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My DCIS has Relapsed…
My DCIS has relapsed…I was treated for DCIS in 2019. It was grade 3 and hormone-negative. I was treated with lumpectomy and radiation. It has recently returned. Again, stage o and grade 2. I had a lumpectomy and repeated to get clear margins.
I’m supposed to see the radiation oncologist on Friday, and get a second opinion next week. I am 71 years old . I have had a heart attack ( right after completing radiation the first time. I was face down during the radiation tx so my heart was not exposed.
I feel like I am in good shape for my age. Should I repeat radiation therapy again? Same breast recurrence.
DCIS Surviv0r
Dear DCIS Survivor-
I am sorry to learn of your DCIS relapse. Rather than give a yes or no answer to your question, “Should I repeat radiation therapy again?” I will list some facts below that I think are relevant to your situation, and then follow with my experience as a long-term cancer survivor.
Grade 3 and hormone-negative DCIS cancer
“Grade 3 hormone-negative DCIS (Ductal Carcinoma In Situ) means abnormal cells are high-grade (look aggressive, grow fast) but lack hormone receptors, increasing recurrence risk, requiring treatment (surgery, maybe radiation/hormone therapy) to prevent invasive cancer, though outcomes are generally good, notes National Cancer Institute (NCI) Dictionary of Cancer Terms, Breast Cancer Research Foundation, and American Cancer Society.”
I was treated with lumpectomy and radiation
Treating Ductal Carcinoma In Situ (DCIS) with a lumpectomy and radiation is a standard approach that successfully removes cancer cells and significantly lowers the risk of the cancer returning (recurrence) or progressing to invasive breast cancer, though overall survival rates remain similar whether radiation is used or not. This treatment preserves the breast, with radiation targeting any remaining cells, but long-term management involves regular monitoring, managing potential skin changes from radiation, and discussing ongoing risks with your doctor, as some low-risk cases might omit radiation.
Again, stage o and grade 2
Stage 0 Ductal Carcinoma In Situ (DCIS) with Grade 2 means you have non-invasive breast cancer cells in the milk ducts that are growing at a moderate pace (Grade 2), indicating they look somewhat different from normal cells and have an intermediate chance of recurrence compared to slower-growing (Grade 1) or faster-growing (Grade 3) DCIS, but treatment, often surgery, typically offers an excellent prognosis.
My interpretation from your post is that:
You are knowledgeable about your situation and DCIS in general. You monitor your breast health regularly. You are in good physical condition. You are getting a second opinion, which is a good idea. By mentioning your heart attack, I can’t help but wonder if you think your local radiation from your first diagnosis of DCIS may have played a part?
My challenge with radiation therapy following a lumpectomy for DCIS is that, according to research, there is little, if any, survival benefit from this therapy. And there may be short-term, long-term and late-stage side effects from it.
Would an Oncotype DCIS Recurrence Test help with your decision-making?
All to say, the decision is up to you. Good luck.
David Emerson
- Cancer Survivor
- Cancer Coach
- Director PeopleBeatingCancer
My DCIS has relapsed My DCIS has relapsed