Expert: Claes-Gustaf Nordquist, M.D. - 10/24/2007

Question
QUESTION: Hi Dr. Nordquist,

I am 29 and I was diagnosed with DCIS, stage 1-3/4 in feb 2007.  I recently got married and so far in 2007, it's been very stressful waiting to see oncologists, surgeons and plastic surgeons.  My margins are clear and now the oncologists are recommending a total mastectomy.  I am having a bit of hard time dealing with this psychologically and getting help but another option was also mentioned and I wanted to know what your opinion would be.
I was wondering if I could wait 3-5 years before the mastectomy.  I would like to have a child within those years and I was wondering if the pregnancy would put me at risk?

thanks for your time.
Gina

ANSWER: Your question is confusing! You are mentioning breast cancer in situ (right breast?) but then you mention stage 1-3/4?! A cancer in situ is by definition a stage 0! If any other stage it is by definition NOT a cancer in situ! Please clarify with a DETAILED description of what has been found (including mammography, x-ray, ultrasound, MRI, PET & biopsy results) and what has been done about it including pathology results. With that information I will understand your situation far better and be much better able to help you!


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

QUESTION: Hi,

I didn't mean to sound confusing -perhaps our terminology has gotten mixed up.  What was written on the pathology report was ductal carcinoma-in situe, with nuclear grade I-II/III.  My MRIs, X-rays, ultrasounds and mammograms have shown no image results even prior to the biopsies.

My question was whether or not pregnancy prior to a mastectomy would put me at risk even though my margins are cleared.

thanks.
Gina

Answer
Mastectomy is normally not considered in a case of cancer in situ! That too confused me! The only reason I can think of would be that cancer in situ has been found in several places in your breast indicating a high genetic risk of developing breast cancer. If so the risk is probably high in BOTH your breasts so mastectomies of both your breasts must in that case be considered. If all these radiological tests were negative why were biopsies done? That is why I asked you to give me an as detailed background information as possible! Please do! To give you information I need as much information as possible otherwise I have nothing to work with! A cancer in situ, since it is at stage 0 by definition always show free margins - it has not started to infiltrate and invade its surroundings yet! So the only reason for your question I can think of is that a number of cancers in situ have been found. Please clarify! For one cancer in situ NO mastectomy is needed! A lumpectomy and radiation therapy after that is all that is necessary!