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Avoid DCIS Radiation?

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Why would you want to avoid DCIS radiation? If you’ve been diagnosed with Ductal Carcinoma In-Situ (DCIS) you probably want to do everything possible to prevent a diagnosis of full breast cancer.

For the record, DCIS is NOT cancer. It is a form of pre-cancer. Examples of pre-cancers are:

  • DCIS
  • Colon polyps
  • Early stage prostate cancer- gleason score of less than 6-
  • Mole or actinic keratosis
  • Barrett’s esophagus

All forms of pre-cancer may increase the risk of getting that cancer but it is not a diagnosis of cancer.

The study linked and excerpted below explains that if DCIS patients are tested by Oncotype DX and they are found to be “low risk” aka a score of 36 or less, they have low enough risk of a breast cancer risk that local radiation will not benefit them. Or I should say that the risks of radiation outweigh the possible benefits.

What are the potential side effects of local radiation for DCIS patients?

Ductal carcinoma in situ (DCIS) is a non-invasive cancer where abnormal cells are found in the lining of a breast duct but have not spread outside the duct. Local radiation therapy is a common treatment option for DCIS, and it is typically used after surgery (such as lumpectomy) to reduce the risk of recurrence. While radiation therapy is generally well-tolerated, it can have some side effects. It’s important to note that the severity of side effects can vary from person to person. Possible side effects of local radiation for DCIS patients may include:

  1. Skin changes: Radiation can cause skin reactions in the treated area. This may include redness, irritation, and dryness of the skin. In some cases, the skin may become darker or more sensitive.
  2. Fatigue: Many people experience fatigue during and after radiation therapy. This fatigue is often cumulative and may increase as the treatment progresses.
  3. Breast swelling or changes in breast size: Some women may experience mild swelling of the breast or changes in breast size due to fluid retention.
  4. Breast tenderness: The treated breast may become tender or sore.
  5. Changes in breast appearance: Radiation therapy may cause long-term changes in the appearance of the breast, such as a slight shrinkage or firmness of the breast tissue.
  6. Lymphedema: In some cases, radiation therapy can affect the lymphatic system, leading to the accumulation of fluid and swelling in the arm or breast. This condition is known as lymphedema.
  7. Rib pain: Radiation therapy to the breast can sometimes cause discomfort or pain in the ribs.
  8. Changes in sensation: Some women may experience changes in sensation, such as tingling or numbness in the treated breast.
  9. Scarring: Radiation therapy can cause scarring in the treated area, which may affect the texture of the skin.
  10. Radiation increases your risk of a secondary cancer

Last but not least, there are a number of evidence-based but non-conventional therapies shown to reduce the risk of breast cancer.

I am a long-term survivor of a blood cancer. I can tell you that without a doubt, undergoing evidence-based, non-conventional therapies in order to avoid toxicity and avoid a diagnosis of full cancer is worth your while.

Have you been diagnosed with DCIS? Let me know if you have any questions. David.PeopleBeatingCancer@gmail.com


David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Oncotype Score Helps Avoid Unnecessary Radiation in DCIS

“There’s a long-standing concern among oncologists that many women with ductal carcinoma in situ (DCIS), a potential precursor to invasive breast cancer, receive more treatment than they need. The potential for overtreatment largely revolves around the extent of surgery and the use of radiation.

Using the Oncotype DX Breast DCIS Score test, a laboratory test that estimates DCIS recurrence risk, may help identify patients with low-risk DCIS who can safely avoid adjuvant radiation after surgery…

Researchers found that the Oncotype DX score helped identify patients who are at low and high risk for DCIS recurrence. Low-risk patients who skipped adjuvant radiotherapy after breast-conserving surgery demonstrated similar 5-year recurrence rates compared with high-risk patients who received adjuvant radiotherapy…

To reduce the risk for DCIS recurrence or progression to invasive breast cancer, most patients with DCIS undergo breast-conserving surgery followed by adjuvant radiotherapy, Khan explained. Instead of breast-conserving surgery, about 1 in 4 patients opt for mastectomy

Women who scored < 39 points on the 100-point Oncotype DX scale were considered to be at low risk for recurrence and were advised to skip radiation. Women who scored > 39 were advised to undergo radiation. Overall, 93% of the patients followed the radiation recommendations: 75 of 82 patients (91.4%) deemed as low risk skipped adjuvant radiotherapy and 84 of 89 patients (94.4%) deemed as high risk had radiotherapy.

At a median follow-up of 5 years, 5.1% (four of 82) of low-risk patients experienced a recurrence vs 4.5% (four of 89) of higher-risk patients.

Recurrence rates among patients who followed the radiation recommendations mirrored these overall findings: 5.5% of 75 patients with low-risk DCIS who skipped radiotherapy experienced disease recurrence vs 4.8% of 84 patients with high-risk DCIS who received radiotherapy…

In short, “women who skipped radiation based on this score did not experience an excess risk of” ipsilateral recurrence over 5 years, said Khan. 

Overall, the study offers “strong evidence” that the DCIS score might help “prevent excessive treatment for some patients,” she concluded, adding that 10-year outcomes will be reported…”

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