DCIS - second opinion regarding a masectomy
Has anyone gotten a second opinion on your treatment for DCIS? My area if 4+ cm and the surgeon is recommending the complete masectomy of that breast.
Thank you.
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Hi @theunexpected, It's worth getting a second opinion from a breast surgeon experienced in oncoplastic surgery. My tumor was 3.2 cm; the surgeon did a lumpectomy using an internal flap of my breast tissue to rearrange things so that I ended up with a good cosmetic result.
Much depends on the amount of breast tissue you have. Some people with large breasts get a lumpectomy and have a breast reduction on the other side to even things out. It is tricky to estimate the size of DCIS since it can be larger than it appears on imaging. I actually went into surgery having signed off on multiple plans: lumpectomy if possible, mastectomy with tissue expander if not, SLNB if those lymph nodes appeared relatively normal, ALND if they did not. I ended up with the oncoplastic lumpectomy and SLNB which was my first preference. My surgeon was very experienced and had stellar ratings and recommendations so I trusted her to honor my preferences while making sure all the cancer was excised. It might involve travel to find such a surgeon but I thought that was worthwhile.
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Thank you very much. I appreciate your detailed response.
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Get a second opinion so you can be bettet prepared to make a decision. I was on the fence between lump and mx for idc, but the plastic surgeon at one of the best facilities said the location would would cause a significant cosmetic defect. I’m glad I had the mx because I had over 2cm of unseen dcis in final pathology, and because of the clean margins and nodes I was able to avoid radiation. A good reconstructive center may be able to offer you a lumpectomy, so it’s worth it to check.
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Thanks. What I learned is that the area of the dcis will likely require the mx. But I will continue to research options.
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