Right breast cancer DCIS: Is 4-5 weeks of radiation normal protocol?

Posted by m3rt @m3rt, Feb 21, 2023

I recently was diagnosed with (DCIS) stage 1, her2 negative, both hormones positive, 4mm size tumor. I chose to have a lumpectomy and do hormone treatment. The doctor removed 4 lymph nodes in the breast and one sentinel node all were negative for cancer. The tumor was removed January 23, the doctors said because the lump was so small they didn’t do a onco. test, but suggested that I do 4-5 weeks of radiation. I was wondering if 4-5 weeks for radiation is being over cautious? Or is this normal procedure? I will be laying on my back for radiation treatment.

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I as well was diagnosed with right breast DCIS in September 2022. I had a lumpectomy in December 2022 and had 6 weeks (31 treatments) of radiation from February through April of 2023. I was skeptical with so many sessions scheduled. I consulted with oncology SMEs who stated that the recommendation was not out of bounds.

Please do your research until you are comfortable.

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@louanne2024

I am 73 years old and I had DCIS in the left breast 3 years ago and had surgery to remove it. Unfortunately I had 2 different Oncologists, one telling me I needed radiation for prevention and the other take some form of medication. They both offered the fact that one was better than the other and in pretense I didn't do either. I had another DCIS found by biopsy in January and finally different Surgeon removed it April 4 and sent it to pathology and found the same but the edges were too close and now wants to do a double Mastectomy and remove lymph nodes up my left arm. The word cancer was mentioned to me and prevention. I really do not understand all of it but it just appears to be so drastic may be I am not undertanding all she has told me. Needless to say surgery is May 4.

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@louanne2024, that must've been hard to hear that breast cancer returned and that it looks like you will need a third surgery now in the form of a double mastectomy and lymph node removal.

It can be confusing. Your best tactic is to ask questions, and keep asking questions until your doctors can explain things in terms you understand. Sometimes we ask a question, they give an answer, and we leave it at that. Only when leaving the room does one realize that the answer wasn't completely understood. You're not alone in this.

What I find helps is to a) make a list of prepared questions and b) to repeat back in your own words. For example, when the doctor explains the procedure or next steps, I say something like: "Let me repeat what you just told me in my own words...."

This gives the physician a chance to correct anything I misunderstood or to recognize steps they may have left out. Rather than considering myself to be a pest or annoying with my questioning, I figure that I'm giving them a gift - the gift of laymen's terms. They do this every day. We don't. By explaining things back to doctors, they can learn more approachable language.

Louanne, do you have another consult before your surgery where you can ask your questions? If not, can you ask a nurse or post your questions on a patient portal? Are you a Mayo Clinic patient?

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I am 73 years old and I had DCIS in the left breast 3 years ago and had surgery to remove it. Unfortunately I had 2 different Oncologists, one telling me I needed radiation for prevention and the other take some form of medication. They both offered the fact that one was better than the other and in pretense I didn't do either. I had another DCIS found by biopsy in January and finally different Surgeon removed it April 4 and sent it to pathology and found the same but the edges were too close and now wants to do a double Mastectomy and remove lymph nodes up my left arm. The word cancer was mentioned to me and prevention. I really do not understand all of it but it just appears to be so drastic may be I am not undertanding all she has told me. Needless to say surgery is May 4.

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The drugs aren't horrible for all of us or even many of us, from what I have heard from others. I really hope people at least try. And it may take a few weeks for side effects to settle down as your body adjusts. I think the meds for recurrence are horrendous though!

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@doxielover1

I just had lumpectomy yesterday! Yea! It’s a relief but waiting for follow up in 2 weeks. Mine is Stage 0 grade 3. I am willing to do radiation but will not do the drugs. I’m not going to ruin my quality of life for it. I have a friend who is feeling the effects of tamoxifen 20 yrs later. If I have a recurrence, I’ll deal with it then.

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I hope it all comes back good and you can do the radiation and move on! 🤞The drugs sound pretty horrible. I am worried about being hormone negative. The thought of Chemo terrifies me honestly as I’ve watched friends go through it.

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@pattier

Absolutely! I agree with everything you wrote! Be assured the lumpectomy is pretty easy to recover from but I too was extremely nervous before the first one. By the 3rd, it was old hat. Ha Those things lurking in the future are what keep us awake at night, right? Cancer or pre-cancer - all the same. Our lives have still been turned upside down for awhile.

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The hardest part is the decision whether to just do the lumpectomy … knowing you might keep going through this or go for the full mastectomy right? The full breast radiation convinced me ( at this point) but we will always be waiting for the next scan won’t we? Yeah, life has definitely changed but it is what is and I’m feeling pretty lucky so far!

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@meg55

I agree! Just had the same conversation tonight about why they call DCIS “pre cancer” when clearly we need to have it removed then go through treatment. My lumpectomy is scheduled for 4/19. I’m not nervous yet but I know I will be as it gets closer. It feels like such a relief after each step.. biopsy, MRI, ultrasound and second biopsy but then there’s always something else lurking in the future. Right now the plan is 4 weeks radiation then possibly 1 week boost. No hormone blockers because I’m Estrogen/progesterone negative. Which is another worry.

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I just had lumpectomy yesterday! Yea! It’s a relief but waiting for follow up in 2 weeks. Mine is Stage 0 grade 3. I am willing to do radiation but will not do the drugs. I’m not going to ruin my quality of life for it. I have a friend who is feeling the effects of tamoxifen 20 yrs later. If I have a recurrence, I’ll deal with it then.

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@meg55

I agree! Just had the same conversation tonight about why they call DCIS “pre cancer” when clearly we need to have it removed then go through treatment. My lumpectomy is scheduled for 4/19. I’m not nervous yet but I know I will be as it gets closer. It feels like such a relief after each step.. biopsy, MRI, ultrasound and second biopsy but then there’s always something else lurking in the future. Right now the plan is 4 weeks radiation then possibly 1 week boost. No hormone blockers because I’m Estrogen/progesterone negative. Which is another worry.

Jump to this post

Absolutely! I agree with everything you wrote! Be assured the lumpectomy is pretty easy to recover from but I too was extremely nervous before the first one. By the 3rd, it was old hat. Ha Those things lurking in the future are what keep us awake at night, right? Cancer or pre-cancer - all the same. Our lives have still been turned upside down for awhile.

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@cathd

Hi!
Here is the link again
https://www.youtube.com/watch?v=IdKIF28C1xg

If you don't see it, do a search for "Peter Attia #278 Breast cancer: how to catch, treat and survive breast cancer". It's a YouTube, 2 hours and seventeen minutes long.

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Thank you. Got it and I plan on watching it this weekend when I have time to really pay attention to it. I appreciate you sharing this!

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@cathd

Hi!
Here is the link again
https://www.youtube.com/watch?v=IdKIF28C1xg

If you don't see it, do a search for "Peter Attia #278 Breast cancer: how to catch, treat and survive breast cancer". It's a YouTube, 2 hours and seventeen minutes long.

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This is an excellent video! Explained so much! Thank you for sharing!

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