I have been saying NO to rads for over 2 years despite the hard sell, fear tactics and claims that there is very little harm, damage, discomfort, pain and short & long-term repercussions from radiation treatment. Most oncologists, radiologists and surgeons tout only benefits and statistics of lowering DCIS recurrence. One major point I discovered that they fail to tell us is that our chance of an invasive recurrence is actually higher.
According to an article published in the Journal of Surgical Oncology 2007 by MELVIN J. SILVERSTEIN, MD and MICHAEL D. LAGIOS, MD entitled Should all Patients Undergoing Breast Conserving Therapy for DCIS Receive Radiation Therapy? No. One Size Does Not Fit All: An Argument Against the Routine Use of Radiation Therapy for All Patients With Ductal Carcinoma In Situ of the Breast Who Elect Breast Conservation:
“More invasive recurrences among irradiated patients: In our experience and the experience of others, the percentage of invasive recurrence after radiation therapy is greater than 50%. After excision alone, it is approximately 34%. In addition, the median time to recurrence is twice as long for the irradiated patients. If a higher percentage of recurrences among irradiated patients are invasive, this could lead to a higher mortality rate.”
DCIS 411 
Radiofrequency Ablation. See this article:
http://www.reuters.com/article/2012/05/04/idUS195301+04-May-2012+BW20120504
It seems to me that this is a great alternative to radiation. Ablation extends the disease-free zone without the side-effects of radiation.
LikeLike
Silverstein et al. did a followup to the 2007 study, in 2010: this one is even more optimistic.
Below, the quotes from the VNPI study, 2010:
“Current recommendations are as follows:
Excision alone for those who score 4, or 5, or 6.
Excision plus radiation therapy for those who score 7, 8, or 9.
Mastectomy for those who scored 10, 11, or 12.”
Silverstein followup, 2010:
Figure 1, A shows 320 patients with scores of 4, 5, or 6 analyzed by treatment (excision alone vs excision plus radiation therapy). The local recurrence rate at 12 years for those who received radiation therapy was 2.5%. For those treated with excision alone, it was 5.4% (P = NS). When analyzed by individual score, those who scored 4, 5, or 6, regardless of treatment (excision alone or excision plus radiation therapy), had a local recurrence rate of 6% or less at 12 years.
With almost three times as many patients as originally published, the USC/VNPI can be more finely tuned to aid in the treatment decision-making process. To achieve a local recurrence rate of less than 20% at 12 years, these data support excision alone for all patients scoring 4, 5, or 6 and patients who score 7 but have margin widths ≥3 mm. [That’s another thing: My margins are 30 mm.]
Excision plus radiation therapy achieves the less than 20% local recurrence requirement at 12 years for patients who score 7 and have margins ❤ mm, patients who score 8 and have margins ≥3 mm, and for patients who score 9 and have margins ≥5 mm.
http://intl-jncimonographs.oxfordjournals.org/content/2010/41/193.full
LikeLike