Expert: Claes-Gustaf Nordquist, M.D. - 1/2/2010

Question
QUESTION: Dear Dr.
I had 2 small dcis in my right breast. One was 0.4cm and the other was 0.5cm. they were both removed(lumpectomy)with clear margins. I also had breast reduction on both sides at the same surgery. I am 49 and still have my period. My dcis was er and pr positive. My surgeon (Dr. Mel Silverstein) and oncologist (Dr Waisman) have both agreed no radiation and no tamoxifen for now. They will just watch me closely. I am happy but very worried because everything I read says you have to have radiation. My dcis was not found on mammogram or ultrasound only MRI. Please help me I do not want this to ever come back.

ANSWER: I do not agree with your doctors. In my opinion you should have had radiation therapy. Probably also tamoxifen or an aromidase inhibitor. So my opinion is different from your doctors. Get a second opinion locally! Good luck!

You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128


---------- FOLLOW-UP ----------

QUESTION: Dear Dr.
Who should I speak to for a second opinion. Another oncologist or radiology oncologist. My Dr is a specialist in DCIS(he has written 34 books) and states not every patient needs radiation. I have not seen or read enough evidence supporting this theory.
I had my surgery on Dec 1, 2009. How much time do I have to make a decision?
I will call UCLA on Monday morning. Who would be the best type of specialist to speak with. Have you known any women that have not had rads and tamoxifen and are they still o.k. Thank you so much for you time. DEE

Answer
Perhaps, but I have been taught to provide radiation therapy to all these patients. It is also the opinion in France where lumpectomies started and in general the European view. But consult with other radiation oncologists and oncologists. Good luck!

You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128