[Becky]

My mother had to go back to the OR a week after her lumpectomy for clean margins (and she got them the second time around). No self respecting surgeon or radiation oncologist will go for dirty margins. I think the only way MIGHT be if a tumor is very close to the chest wall - then I really don't know what they do (unless the radiation protocol is different).

Another way to get cancer from DCIS is that there are truly precancerous changes in the rest of the duct. A woman gets a lumpectomy but 18 months or whatever time goes by and the duct gets a new cancer (probably one very similar to the first as it is the same duct) and that one becomes invasive. Otherwise, the dcis she had the first time had the smallest amount of mircoinvasion that wasn't picked up the first time. If that happened and one of those cells traveled before radiation (if a lumpectomy is done) or masectomy, then mets could happen later.

Remember, most dcis is curable with surgery alone although that is not recommended in many cases with lumpectomy alone. However, I am a dcis alone person who had lumpectomy only and all is well. However, in my case, because I had a Stage 2 cancer in the other breast, I received chemo, herceptin and arimidex - and besides that mine was only 3mm, low grade, and only ER/PR+, this may all help my no rads on that dcis cause.

There are many ongoing studies on dcis all to include - rads for all dcis no matter what to looking closer to decide on rads (if clean wide margins and lumpectomy are employed). Just like bc, they are learning molecularly every day so that women are treated with the right ammo but not over treated.