Diagnosed with DCIS: How do I decide on treatment?

I have questions about adding chemo to treatment in addition to letrozole after a single mastectomy on 8/11 (dcis stage 1 grade 1) and an Oncotype score of 28 which falls into the intermediate range. As a 75 year old, I feel like I need to assess the side effects of chemo against the benefit of stopping a recurrence of 17% over 9 years. I am also unsure of what additional testing might be done over time.

If you can still have the OncotypeDX genomic test done, you can have an idea of your risk of recurrence. And, if it's very low, it makes decisions easier as a low score also suggests against chemo. I had the test done nearly 3 weeks after a lumpectomy so the time lag wasn't an issue.
(And the resulting low score was helpful.)

I was offered local site-specific precision radiation that was every other day for a total of 5 sessions. I think it's considered very low risk but is specifically to "clean up" the area around the tumor site and offered only that local protection in case some rogue cells remained. I didn't have it but think it's not a bad idea. And if the tumor (caught at stage 1A) were larger or the sentinel node biopsy detected cancer cells, I likely would have had it. But I hope you get enough information to look at the options and don't rule out anything just because of age either. Just look at the big picture and which decisions would 'wear well' meaning least likely to cause second-guessing later.

As you can see, you are definitely not alone. Welcome.

Welcome @finallyretired. Being freshly diagnosed with DCIS is likely not the retirement gift you were hoping for.

You'll notice that I moved your question about deciding on treatment after a partial mastectomy to this existing discussion:
- Diagnosed with DCIS: How do I decide on treatment? https://connect.mayoclinic.org/discussion/dcis/

I did this so you can read previous posts about DCIS and treatment decision making as well as connect with other members like @tctredwell1 and @sakina who were also recently diagnosed and those who have journeyed before you like @sequoia @kathyomaha55 @jennie23b @collielady and many others.

I can certainly understand the choice to not have further treatment after surgery. It's a personal choice. Did your cancer team perform the Oncotype DX test on a tissue sample that may help with your decision about chemo's effectiveness for you?

The Oncotype DX Breast Recurrence Score® test has been developed for patients with early-stage HR+, HER2- breast cancer to:
– Precisely identify those patients who will and will not benefit from adjuvant chemotherapy
– Determine the magnitude of chemotherapy benefit
– Provide an individual’s risk of distant recurrence

About the Oncotype DX Breast DCIS Score test https://www.oncotypeiq.com/en-US/breast-cancer/patients-and-caregivers/stage-0-dcis/about-the-test

Hello all. I just had a partial mastectomy three weeks ago for stage 0 DCIS. I've been to the oncologist (yesterday) and have an appointment with the radiologist mid September. I've been researching the two treatments that are available and I'm leaning towards no treatment. I'm 72 years old and it seems like both treatments are fairly extreme and I'm wondering if my quality of life is more important than taking either of these treatments. I would love feedback as I feel like I really have no one to help me make this decision.

All is well for now. I went to see another doctor yesterday for a second opinion. He said he and his team need time to go over all the labs and get the rest of that MRI report from Christ Hospital. I hope he has better luck than I did! He thinks I’ll need more tests but his office will let me know asap. Also his office is closed next week so I won’t see him for awhile. I’m glad for the rest but not the waiting…😱

Thank you for your support. It means a lot. 😊

Thank you for your reply. Unfortunately, I don’t have any family to lean on but my friend and neighbor has been a tremendous support. However she is battling her own health difficulties and I don’t know when she’d be well enough to accompany me. We’ll have to see. I was able to get through to one of the recommended doctors at the center last night who clarified some confusion. He said the enhancement on the MRI film was not me moving (a tiny bit) during the breast MRI. He said the radiologist will mark the film with a symbol indicating movement. He said images caused by movement are different than “enhancement”. The center doctor said that the enhancement area probably needed to be biopsied. That would be biopsy #3 for me. I texted my own doctor back with this info. The center wants me to call back on Monday for an appointment next week and to arrange for the transfer of results. Then the center doctor said his whole office is closed not only for Labor Day weekend but for the whole week ! Aahhh!

I'm glad you're getting a second opinion. I don't know what a 'breast doctor" even is but I'd stick with experienced board-certified oncologists. And get areas two opinions about anything related to breast cancer diagnosis and treatment.

Good for you for looking toward the second opinion. Another benefit of being at the cancer center for the second opinion is that you will have oncology doctors helping you to understand everything better. There is so much information, some good some not so good on the internet, definitely better to get all the information you can from your own doctors, especially since there are soooooooo many variables to breast cancer.
I am glad you came here for support. There are many of us who have been through varying stages of breast cancer to lean on. In December I will be an 18 year survivor.
Do you have friends and family to physically lean on when you need it? Like someone who can go with you to appointments and help you ask questions, and get all the answers?