This is a challenging situation that can be seen in spite of evaluation prior to definitive procedure. I would agree with an MRI after the patient heals to look for any obvious residual disease. In the absence of a completion mastectomy which is usually unlikely, I would favor a course of whole bre...

Based on the age and high risk pathology, would favor RT.  That being said, would do breast MRI once healed to rule out any gross residual disease missed on mammogram.

These are challenging situations and often margin status cannot be determined. We counsel the patient that the only way to truly know all DCIS has been removed is with mastectomy though this is a substantial operation. The patient can also consider whole breast RT but we usually can't boost given th...

There are multiple studies showing low local failure rates following whole-breast irradiation without breast surgery for patients presenting with axillary adenopathy with no apparent primary lesion in the breast on mammograms or MRI (e.g., Rueth et al., PMID 25249256). However, we do know if this pa...