• Diagnosed with DCIS and had lumpectomy. Oncologist says to start radiation and the radiation specialist says to skip it?

    Asked by SuzanneV on Friday, October 26, 2012

    Diagnosed with DCIS and had lumpectomy. Oncologist says to start radiation and the radiation specialist says to skip it?

    Since the mass removed was taken out with a clear margin should I go ahead with radiation or skip it and only take Tamoxifin for 5 years?

    11 Answers from the Community

    11 answers
    • leepenn's Avatar

      Did you get an oncotype score? Do you know what your risk of recurrence is? Maybe rads but no Tamoxifen? Maybe tamoxifen but no rads? Maybe neither? Maybe both? TOUGH QUESTIONS.

      Sounds like your DCIS was estrogen receptor positive. Do you know anything else about your DCIS?

      Definitely, I think you need more information before you can make an informed decision with which you can feel peace. Minimizing side effects AND recurrence risk = good.... But it is a bit of a balance, I think.

      Don't know if that helps at all....

      Good luck. I hope you are able to come to a decision that is right for you.

      over 8 years ago
    • nancyjac's Avatar

      There are pros and cons to both. Since your current cancer is in situ, (i.e. non invasive) you might want to consider not having radiation now so that it will still be available as a treatment option should you have invasive cancer at some point in the future. If you haven't already, I would recommend you have both doctors give you their specific reasons for their opinions for and against and then make your own call.

      Rads and tamoxifen are not an either/or choice. The rads are to eliminate any stray cells that might have escaped the area of the lumpectomy. The tamoxifen is to block estrogen availability if the cancer cells were estrogen receptive and thereby reduce the risk of recurrence.

      over 8 years ago
    • Ydnar2xer's Avatar

      Whoo boy! I can answer this one. I had DCIS and lumpectomy in 2003. My onc had me do 35x of rads then 5 years of Tamoxifen---and I was diagnosed again in August with Invasive Ductal Carcinoma. Would I have done all that I did in 2003 again? You bet. I'm taking the wise advice of my onc...who told me there was "no way" this cancer should have gotten me again. This time, it's bilateral mastectomy (my choice), 18 weeks of TCH chemo and Herceptin until September 2013. If there were any more precautions/treatments he wanted me to take, I would do them. He has been in onc for over 30 years, and I trust him completely...it's the cancer that is unreliable. Good luck with your decision making. Trust me, I feel your pain. :-0

      over 8 years ago
    • SueRae1's Avatar

      Tough decision. I know women who have done the radiation therapy, and those that have only taken Tamoxifin. I would suggest that you get a 2nd opinion form both a Breast and Radiation oncologist . They maybe be able to give you some insights, and information that will help you make your decision. One of my friends ask her 2nd opinion doctor (who was male) "If I were you wife, mother or daughter, what would you tell them to do?"

      over 8 years ago
    • Gena's Avatar

      I was diagnose with Stage I DCIS. Had lumpectomy, radiation and chemo and took tamoxifen. Had clear margins. Cancer came back 3 years later. Now Stage IV. Do not regret in 3 years you didn't do whatever it took to make sure you remain cancer free.

      over 8 years ago
    • cher598's Avatar

      I had a lumpectomy Sep 5--I have not started radiation yet. I turned down kemo.which they also recommended(you can get a gene test to see if you are more prone for it to come back, in addition to the first screening.}I take the harmone drug for 5 years. I have taken it for only 2 weeks with no side effects(Doc said it takes about a month for effects to show up}. I have read that anastrozole has less side effects than tamoxifin.With radiation it will bring down the percentage of cancer coming back.Your body /your choice, but I would get another opinion or go ahead with the radiation--hope this helps TC--let us know what you decide

      over 8 years ago
    • debco148's Avatar

      Key question that seems unanswered here.. did they check your lymph nodes during lumpectomy? Also, did you ask the radiation oncologist why they said no to radiation? Did they review your pathology report? Seems clear cut but, the oncologist must have a reason.. you will need to ask more questions. Radiation is tolerable so don't skip it if can get rid of any stray cells, axillary node isses, etc. Please question it some more.. you deserve it! Best to you.

      over 8 years ago
    • SuzanneV's Avatar

      Thank you for all your feedback. I am still emailing back and forth with my oncologist and radiation specialist to get more details and assurance. So far they both claim that radiation is standard for everyone. However, considered my low grade: 0 nuclear grade 1, small size 0.35 cm and clear margin, actually all the cancerous cells were removed by the initial biopsy and the lumpectomy was already DCIS free (no lymph nodes checked). The oncologist doesn't want to take any risks but the radiologist keeps being optimistic about those facts. I know I have to be ready for the cancer to come back at any stage in my life as of now but don't want to get radiation if it is not 100 % necessary. If they would tell me that the cancer was invasive I wouldn't doubt a moment. But now I have 2 opinions that are telling me to choose. I will give it time this weekend to digest but for now I am pretty much set on 'no radiation 'due to the convincing facts that my radiologist is giving me.
      So difficult to decide on something that will affect the rest of my life and trying to keep sane at the same time.

      over 8 years ago
    • nancyjac's Avatar

      DCIS is non-invasive because it hasn’t spread beyond the milk duct into any normal surrounding breast tissue. Since it is contained in the milk duct, that already rules out any lymph node involvement.

      Statistically, radiation for DCIS does slightly lower the risk of recurrence. The trade off is, that if you still get a recurrence in a breast that has been previously irradiated, it may not be detected as early and radiation may not an an option for the recurrence due to the levels of previous radiation or because it might not be an effective treatment option at a higher stage of invasive cancer.

      over 8 years ago
    • Bonanza's Avatar

      I think you should se a holistic doctor before you make a decision. Holistic medicine might show a different approach.

      over 8 years ago
    • Paw's Avatar

      Hi SuzanneV. What ever you do, please don't stop taking tamoxifen after five years. I stopped taking tamoxifen after five years and the cancer came back. I believe that if I continued taking the tamoxifen, the cancer probably wouldn't have come back . I believe you should take the radiation because there might be small cancerous cells in the surrounding area of breast that are not visible. I would take the radiation as a precaution. I wish you well.

      over 8 years ago

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