subject over the last 4+ years, I'm firmly convinced that the rad oncs know exactly what the potential consequences are. When you read research reports and literature submitted to medical journals written by radiation oncologists, they almost always downplay and otherwise minimize consequences and focus on emphasizing the continued need for radiotherapy - similar to what pharmaceutical companies do when they're marketing their patented drugs.

And you're absolutely right - that line about "nothing goes anywhere except the breast" is pure B.S. I can show you a stack of journal articles speaking to the contrary...and not just regarding radiation in years past either. It's a continued problem and an ongoing concern in trying to figure out how to minimize the radiation to areas it's not suppose to be affecting, but still does despite more recent improvements in the delivery.

Since I had a mastectomy and one positive node, that's where most of my research has been focused. Until recently, the rad onc profession made a distinction between mastectomy patients who had 4+ nodes, and those with 1-3. The 4+ patients were considered those who would receive high benefits from radiation, but the benefits were less clear for the 1-3 node patients. The rad onc profession now is moving to abolish this distinction, as an editorial in the May 2008 Journal of Clinical Oncology, Vol 26, No. 13, states:

"We believe thatcomprehensive PMRT [Post Mastectomy Radiation Treatment] is appropriate for the great majority ofnode-positive patients undergoing mastectomy. Some selectionbased on other clinical and biologic factors may be importantand appropriate. For example, Cheng et al²⁹ developed a modelto predict locoregional recurrence and the impact of PMRT onsurvival. In addition to axillary nodal status, estrogen-receptorstatus, lymphovascular space invasion, and age at diagnosiswere all found to be significant. Similarly, Truong et al³⁰ suggested that young age, medial tumor location, ER-negativestatus and greater than 25% of nodes positive were also predictorsfor a higher risk of locoregional recurrence. It is likely thatother more sophisticated biologic factors, such as gene expressionprofiling, will also be helpful in this regard."

I have read the two studies referenced in the editorial by Cheng and Truong:

1. Cheng SH, Horng CF, Clarke JL, et al: Prognostic index score and clinical prediction model of local regional recurrence after mastectomy in breast cancer patients.Int J Radiat Oncol Biol Phys 64:1401-1409, 2006[CrossRef][Medline]

1. Truong PT, Olivotto IA, Kader HA, et al: Selecting breast cancer patients with T1-T2 tumors and one to three positive axillary nodes at high postmastectomy locoregional recurrence risk for adjuvant radiotherapy. Int J Radiat Oncol Biol Phys 61:1337-1347, 2005[CrossRef][Medline]

In each case, they went beyond the number of positive nodes, and sought to identify women who were at low, medium, and high risk of recurrence.  Each found certain factors, as summarized in the editorial above, were predictors for a  risk of  recurrence. 

The Cheng study states: "In the low-risk group, there is no influence of PMRT on either LRR (locoregional recurrence) or survival." 

The Troung study concludes, "The absence of high-risk factors identifies women who may reasonably be spared the morbidity of PMRT."

I agree whole-heartedly with Marie that the rad onc profession systemically downplays the risks involved and pushes only the benefits of rad therapy, even if the potential benefits are small to non-existent and the risks for s/e like lymphedema are high.  The first rad onc with whom I met never even mentioned lymphedema as a risk - and this was at a major breast center!! 

A good article about the incidence and risk factors of lymphedema after PMRT is: Lymphedema Secondary to Postmastectomy Radiation: Incidence and Risk Factors, Annals of Surgical Oncology, Vol. 11, No. 6, 2004. 

I have one last consultation with a rad onc this coming Monday, but unless she is extremely persuasive and can give me facts and figures showing me that the potential benefits of rads outweigh the potential harm, I will be opting against radiation.  I've been through a bilat mast, 6 TAC chemo, and will be getting hormone therapy.  I had clean margins, no extranodal extensions, and no vascular involvement.  From what I've read, rads will give me little if any additional protection, and have the potential to leave me with permanent s/es.  Enough is enough.

