• advice please -DCIS diagnosis with treatment choices

    Asked by torystory on Tuesday, March 20, 2012

    advice please -DCIS diagnosis with treatment choices

    i went to the surgeon today and i have to chose between a partial mastecomy (lumpectomy) and radiation or a total mastectomy.

    6 Answers from the Community

    6 answers
    • saltermd's Avatar

      Our center tends to treat most DCIS with lumpectomy followed by radiation and then tamoxifen. This is considered a fairly standard approach to managing this disease. I have rarely seen DCIS managed with mastectomy unless there was also a component of invasive cancer, or the patient wanted to avoid radiation completely. Hope that helps !

      over 8 years ago
    • KJB's Avatar

      Torystory - I was diagnosed with DCIS in October. Had a lumpectomy followed by 33 radiation treatments and now on Tamoxifen and doing well. I would be happy to share any information or my experience with you. Sending you positive thoughts.

      over 8 years ago
    • nancyjac's Avatar

      I had DCIS 18 years ago. I had a lumpectomy and lymph node removal plus radiation. I now have IBC in that same breast and this time chemo, mastectomy, and radiation. 2 completely separate cancers, 17 years apart, just happened to be in the same breast. If I had had the mastectomy 17 years ago, I wouldn't have cancer again now.

      over 8 years ago
    • leepenn's Avatar

      This is a tough one... What was your hormone receptor status? That could make a difference. Are you able to get an oncotype score? That is a measurement that helps because it can tell you about the probability of recurrence. This is only available for hormone positive cancers. What are your health care providers suggesting?

      It's such a personal decision, whether to do lumpectomy or do the mastectomy or even to do the total bilateral mastectomy.

      I had a full on lump - invasive ductile carcinoma... For me, I never loved having fairly substantial breasts... I had always wanted to be smaller. Also, my tumor was triple negative and fairly large (~3 cm), so mastectomy was recommended. Two things led me to choose bilateral. One - I'm already bumpy (fibrocystic), and I didn't want to be constantly in the office for biopsies... Two - I can't really handle asymmetry. So, I had bilateral mastectomy, and I am very happy with this decision. I don't care for my scars, but I sure do like being flat!

      Other women I know have done reconstruction - a minimum of two surgeries... Other women I know have done just the lumpectomy. At the end of the day, it's such a deeply personal decision!

      Lumpectomy with radiation, mastectomy with reconstruction, mastectomy with no reconstruction, bilateral.... Talk it out with people you trust... And no matter what you decide, it will be the right decision FOR YOU! I wish you peace around your decision.

      over 8 years ago
    • laurie's Avatar

      I was diagnosed with DCIS in November and had a mastectomy with tram flap reconstruction in December. The first few weeks recovering was hard but now that I am 3 months out I feel great! I have my secondary surgery April 17th and I can't wait! My new breast looks good. They did a lift on the other side and I love not having to wear a bra!

      over 8 years ago
    • hikerchick's Avatar

      Mine started out that way also. It turned out that there was more than one "cluster" of DCIS quite close together. To me, that meant it had begun growth from more than one source, and that was significant in my decision-making process, but nearly impossible to get that detail from the nurse practitioner. For me, it was essential to get a copy of my pathology reports and find a professional to explain it all to me in detail to be sure I didn't misunderstand parts. Also, thank goodness for the foresight of that nurse practitioner, I had a chest MRI taken to also look at the other breast before going in for a lumpectomy. That quickly showed a very large area of over-activity in the right breast that had gone undetected thus far and was extremely close to the chest wall. The lumpectomy turned into a bilateral lumpectomy right there when I was getting wired for surgery. The DCIS areas in the left breast had progressed to Stage 1 in two spots, which was also impossible to find out without the pathology report in my hands. Staff just mentioned the largest of the Stage 1 tumors; didn't even mention the fact that there was more than one! And this, also , was part of my dicision-making process: cancer was sort of everywhere, it had spread past the ductal walls...... and what I needed was a bilateral mastectomy. And I have never regretted that decision. I didn't need radiation, hormones, chemo or reconstruction. I was done.

      Now, of course, this is MY journey and yours is so very likely to be better. But the parts about getting ALL the DETAILED information about your circumstances is what I would want to hear if I were in your shoes. Also, results from a chest MRI are essential before going in for a lumpectomy, if there's any chance (dense breast tissue, under age 55, etc.) early cancer may have been missed in the other breast.

      I hope that helps rather than frightens you. I hope it provides more tools amongst your resources. Good luck to you!

      over 8 years ago

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