Lumpectomy + radiation or mastectomy for DCIS?

Hi. I was diagnosed with DCIS nuclear grade 2 in my mammogram and subsequent sterotactic biopsy. Another mammogram and sterotactic biopsy revealed multi focal and multicentric dcis (still low nuclear grade). Since half the breast had microcalcifications and my boob size wasn't huge (36 c), the surgeon opted for mastectomy. I was given an implant directly after the mastectomy to reduce the emotional trauma.

Three weeks on and the results of the mastectomy were in. Apparently microcalcofications were in the deep lateral and surgical margins as well. No way out except radiation, which might negatively affect the implant. This has been a long torturous downhill journey and there is no end in sight. Your surgeon will advise you, but there are still no guarantees :( . The final result you ll only know once the biopsy of the mastectomy / lumpectomy comes through. Wishing you health x 

Hello Sakura,  Sorry to hear about your latest challenge.  Seems with breast cancer there is always one more thing that comes along.  Radiation makes sense and let’s hope the implant will be ok.  Everyone is different and I haven’t read anything that can be done but I wonder if breast massage would help after you got finished with radiation?  Guess radiation oncologist could help with that question.  I would bring all my questions with me and try to get answers.

 I had DCIS intermediate grade in right breast and stage 1 invasive in left so had two lumpectomies and bilateral radiation.  In DCIS they want to have 2mm clear margins but there was a small area that had <1mm margin but no ink on area so they did 15 radiation treatments on right snd left but an extra boost of 5 on right.  breast.  I am small breasted and surgeon told me that he would not be able to give a good cosmetic outcome so tumor board all agreed this was a good plan for me.  I am 73 but healthy snd active.  I will try and find that article on surgical margins for you.  I pray you will be fine and your implant will hold up well too.  
https://pubmed.ncbi.nlm.nih.gov/28928852/

I was on Anastrazole as have ER+ cancer but got so itchy I am off it for 2 weeks and then will see what my next step will be.  I just hope next one will not give me the itchy, scratchy problem.  
Bye for now.

Barbara

Dear Sakura. I'm so sorry to hear that things didn't turn out as hoped after the operation. That is the biggest difficulty I am facing - the constant uncertainty and not knowing what you are actually dealing with! Trying to make the decisions you feel will be best for you and your circumstances on the basis of educated guesses at best! So frustrating when it then turns out to be different :( I can totally understand your upset. I hope the radiation goes well for you and that the end does come into sight sooner rather than later. Stay strong! x

Hi Barbara, thank you for your kind uplifting words, they did lift my spirits up so. To be honest I just feel tired. I don't know if I have it within me to bear another treatment line. There are days when the task ahead seems impossible and hopeless. I have never felt more alone. Its as if life has gone on for everyone else and I am still stuck in the same spot....anyway, don't let my morbid thoughts get you down.

Please can you tell me what to expect in radiation. I will have my appointment with the oncologist soon and want to go in feeling a bit informed. 

So true. I was always such an optimist in life and now it seems all I do is take the negative view. Thank you for your kindness and support. I wish you health and peace in your journey x

Dear Sakura. It really is awful I know, and I find the same - some days are much worse than others and everything can feel emotionally exhausting. Just take it easy and be kind to yourself. Have you joined any Facebook groups? I have found them really useful, and a bit more active than some of these forums. You can find very specific ones for your situation - for example one I am.cutrenlty using is for women choosing to stay flat after mastectomy and I am getting a wealth of information. Something like that might be good to feel less alone? I also used the Breast Cancer Now 'someone like me' service to speak to someone about her experience, which I found really helpful. 

As regards radiation I'm afraid I can't help you as I am now having a mastectomy so should not need radiation (unless of course something more is found).

Maybe start a new thread to ask any questions you might have?

All the best to you, sending you positivity xxx

Dear Staying positive,

Thank you so much for your advice to Sakura, this has helped me too. Hugs to both of you.

Ah that's great to hear. I was a silent lurker on so many threads too, and always take something away from the discussions. That's what we're here for right?   take care and hugs back xxx

I understand completely sweetheart and was also very optimistic before this journey began. No it just seems more bad news and difficult to know what choices to make. So I just wanted to reach out and send you my love XXX

Hello Sakura, radiation was not bad at all.  I did not want to have radiation and almost opted for double mastectomy but after going over everything with my breast surgeon and radiation oncologist it didn’t make sense as tumors were DCIS and stage 1.  So off I went to my sessions.  The planning session took quite a while and lots of scans and measurements to decide on location of radiation etc.  but treatments themselves were only about 10-15 minutes.  You are naked from waist up but I quickly got used to it.  Would use a towel wrapped around my chest and then remove it when I lied down.  The staff was great and I never felt uncomfortable.

 I was also worried about my skin as I have super sensitive and reactive skin.  But I was very diligent with my skin care and only got a little pink and occasionally had some scattered itching which I put cortisone on and instant relief.  I did get zinging type pain in right breast now and again and was told just nerves regenerating.  It was in right breast usually and I think it was because surgery on that breast had been 4 weeks where other breast had been about 16 weeks.  
3 weeks after radiation treatments were done I started breast massage per radiation oncologist order and seems my zinger pain stopped .  Was told to do daily for 6 months and then at my follow up told to do for 6 more.  You would need to ask your radiation oncologist about it.  So far my breasts are soft and feel normal and skin looks like before radiation.  I am hoping it stays that way as radiation changes things.  
Good luck snd you can ask me any questions too.  
I have attached the link for breast massage

https://m.youtube.com/watch?v=uRlGXeOcJno

Happy New Year.

Barbara