Hi. I also find this thread interesting. Like OldOakTree, I did not have rads recommended to me. My docs said that it's not they they wouldn't benefit me, it's that the %  was not really worth it. Same with tamox, but I am on that anyway. My risk of recurrence was about 6% in ten years. They go to 10 years with DCIS because it usually takes longer to come back.  About 3% dcis, 3% invasive for someone with my pathology. Rads would lower that number by 50% to 66%. Mel Silverstein does recommend rads to many of his lumpectomy patients, just not the ones whose DCIS areas were less than 5mm, with 1 cent margins and lower grade. Like, Marie Kelly, I think that he's on his way to changing the way we look at small lesions.Unfortunately, most of the time, DCIS is not found that early or is just a faster growing type.I know that Silverstein and Lagios are pretty much the only ones, but it is a very important study that has now been followed for a few years by prominent docs in big cities. I live in Chicago  and I found at Northwerstern hosp that were quoting Silversteins studies. No rads for lower grade, large margins, and small focus. Hope my info helps. I have to believe I did the right thing. Three opinions can't all be wrong! I don't know anything about no rads and invasive, though, I belive that if your margins are really large and clean, you need to really analyze the situation and not just jump. Nada

OldOaktree wrote:

"...However, EVERYTHING I read says that ALL studies show rads to be beneficial (i.e. lowers recurrence rates) in ALL cases.  There is no subset that rads does not help.  Could someone (maybe MarieKelly or MarieS or mdb, as you seem very knowledgeable in this area) point me in the right direction where I can find studies that show this is not the case?  Or are there no such studies?..."

Yes indeed, there definately ARE such studies...for both DCIS and invasive disease as well.  First of all, literally all studies show that most don't benefit from the addition of radiation therapy -  it's just that the emphasis in studies is never about how many didn't have a recurrence without radiation. The emphasis and focus is placed on the difference in recurrence between having radiation or not having it. 

When a study shows that, for example, in a group of 100 who didn't recieve radiation there were 18 recurrences but only 9 in the 100 who did recieve radiation, the emphasis is on that difference. The fact that 82 (the vast majority) out of those 100 who were not radiated didn't have a recurrence is de-emphasized making it seem almost irrelevant..unless of course, that happens to be the information you want to know. But in reality, those 82% would not have recieved any recurrence benefit from having radiation.

Here's some journal information for you -    

For example -

http://www.annalssurgicaloncology.org/cgi/content/full/11/3/316

"An ideal group of 80 breast cancer patients was empiricallydefined for avoidance of adjuvant radiation after BCS on thebasis of older age (>50 years), smaller size (1.5 cm), lowergrade (grade 1 or 2), and adequate surgical margins (1cm). The local recurrence rate was only 6% after a median DFSof 64 months (range, 15-86 months). Median follow-up was61 months (range, 1-174 months); only one patient wasDOD. When patients from the unknown group (grade or margin datanot available) were included in the ideal group, the expandedideal group of 96 patients had a local recurrence rate of 5%and a median DFS of 64 months (range, 15-86 months). Themedian follow-up was 59 months (range, 1-174 months),and no additional patient was DOD. In patients who had one ormore nonideal characteristics, the local recurrence rate was22%.

Consideration should be given for BCS without adjuvant breastradiotherapy in such selected ideal patients after a thoroughdiscussion, including a description of standard alternativesand risks and benefits of radiotherapy. If treated with surgeryalone, these patients would still be candidates for radiotherapyin the future if local recurrence occurred. Patients not inthe ideal group should be considered for adjuvant radiotherapyafter BCS.": Eur J Surg Oncol.

2002 Jun;28(4):379-82. Links

Is radiotherapy needed after breast conservation for small invasive breast cancers?

St Bartholomew's Hospital, West Smithfield, London, UK.

AIMS: The purpose of this study was to determine the rate of local recurrence in patients with small invasive breast cancers (<1 cm) who had been treated with breast-conserving surgery either with (group 1) or without (group 2) adjuvant radiotherapy. METHODS: This is a retrospective study of 110 patients with an invasive breast cancer less than 1 cm in size, treated in our centre by breast-conserving surgery. Parameters examined included age at and mode of presentation, histopathological features, adjuvant therapy, length of follow-up and outcome in terms of local recurrence rate and death. RESULTS: In group 1 there were 59 women of median age 57 (38-80) years. The median tumour size was 9 (1-10) mm and median follow-up was 74 (15-110) months. There were no local recurrences. In group 2 the median age at presentation was 59 (48-81) years. The median tumour size was 7 (2-10) mm and median follow-up was 47 (14-93) months. There were three non-breast-cancer related deaths and three local recurrences (6%). CONCLUSIONS: A local recurrence rate of 6% at almost 4 years median follow-up suggests that it may be possible to avoid adjuvant radiotherapy in a subgroup of largely screen-detected, node-negative patients with invasive tumours less than 1 cm, in whom adequate local excision is performed. Further follow-up is required to substantiate this. Copyright 2002 Elsevier Science Ltd. All rights reserved.

