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I was just recently Dx with DCIS in L. breast ER+ and PR+. I am debating between the recommended treatment of partial mastectomy, radiation, and Tamoxifen for 5-10 years. The radiation significantly reduces my options for future reconstructive surgery if needed after treatment, and the meds do not seem appealing either.

March 27
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A MyBCTeam Member

Each case can be so different. A lot of quesions about making these decisions but hopefully you have a good team to guide you. I was very afraid of chemo and radiation, but my reports said not necessary = but if I’d done a lumpectomy, they probably would have added radiation. My other breast had some suspicious areas, plus each breast had had prior biopsies. At 73, I did not want to go all through everything on one side, only to have the other side have problems in a few years, so, after discussions with surgeons, everyone agreed that bilateral mastectomy would give me the best outcome. I agreed. Currently waiting for April
appt to discuss revision surgery. Did tissue expanders with July mastectomy, then the Dec. implants. Nothing fast about any of it, but giving our bodies time to heal is so very important. Maybe I won’t have to have any additional surgery. Maybe I will learn how X Y or Z would help. The healing of our minds is a huge factor in deciding and completing each possible procedure. Best wishes. Never be afraid to ask a million questions because there isn’t much that a good cancer team hasn’t heard before. They are there to help.

March 31
A MyBCTeam Member

Thank you for your thoughtful response. I appreciate you sharing your experience. 💗

March 28
MyBCTeam

What are the treatment options for unilateral DCIS, and how do they compare?

For DCIS in one breast, the standard treatment options are lumpectomy (partial mastectomy) or mastectomy. With a lumpectomy, the surgeon removes the tumor and some surrounding tissue, preserving most of your breast. This is typically followed by Show Full Answer

What are the treatment options for unilateral DCIS, and how do they compare?

For DCIS in one breast, the standard treatment options are lumpectomy (partial mastectomy) or mastectomy. With a lumpectomy, the surgeon removes the tumor and some surrounding tissue, preserving most of your breast. This is typically followed by radiation therapy to eliminate any remaining cancer cells.

A mastectomy removes all breast tissue from the affected breast. This may be necessary if you have large or multiple tumors, can't undergo radiation (due to pregnancy or previous radiation), or prefer this option. Some people at higher risk choose bilateral mastectomy, though this isn't typically the first recommendation for DCIS in one breast.

Since your DCIS is ER+ and PR+, hormone therapy like tamoxifen is often recommended after surgery to reduce recurrence risk. This is usually taken for 5 years and can significantly lower the chance of cancer returning.

Both lumpectomy and mastectomy can be followed by reconstructive surgery if desired. You're right that radiation can affect reconstruction options, so discussing timing and techniques with both your oncologist and a plastic surgeon is important.

DCIS has an excellent prognosis - over 98% of people survive 10+ years. The choice between lumpectomy and mastectomy often comes down to tumor characteristics, your personal preferences, and future cancer risk.

March 27
A MyBCTeam Member

The million dollar question!
I agonized over this. I had to chemo first. My surgeon recommended lumpectomy, but told me to some research and to get a second opinion. Then she said she do whatever I wanted.
I really appreciated her honesty.
Wishing you well!

March 31
A MyBCTeam Member

As breast cancer patients most of our options to treat our initial breast cancer diagnosis and to prevent a future cancer recurrence are not appealing. The first time I had breast cancer I was diagnosed with invasive ductal carcinoma in 3 of the 4 breast quadrants which meant I was not eligible for lumpectomy and had to have a mastectomy. Since my mother had died from breast cancer that was stage 4 when she was diagnosed, I opted to have the double mastectomy to be on the safe side and I had immediate reconstructive surgery. Lots of hormone positive women have reconstructive surgery performed at the same time they have a mastectomy. Plastic surgeons do say reconstruction surgery is easier to do and the patient has more options if it is done prior to having radiation because radiation can damage the elasticity of your skin making it harder to use implants during reconstruction since the skin doesn't stretch as easily to accomodate an implant. After my second bout with breast cancer I had the cancererous tumors and a bunch of lymph nodes removed along with reconstructive surgery. I had some post reconstuctive surgery issues and my implant had to be removed. I couldn't wait any longer to start chemo and radiation since my latest cancer is aggressive. The plastic surgeon told me if I wanted reconstruction later on that I would most likely have to have a flap surgery done in large part because that way the radiation damaged skin is replaced with undamaged skin from the flap surgery. My post radiation skin in the radiated area does still have some stretch and elasticity, but not as much as it did before radiation. I'm letting the skin recover until I'm one year post radiation and then I plan to look into reconstructive surgery with an implant if my skin does have enough stretch. Take some time to research all of your options with reconstructive surgery done both before and after radiation so you will have the knowledge needed to make the best decision for you personally. Good luck to you with whatever option you decide to pursue ❤️

March 27

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