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Diagnosed with DCIS: How do I decide on treatment?

Posted by tctredwell1 @tctredwell1, Aug 23, 2022

I was diagnosed with DCIS. I have to go in for a breast MRI with contrast tomorrow to see how active the cancer is. If it’s contained and not very active, do I have to have a lumpectomy?

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k9imnot | @k9imnot | Nov 28, 2023
In reply to @callalloo "I don't what your doctor will recommend but the recommendation will undoubtedly be governed largely the..." + (show)
@callalloo

I don't what your doctor will recommend but the recommendation will undoubtedly be governed largely the stage of the cancer. Which is determined by several variables, including size of the tumor, whether any lymph nodes are affected and other more qualitative things like location of the cancer and containment of cancer cells. The other factors include the type of cancer which the biopsy will note.

I'm assuming, since you have a diagnosis, that there was at least a biopsy done and the pathology report will yield a lot of information. I'd start by asking whoever made the cancer diagnosis these question. (DCIS is a cancer diagnosis though might be a Stage 0 which some oncologists consider a kind of 'pre-cancer' or possible-to-become-cancer.) And get a copy of any medical record in case you want to get a second opinion. And ask about any testing that can yield more data.

If a lumpectomy is suggested and you're worried about having one, I had one and it was a very simple procedure that healed, in my case at least, scar-free. (A small tumor, excellent surgeon, cancer-free margins.) I have a small scar from the removal of a lymph node that looks like a kitten-scratch and is nearly invisible eleven months later.) I had no pain from the lumpectomy and lymph node removal after discomfort (buy not pain) the first day.

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During my first MRI
I wore the headphones they provided.
I asked the technician to tell me everything that was going on and how long each one would last.
And I sang Nik Nack Paddy Wack give a dog a bone this old man came rolling home.

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maryanne7 | @maryanne7 | Nov 29, 2023

A diagnosis of breast cancer, any cancer, is terrifying. When I got my treatment plan from my doctor, I found out that chemo was a part of it, and that was terrifying, too. Luckily, I had a great therapist who helped me see that in a different light. I have mentioned several times on this forum, that chemo was not as bad as I imagined.

But here is what I haven't said. I don't get why so many here are talking about decisions about whether to do this or that. I followed my oncologist's plan to the letter. I had chemo, lumpectomy, biological infusions, radiation, and medication. My oncologist never gave me a choice, he gave me the plan. He gave me a rational for everything; he answered my questions before I asked them. I trusted that he knew how to take care of me. Everything worked out. I had a brilliant, caring, experienced oncologist and he teamed with a highly respected surgeon and radiation oncologist. I have been clear since 2015.

So, if you have doubts about your doctor, get another one. I'd be leery of an oncologist who left the decisions up to me. However, there is one decision that I think is personal and that is whether or not to have reconstruction. I did not have to face that one.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Nov 29, 2023
In reply to @mmichele "Good morning, I have just been diagnosed with Extensive Low Grade DCIS with a small Invasive..." + (show)
@mmichele

Good morning,
I have just been diagnosed with Extensive Low Grade DCIS with a small Invasive component after a biopsy (echo and mammography done). The ultrasound scan of abdomen and pelvis is clear as well as my chest X-ray. What would be the treatment? Would you recommend a mastectomy or lumpectomy? My surgeon is recommending a mastectomy of the breast and removal of the lympth node.

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@mmichele and @mandyc, welcome. Deciding on treatment is a very personal decision that is hard to make on your own. It helps to talk with others, but ultimately the factors that contribute to your decision will differ from other women. It sounds like you might have additional questions for your surgeon and cancer team. I would consider asking things like:
- In Michelle's case: Why do you recommend mastectomy over lumpectomy? In Mandy's case: Why do you recommend a lumpectomy over mastectomy?
- What are the risks and benefits of each option?
- Are you recommending removal of the sentinel node(s) or will more nodes be removed?
- What else should I know to help me make the right decision for me?

I also encourage you to read these 5 related discussions where members talk about lumpectomy vs mastectomy. https://connect.mayoclinic.org/search/discussions/?search=mastectomy+vs+lumpectomy

When will you talk with your surgeon again?

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christylv | @christylv | Mar 19 7:16am
In reply to @tapgirl "My lumpectomy (DCISstage0) was several years ago. As i recall, the recovery was uneventful. I opted..." + (show)
@tapgirl

My lumpectomy (DCISstage0) was several years ago. As i recall, the recovery was uneventful. I opted for radiation because I wanted the additional reassurance that there would not be a recurrence. I did not follow up with hormone therapy or medication of any kind.

If you do decide to have radiation and if the lumpectomy is on the underside of your breast, be sure to get a ComfortSling to protect your skin from radiation burns. It helped me immeasurably. My skin turned slightly pink by the end of radiation, but I had no burns, no broken skin, no pain.

Good luck with all!

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Hi! May I ask why did you decide against the hormone medication? Also what is your age? Thanks! 🙂

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tapgirl | @tapgirl | Mar 20 10:00am

A crystal ball would be so helpful when we try to navigate medical options. My doctors felt that radiation would probably (probably being the operative word) sufficient. I crossed my fingers and hoped they were right because I didn’t want to suffer the side effects of medication. So far, so good. That was 17 years ago; I am 85.

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