PMID: 12099645 [PubMed - indexed for MEDLINE]

Eur J Cancer. 2003 Aug;39(12):1690-7. Links

Breast conservation surgery, with and without radiotherapy, in women with lymph node-negative breast cancer: a randomised clinical trial in a population with access to public mammography screening.

Department of Oncology, Lund University Hospital, S-221 85, Lund, Sweden. per-olof.malmstrom@onk.lu

The effect of postoperative radiotherapy after sector resection for stage I-II lymph node-negative breast cancer was evaluated in a patient population with access to public mammographical screening. 1187 women were randomised to no further treatment or postoperative radiotherapy following a standardised sector resection and axillary dissection. Radiation was administered to a dose of 48-54 Gy. Median age was 60 years, and median size of the detected tumours was 12 mm. Of the women 65% had their tumours detected by mammographical screening. The relative risk (RR) of ipsilateral breast recurrence was significantly higher in the non-irradiated patients compared with the irradiated patients, RR=3.33 (95% Confidence Interval (CI) 2.13-5.19, P<0.001). The corresponding cumulative incidence at 5 years was 14% versus 4%, respectively. Overall survival (OS) was similar, RR=1.16 (95% CI 0.81-1.65, P=0.41), with 5 year probabilities of 93 and 94%, respectively. Recurrence-free survival (RFS) at 5 years was significantly lower in the non-irradiated women, 77% versus 88% (P<0.001). Although women above 49 years of age, whose tumours were detected with mammographical screening, had the lowest rate of ipsilateral breast recurrence in this study, the cumulative incidence of such event amounted to 10% at 5 years if radiotherapy was not given. Such a recurrence rate has been considered as unacceptably high, but is, however, in the same range as that reported after lumpectomy and postoperative radiotherapy in published series.

PMID: 12888363 [PubMed - indexed for MEDLINE]

 1: Eur J Surg Oncol. 2008 Apr;34(4):369-76. Epub 2007 Jun 8. Links

The role of radiotherapy in treating small early invasive breast cancer.

Breast Unit, St Bartholomew's Hospital, Queen Mary University of London, London, UK. drphilipv90@yahoo.com

AIM: The aim of the study was to identify if radiotherapy can be safely avoided in a selected subgroup of largely screening detected small invasive breast cancer. METHODS: One hundred and eighty-eight patients with node negative invasive early breast cancer < or =1cm (< or =T1b) treated in our centre between 1990 and 2004 were retrospectively followed for local, regional and distant recurrences. Treatment involved adequate local excision by breast conserving surgery (BCS). Axillary staging was performed by a four node axillary sampling until 2000, following which sentinel lymph node sampling was employed. All sections were assessed histologically by haematoxylin and eosin stained sections. The inked margins were reported as being involved, close and clear. Radiotherapy (RT) was employed only if the resected margins were inadequate, and in those with involved axillary nodes who refused further completion axillary clearance. RESULTS: Ninety-four patients (Group A) had BCS alone and 79 patients (Group had both BCS and RT. There was no ipsilateral breast tumour recurrence (IBTR) in 88 patients in Group A, corresponding to an actuarial freedom from IBTR of 96%, 91% and 88.1% at 5 years, 8 years and 9 years. In Group B, there was no IBTR in 75 patients corresponding to an actuarial freedom from IBTR of 97%, 94.9% and 90.6% at 5 years, 8 years and 10 years. CONCLUSION: Our experience over 14 years has shown that it is possible to safely avoid radiotherapy in a selected subgroup of small invasive breast cancer.

