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Breast Cancer (Expert Forum)
second request for information / opinion
Answered by
Cleveland - OH
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
second request for information / opinion
by mulie, Feb 28, 2008 01:25PM
Recently had a lumpectomy for intraductal carcinoma Completely removed with clear margins and no node involvement or metastases. I will have standard chemotherapy Assuming a positive BRCA-1 test, what offers the best chance of preventing a recurrence - Radiation therapy following chemo or bilateral mastectomy? Additional info: I am 67 years old; mother died of ovarian cancer many years ago; sister recently underwent complete treatment for breast cancer
Doctor's Answer
by Cleveland Clinic, Feb 28, 2008 02:48PM
, Feb 28, 2008 02:48PM
Dear mulie: Both lumpectomy + radiation and mastectomy address the issue of local recurrence. In terms of local recurrence, mastectomy may offer a slight advantage over lumpectomy and radiation (though this must be considered in view of personal preferences as well). Removing the other breast addresses prevention of developing a second primary breast cancer. This must be considered in the setting of risk. If you have positive BRCA-1 and a personal history of breast cancer, you may benefit from a discussion with a genetic counselor who can more accurately outline your personal risk and make recommendations that would be appropriately suited to your situation. For intraductal carcinomas (DCIS) without any invasive cancer, there is no role for chemotherapy, however, tamoxifen is often recommended to further reduce the risk of recurrence following lympectomy and radiation. You may wish to further clarify your individual diagnosis and treatment recommendations with your oncologist.
