Aug 11, 2019 12:20PM Beesie wrote:
Brandy, welcome! But sorry you've had to join us.
I will try to answer your questions but with one caution. Your diagnosis is preliminary, and could change when you have surgery. And that could change a lot.
At this point, if the two areas of DCIS are near each other, you probably could have a lumpectomy. With a lumpectomy for DCIS, lymph node removal isn't required, so it's usually an easy surgery and a quick recovery. But with a lumpectomy, normally radiation is recommended. There are different protocols but I believe most common is 5 days a week for 6 weeks. To my understanding (I never had rads), the appointments are quick.
Alternately, if the areas of DCIS are far apart, a mastectomy might be recommended. Or you could opt for a MX rather than a lumpectomy. Normally a sentinel node biopsy will be done with a MX even though DCIS does not require that nodes be checked. This is just in case some invasive cancer is found, because at that point the nodes would need to be checked and an SNB can't easily be done after a MX. The recovery after a MX and SNB (and reconstruction, should you choose it) will be longer and considerably more restrictive than the recovery after a lumpectomy. In most cases, radiation is not necessary after a MX.
With pure DCIS, that's it in terms of active treatment. If your DCIS is hormone positive, endocrine therapy will be recommended (although possibly not after a MX), which is a pill you take once a day. So this has no effect on your schedule.
But...sometimes there is more DCIS than expected, and the surgical margins after a lumpectomy aren't clean, necessitating a re-excision surgery. I think that happens in about 20% of cases. And sometimes invasive cancer is found mixed in with the DCIS. Again, this happens in ~20% of cases. Most often, if it's just a microinvasion (1mm or less of IDC) or just a bit larger, the treatment plan doesn't change. But if it's a larger area of IDC, or a small IDC that is particularly aggressive (hormone negative or HER2+) then chemo might come into play. And if you have a MX and opt to have reconstruction, that could add more recovery time, more appointments, and possibly more surgeries.
So could you continue with your plans for school? Probably yes, if all goes well and so long as you can work around the time off for surgery. But there could be surprises that throw a wrench in the plans.
I don't know how much you know about DCIS. This thread might be helpful: https://community.breastcancer.org/forum/68/topics/790992