How do you incorporate DCISionRT testing in the setting of close (<2 mm) or positive DCIS margins?

No matter how much Panera Bread they bring you, the answers are these: Positive margin? Surgical re-excision. <2 mm margin? Surgical re-excision.

Why? Because the SSO guidelines say so. That's why.

"But she doesn't want surgical re-excision for the positive margin." Ok. Then you recommend radiation...

For someone who needs re-excision and declines re-excision needs RT, I would not do any test other than a pre-mammogram to counsel the patient better before RT.

I commented on the issue of margins in July 2023. To summarize that post, the available evidence shows that margin widths 2 mm or wider are NOT required to achieve acceptable results for most patients with DCIS following partial mastectomy when RT is used. I feel that no tumor on ink is adequate exc...