PMID: 17560754 [PubMed - indexed for MEDLINE]

J Clin Oncol. 1999 Aug;17(8):2326-33. Links

Comment in:

J Clin Oncol. 2000 Feb;18(4):942-3.

10-Year results after sector resection with or without postoperative radiotherapy for stage I breast cancer: a randomized trial.

Department of Surgery, Orebro Medical Center Hospital, Orebro, Sweden. goran.liljegren@orebroll.se

PURPOSE: To study the long-term effectiveness of postoperative radiotherapy after sector resection for breast cancer in a randomized trial in which mammography is a major pathway to diagnosis. PATIENTS AND METHODS: Three hundred eighty-one women with a unifocal breast cancer < or = 20 mm in diameter on the preoperative mammogram and without histopathologic signs of axillary metastases were treated by sector resection plus axillary dissection. Of these patients, 184 women were randomized to receive postoperative radiotherapy to the breast (XRT group), and 197 women received no further treatment (non-XRT group). RESULTS: The local recurrence rate was 8.5% (95% confidence interval [CI], 3.9% to 13.1%) in the XRT group and 24.0% (95% CI, 17.6% to 30.4%) in the non-XRT group (P =.0001). Survival free from regional and distant recurrence was 83. 3% in the XRT group (95% CI, 77.5% to 89.1%) and 80.0% in the non-XRT group (95% CI, 73.9% to 86.1%) (P =.23). Overall survival was 77.5% in the XRT group (95% CI, 70.9% to 84.1%) and 78% in the non-XRT group (95% CI, 71.7% to 84.3%) (P =.99). A subgroup analysis suggested that women older than 55 years of age without comedo or lobular carcinomas had a low risk of local recurrence of 6.1% (95% CI, 0.1% to 9.1%) in the XRT-group and 11.0% (4.0% to 18.0%) in the non-XRT group (P =.16). CONCLUSION: Sector resection plus radiotherapy resulted in an absolute reduction in local recurrence of 16% at 10 years compared with surgery alone. Women older than 55 years of age without comedo or lobular carcinomas may have a low risk of local recurrence. Postoperative radiotherapy was not shown to reduce distant recurrences or improve overall survival.

PMID: 10561294 [PubMed - indexed for MEDLINE]

 Ann Surg Oncol. 2000 Sep;7(8):562-7. Links

Comment in:

Ann Surg Oncol. 2000 Sep;7(8):552-3.

Factors associated with local breast cancer recurrence after lumpectomy alone: postmenopausal patients.

Department of Surgical Oncology, University Health Network, Princess Margaret Hospital, University of Toronto, Ontario, Canada.

BACKGROUND: We have been following a cohort of patients who underwent a lumpectomy without receiving adjuvant radiotherapy or adjuvant systemic therapy. We now report the experience of a postmenopausal subgroup. METHODS: The postmenopausal subgroup included 244 patients accrued between 1977 and 1986 and followed up. The end point was ipsilateral local breast cancer recurrence. The factors studied were the patient's age in years; tumor size (in mm); nodal status (N-, Nx, N+); estrogen and progesterone receptor status (< 10, - 10 fmol/mg protein); presence or absence of lymphovascular/perineural invasion; presence or absence, and type, of DCIS (none, non-comedo, comedo); percentage of DCIS; histological grade (1,2,3); and nuclear grade (1,2,3). Univariate analyses consisted of Kaplan-Meier plots and the Wilcoxon (Peto-Prentice) test statistic; the multivariate analyses were step-wise Cox and log-normal regressions. RESULTS: The median follow-up of those patients still alive was 9.1 years, and the overall relapse rate was 24% (59/244). The univariate results indicated that the characteristics of smaller tumor size, negative nodes, positive ER status, and no lymphovascular or perineural invasion were associated with significantly (P <.05) lower relapse. From the multivariate analyses, the factors lymphovascular or perineural invasion, age, and amount of DCIS were all significantly associated with local relapse with both Cox and log-normal regressions. Additionally, there was weak evidence of an association between ER (P = .08 in the Cox regression and in the log-normal) and nodal status (P = .09 in the log-normal regression) with local relapse. We also are able to define a low-risk subgroup (N-, age -65, no comedo, ER positive, no emboli) with a crude 10-year local recurrence rate of 9%. CONCLUSION: With longer follow-up, and for postmenopausal patients, there continues to be support for the theory that local relapse is affected by the factors lymphovascular or perineural invasion, age, amount of DCIS, ER, and nodal status. A low risk subgroup has been identified.

