Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Is Chemotherapy Needed For Ductal Carcinoma?
Question: hi
i live in Canada. i am 45yrs old, no children, good health. i just had mastectomy with immediate TRAM flap construction. I have dcis grade 3, comedo necoris is present and extensive and the pattern is solid. The tumour size is 3.5cm, clear margin of 1.6mm posterior. Four lymph nodes were removed and one had isolated tumours (the path report says four keratin positive cells in one of the two lymph nodes). No skin or vascular invasion. Do i need chemo and or radiation as per Canadian treatment/standards?
thankyou
i live in Canada. i am 45yrs old, no children, good health. i just had mastectomy with immediate TRAM flap construction. I have dcis grade 3, comedo necoris is present and extensive and the pattern is solid. The tumour size is 3.5cm, clear margin of 1.6mm posterior. Four lymph nodes were removed and one had isolated tumours (the path report says four keratin positive cells in one of the two lymph nodes). No skin or vascular invasion. Do i need chemo and or radiation as per Canadian treatment/standards?
thankyou
Brief Answer:
Radiation therapy might be needed
Detailed Answer:
Thanks for asking on HealthcareMagic.
DCIS (Ductal Carcinoma In Situ) is usually non-invasive and hence chemotherapy is not needed. But radiation therapy might be needed, especially because Comedo-type Necrosis was present and since lymph node involvement was present or suspected. Going through the following should be helpful for you:
http://www.breastcancer.org/symptoms/types/dcis/treatment
http://jnci.oxfordjournals.org/content/96/12/906.long#sec-16
http://www.hindawi.com/journals/ijbc/2013/914053/ (section 7)
Your doctor would be able to assess your case specifically and comment whether radiotherapy or hormone therapy are needed for you.
Hope that helps.
Regards
Dr. Kunal Saha
Radiation therapy might be needed
Detailed Answer:
Thanks for asking on HealthcareMagic.
DCIS (Ductal Carcinoma In Situ) is usually non-invasive and hence chemotherapy is not needed. But radiation therapy might be needed, especially because Comedo-type Necrosis was present and since lymph node involvement was present or suspected. Going through the following should be helpful for you:
http://www.breastcancer.org/symptoms/types/dcis/treatment
http://jnci.oxfordjournals.org/content/96/12/906.long#sec-16
http://www.hindawi.com/journals/ijbc/2013/914053/ (section 7)
Your doctor would be able to assess your case specifically and comment whether radiotherapy or hormone therapy are needed for you.
Hope that helps.
Regards
Dr. Kunal Saha
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thank you Dr Saha. Should I ask this question to a medical oncologist for more clarification.
I also want to know if 1.6 mm margin is adequate. What is the standard. I would not require hormonal therapy as I am Dr/or negative.
I also want to know if 1.6 mm margin is adequate. What is the standard. I would not require hormonal therapy as I am Dr/or negative.
Brief Answer:
You should talk to a medical oncologist
Detailed Answer:
Yes, you should talk to a medical oncologist and discuss the further treatment plans. Rather than the measurement of the margin, what is more important is 100% excision of the affected tissue. Unless that is successfully done, even a single cell remaining, can recreate the damage. The role of radiation therapy comes for the same, just to be doubly sure. May be hormone therapy is inapplicable for you but your medical oncologist would be better able to comment.
You should talk to a medical oncologist
Detailed Answer:
Yes, you should talk to a medical oncologist and discuss the further treatment plans. Rather than the measurement of the margin, what is more important is 100% excision of the affected tissue. Unless that is successfully done, even a single cell remaining, can recreate the damage. The role of radiation therapy comes for the same, just to be doubly sure. May be hormone therapy is inapplicable for you but your medical oncologist would be better able to comment.
Above answer was peer-reviewed by :
Dr. Shanthi.E
my oncologist does not suggest chemo as it would only reduce the reoccurrence by 1-2%. can i request for radiation for peace of mind? is this normally done (requested by patient) if the radialogist were to recommend no radiation?
thank you
thank you
Brief Answer:
Discuss the pros and cons with your oncologist
Detailed Answer:
Thanks for writing back.
Even I would not recommend chemotherapy. I would suggest you to leave the judgement of giving or not giving radiotherapy upon your medical oncologist. It is generally done based on the clinical indication and not the patient's willingness. It has its adverse effects too. Just discuss the options with your doctor and I think that it would be fine.
In case you found my answer to be helpful, I would request you to close the thread with a positive review an a 5 star rating.
Regards
Dr. Kunal Saha
Discuss the pros and cons with your oncologist
Detailed Answer:
Thanks for writing back.
Even I would not recommend chemotherapy. I would suggest you to leave the judgement of giving or not giving radiotherapy upon your medical oncologist. It is generally done based on the clinical indication and not the patient's willingness. It has its adverse effects too. Just discuss the options with your doctor and I think that it would be fine.
In case you found my answer to be helpful, I would request you to close the thread with a positive review an a 5 star rating.
Regards
Dr. Kunal Saha
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
