DCIS with no clear margin-what to do?
Hi, this is my first blog, EVER. I am hoping someone out there can can give me advice as to what to do.
A routine mammogram found DCIS in my right breat. Subsequent biopsy showed DCIS- high grade, with no invasive cancer cells in the breast tissue. I have since had 2 lumpectomies (histopathology showing intermediate grade DCIS) but unfortunately I still dont have 100% clear margins. My surgeon feels that mastectomy with immediate reconstruction would be the next best option, but is it overkill, since not all DCIS leads to cancer and also my cancer is only intermediate?
Has anyone has a 3rd excision performed and was it successful? Am I better off getting a second opinion from another surgeon, or should I get advice from a radiooncologist.
I would love to hear from women who have had similar experiences and hear how they have dealt with the situation.
Comments
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Hi,
My story, I had large area of DCIS - after 2 rounds of needle biopsy, they can not find any cancer cell. So more test, like the very expensive MRI etc. followed by a lumpectomy operation 3 days before my mastectomy and implant ...
Every situation is different, your decision only effects you no-one else. There is no right answer - even doctor will only come up with recommendation base on stats and historic data + risk managment plans ...
More questions:
* how comfortable are you and your partner feel about the "not 100%" clear margin
* does the doctor feel it is over-kill? Or Risk Management for your well-bring? Definately get a second opinion, see a private surgeon?
* DCIS - is a medical term, do you feel comfortable about the bc risk factor & have done what is best for yourself?
* Are you afraid of Mastectomy? and how it might make you feel
all the best,
Amy
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I had DCIS high grade, 1 lumpectomy before i had the mastectomyinbox me . I would have the mastectomy and reconstruction again. no choice about it. no matter how much i complain about my recon, what other choice do we really have, thats my opinion... let me know what u decide. its all up to u, but i think its safety first !!!! inbox me if u wish with questions, or just to talk....
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I had DCIS high grade, 1 lumpectomy before i had the mastectomyinbox me . I would have the mastectomy and reconstruction again. no choice about it. no matter how much i complain about my recon, what other choice do we really have, thats my opinion... let me know what u decide. its all up to u, but i think its safety first !!!! inbox me if u wish with questions, or just to talk....
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You sure have a difficult decision to make.Maybe you need to ask your surgeon more questions such as how long can you safely wait before you decide- weeks?months?I had a lumpectomy(clear margins)and radiation back in 2003 and it grew back in the same spot 7yrs later so had to have a mastectomy and chemotherapy last year.Radiation doesn't give you any guarantees,there is an 8% chance of cancer coming back.Although a mastectomy is radical surgery and harder to get used to,it's not as bad as chemotherapy.That is one treatment you want to avoid at all costs.We all have different breast cancer stories and personal reasons why we decide what we do.Just gather as much info as you can and then go with what you feel is right for you at this present time.Have no regrets because either way is an awful decision that you'd rather not be making.
Tonya xx
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Hi Hynda
As the girls have said above, it really is a decision only you can make, and everyone's feelings about their breasts is different. I had a 16cm lump that I could feel and whilst my surgeon suggested lumpectomy and radiation - I insisted that I have a bilateral mastecomy. Sure at 40 this was radical but 7 years ago my mum had a single mastecomy without recon and I promised myself that if I ever contracted this damn disease that I would remove them both (as this is something she wishes she had done)....the pathology after surgery showed that my decision was timely as there was another small tumor and pre- malignant cells in the other breast that the MRI and mammogram did not detect. The other thing you have to consider is your current relationship with your breasts. In all honesty I felt no sense of loss or remorse when they were removed. I did not have a great deal of sensation in them and they were not a very big part of my sexual being.They were enormous during puberty for me and a great source of angst and I was very self conscious. With both babies they let me down and I had all sorts of trouble with my milk. They ended up very stretched and saggy. So it was not really sad to see them go. I like my new reconstructed breasts and are enjoying wearing shoestring tops and strapless tops, something I rarely wore before. Sure - if given a choice I would have the old girls back - but I didn't choose cancer it chose me........Good luck with your decision, I am sure you will make the right one for you
x Liz
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Hi,
well I saw a second surgeon today and she also agrees that a mastectomy is the best option for me at this stage, if i want to be cured of this disease. The DCIS appears to be in more than one area of my breast and it will probably become invasive in 5 years if i do nothing now. As i dont have clear magins, radiotherapy will not work, as they NEED clear margins.I have decided to now see the 2nd surgeon as she is more informative than the first and we both like her better than the first surgeon (not that she there was anything wrong with her surgery). She also works with a highly regarded plastic surgeon who comes recommended to me- he only does boobs! Alan's kind of man!
As we leave for Fiji tonight, the surgery wont happen till Jan 10, but at least it is all booked.I can get a tummy tuck, new breast and breast lift (for the existing boob), so I will hopefully look "bloody amazing" at the end of all of this. I do understand theat it will may not turn out as good as I hope, but I am confident that is the right decision for me.
Thank you all for advice and support during this trying time.
Hynda
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thnaks Amy- I will be relaxing and chilling.
All the best to you,
Hynda xx
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