281. DCIS Isn’t “Nothing”: Stage Zero Breast Cancer and the Decisions No One Explains

Love the podcast? Send us a text!What does it really mean to be diagnosed with DCIS (ductal carcinoma in situ)—often called “stage zero” breast cancer?In this in-depth episode of Breast Cancer Conversations, host Laura Carfang is joined by a breast surgical oncologist, a radiation oncologist, and a patient advocate to unpack why DCIS can be both reassuring and deeply complex. While survival rates are excellent, treatment decisions often involve difficult trade-offs between reducing recurrence risk and preserving long-term quality of life.The panel explores how advances in tumor biology, radiation techniques, and genomic testing—particularly the DecisionRT test—are helping clinicians and patients personalize care. Together, they discuss when radiation may meaningfully reduce recurrence risk, when it may be safely avoided, and how shared decision-making empowers patients to choose treatment paths based on information rather than fear.Guests:Dr. Erica Giblin, a breast surgical oncologist in Indianapolis and Director of Breast Surgical Oncology at Ascension, who brings a surgeon’s perspective on balancing effective treatment with long-term survivorship.Dr. Fleure Gallant, a nationally recognized leader in breast radiation oncology and Radiation Medicine Lead for the Breast Disease Management Team at Northwell Health Cancer Institute, whose work focuses on delivering highly personalized, quality-of-life-centered care.And Dr. Leona Hamrick, Vice President of Global Medical Affairs at PreludeDx, a board-certified physician associate with decades of experience in internal medicine and oncology diagnostics—and an 11-year stage III breast cancer survivor who brings the patient voice into every scientific conversation.Topics Discussed:What DCIS is—and why it’s considered non-invasive breast cancerWhy DCIS is classified as stage zero, regardless of sizeHow DCIS differs from invasive breast cancer and LCISWhy a DCIS diagnosis can still be emotionally traumaticStandard treatment approaches: lumpectomy, mastectomy, radiation, and hormone therapyWhen and why radiation therapy is recommended after DCISHow radiation schedules have evolved (5 days vs. 3–6 weeks)What DecisionRT measures and how it helps predict recurrence riskWhy tumor biology matters more than age aloneShared decision-making vs. fear-based decision-makingQuality-of-life considerations, especially for younger patientsWhy more options can sometimes feel more overwhelmingThe importance of second opinions and patient self-advocacyHow DCIS care is moving toward personalization and de-escalationSupport the showListener FeedbackIf this episode resonated with you, we invite you to leave a review on Apple Podcasts or Spotify.You can also click the link in the show notes that says "Love this episode? Send us a text" to share feedback.Messages are completely anonymous.If you would like us to follow up directly, please include your email address in your message so we can respond.Latest News: Join our Mailing List - New content drops every Monday! Discover FREE programs, support groups, and resources from SurvivingBReastCancer.org! Become a Breast Cancer Conversations+ Member! Sign Up Now. Enjoying our content? Please consider supporting our work.