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Radiotherapy after DCIS mastectomy & DIEP reconstruction?


Re: Radiotherapy after DCIS mastectomy & DIEP reconstruction?

Hi Nicola, 

Fortunatly I am not quite in your position, however  I had high grade DCIS but due to size of area my surgeon recommended a masectomy over a lumpectomy and radiotherapy.


He advised me to not have immediate recon as he suspected IDC within the DCIS and therefore a possibility of rads and the potential problem with the recon.


So I had the masectomy followed by 15 rads and being ER+ am on tamoxifen for 5 years with a planned DIEP next June and yes 2 x IDC tumours within the DCIS, small but still there...


I used  breath holding during rads to protect heart and lungs and seeing the oncologist for a follow up on Monday, finished 12th July but still warm below my scar, still Aloe Vera 3 x day and a bit itchy.


I had no concern at having the rads although I am very glad I did as an Aunt who had ovarian cancer last year and was part of a research is BRCA2 so I will now get tested (grandmother and cousin both died from BC at 52 & 42).


Listen to what is advised but at the end of the day you have to make that decision yourself, if there is any ‘damage’ to your reconstruction it can be sorted later on, from what I can gather it is more chance of problems with implants.


Good luck with your decision x


ps I’m 52

Community Champion

Re: Radiotherapy after DCIS mastectomy & DIEP reconstruction?

Hi Nicola, what a shame they couldn't have decided this earlier. A lot of ladies have radiotheraphy for DCIS but I know often a mastectomy is all that is required also. I completely understand your concerns around having treatment but as Ann says the issues you mention are rare and personally I would have felt uneasy not having radiotheraphy and over three years on have had no lasting problems. 


I know you have the added issue of having had a reconstruction but I guess this needs to weighed up against the percentage chance of any reacurrance without having radiotheraphy. It really is seen as belt and braces as although they can be fairly confident of having removed all the cancer they can't give us 100% certainty that there wasn't anything microscopic left behind which is what radiotheraphy is used for. 


Good luck with your decison Xx Jo 


Re: Radiotherapy after DCIS mastectomy & DIEP reconstruction?

Thanks for responding Ann, it’s been quite a lonely experience thus far, so it’s really nice to hear from others in our ‘community’...
Community Champion

Re: Radiotherapy after DCIS mastectomy & DIEP reconstruction?

Hi Nicola,
Yes, it’s a bit of a dilemma isn’t it & you’ve already had two divergent professional views.
My understanding is that the risk of rads itself causing more tumours is rare & far lower than the risk of recurrence, but also as you say there is the issues of it affecting the recon as well as any other side effects. Usually, for many of us, there are only transient effects from rads such as reddened skin &/rashes which subside.
Hopefully, one of the other ladies will be along to offer more help on this. It might also be an idea to post in ‘ask our nurses.’
Wishing you well with it all.
ann x

Radiotherapy after DCIS mastectomy & DIEP reconstruction?

Hi everyone


This is my first time on here and I’m really hoping for some advice. I’m 48 and was diagnosed with DCIS in April. After a sentinel node biopsy to check if it had spread (it hadn’t), my surgeon advised that he could go ahead with the surgery and I wouldn’t need any further treatment. I underwent a skin sparing mastectomy and DIEP reconstruction on 30th April.


Unfortunately, when I went for my first post-op appointment, he advised that his ‘team’ felt I would benefit from a 5-week course of radiotherapy. The posterior margin was .5mm and the anterior margin was free by 4mm. I’m considered high risk apparently (large, high grade tumour; my young(?!) age; DCIS is ER negative).


Now I’m faced with a dilemma; the radio could damage the new reconstruction, impact on ribs and underlying lung, and potentially cause secondary tumours in the future. I had a second (phone) opinion with a female oncologist at the Royal Marsden, who told me that they consider a mastectomy for DCIS to be curative (if my surgeon has taken all the affected breast tissue, no further treatment is necessary).


Has anyone else had a similar dilemma? I can’t think of anything else at the moment. I’m an older mum with 2 young children, 4 & 6, so I’m really worrying about doing the right thing. I don’t find it easy talking to friends and family so I’d be incredibly grateful for any advice.


Thank you so much