Ductal Carcinoma In-situ of the Breast
The major issue in the management of ductal carcinoma in-situ (DCIS) is the risk for progression to invasive cancer. Recurrences after lumpectomy (removal of the tumor + margin of soft tissue) alone have demonstrated a 25 - 30% risk of recurrence. Half of those will be invasive cancer not DCIS when they come back. So lumpectomy alone is an option, but it may not be the best one.
If you have DCIS alone, there is no need for an axillary (under arm) lymph node dissection (surgery). The risk of DCIS going to lymph nodes is less than 1%many studies in the past of patients that had their lymph nodes removed have demonstrated this (Dr Silverstein of Van Nuys Cancer Center reported on 189 consecutive axillary dissections done on DCISno positive lymph nodes). Axillary lymph node dissections have a high complication rate of lymphedema.
The Bottom Line:
One other thing to factor into the situation is the amount of time for the radiation therapy. The typical time scheme is for the lumpectomy to happen and the radiation to start 2 - 4 weeks after. The radiation is done to whole breast initially and then to the tumor bed. These are daily treatments lasting approximately 5-15 minutes per day Monday - Friday for approximately 5-7 weeks. The first session is a mapping session, which can last 1/2 to 1 hour, but daily sessions are quick. Most people are able to continue working during treatment and go on with their daily lives as normal. Breast radiation acute side effects mainly have to do with skin irritation, which is usually minimal. It is usually very well tolerated.
Mastectomy is a very good choice. There is a high likelihood your mother will never hear from this cancer again. She will need to continue yearly mammograms and monthly self-exams on the other breast. Please have her discuss all of these options with her physicians.