PMID: 11005553 [PubMed - indexed for MEDLINE]

 Am J Surg. 2007 Oct;194(4):532-4. Links

Multidisciplinary management of ductal carcinoma in situ: a 10-year experience.

Department of Surgery, Breast Care Center at the Cordelia Knott Center for Wellness, 230 S Main St, Orange, CA 92868, USA. jwest@breastcare.com

BACKGROUND: Two ductal carcinoma in situ (DCIS) treatment controversies are (1) what is the preferred margin for patients undergoing lumpectomy plus radiation, and (2) is there a subgroup that can be safely treated with lumpectomy alone? A multidisciplinary team was established to evaluate these issues. METHODS: Patients with DCIS who were candidates for breast-conservation were divided into 2 groups. Group 1 had a minimum 5-mm margin and received radiation, and group 2 had a minimum 10-mm margin and received no radiation. RESULTS: One hundred fifty-two patients (153 cancers) met the inclusion criteria. The median follow-up was 8.2 years. Overall, there were 6 recurrences (3.92%); 1 of 71 recurred in group 1 (1.40%), and 5 of 82 recurred in group 2 (6.01%). CONCLUSION: Five-millimeter margins plus radiation results in low rates of recurrence. A subgroup of DCIS patients can be identified in which radiation can be safely avoided. The multidisciplinary team approach to managing DCIS enhances the potential for improved outcomes.

PMID: 17826074 [PubMed - indexed for MEDLINE]

Dear Ladies,

I was just diagnosed with tubular breast cancer in the very early stages. My BS called Friday with the results of the wire loc biopsy I had done on June 12th. She is scheduling me for more surgery to check the margins and remove 2 lymph nodes to make sure they're clear. She said the tumor(s) were very tiny and we caught this at a good time. My post op appt with her is this coming Wednesday. I'm going to ask for copies of all the reports at that time. She has also referred me to a rad oncologist since she is recommending rad therapy. They already called and left me a message to call and make an appointment.

I am 49 years old and this is my 3rd go around with cancer. The first time, I was 29 and grew a tumor the size of a grapefruit in my neck. Had 6 months of chemo and rad therapy then. The 2nd go around was in '05, started growing milignant tumors in the soft tissue of my right shoulder (same area that I was radiated when I was 29). I had 4 tumors over the course of two years. All were surgically removed with some muscle replacement as well as having the scapula trimmed (the bone had broken through the skin and I had a small hole in my back).

I am seriously considering saying no to the rad therapy. I will meet with the rad oncologist to hear what he has to say before making a final decision. I'm thinking that at this point in time, I don't have enough information.

I've read all your posts this morning and it's been a lot of help. I's like to hear back from you with your thoughts.

Gosh, Rafaela, I can see why you are not racing out to have (more) radiation! Do you feel good about the communication among your oncologists (surg, rad, med)? and that your current rad onco has a good sense of the radiation you have undergone before?  That's all I can offer at the moment. Except my best wishes -- and appreciation (awe?!) that you are here and posting.  

Hi Guys....I just had a lumpectomy....Clean margins, and the last tiny bit of cancer that was left after the biopsy was taken out....I will be discussing my coming six weeks of radiation treatments with my BS in the mornig....

I decided on rads because the BS told me that there was a 20% chance of recurrence withouth it, and only 5% with it....I fell into the 20% of those whose calcs were malignant, so didn't like those odds...Hence the rads.

I want to do everything possible to rid myeslf of cancer, and assure myself that it's chance of returning is reduced as much as possible...Because of other medical issues I will not be taking Tamoxifen....So..This is my best shot.

No...I don't want to do the rads....six weeks of trekking to the hospital, trying to work part-time, possible SE's...But....I am determined to give myself the best possible chance at a full recovery...

Sandy

Sandy,

Was your DCIS left or right sided???

MarieKelly - it was an undifferentiated carcinoma - no primary site found at the time. one day nothing - next day I looked in the mirror and said what the heck is that?