Invasive DCIS Cancer

SCmom Member Posts: 46
edited March 2014 in Breast Cancer #1
Could you please help me with a question, and please don't think I am stupid. I just had Lumpectomy about a week and a half ago. My tumor was 1.2cm. I was told after the surgery that I had Negative Nodes and that my margins were good. I was able to do the Mammosite Radiation successfully last week. Then I was told my tumor was invasive. Now my surgeon is sending me to Oncologist to determine chemo or not. Now my stupid question...If I had good margins, and negative nodes, could the cancer still have spread somewhere else since it was invasive? I argued with my husband and a friend about this over the weekend. I think yes, they think no. Would love input from you. Thanks Laura


  • Sharon345
    Sharon345 Member Posts: 26
    My tumor was also invasive and 1.2cm. This was this past February. Before the surgery my sugeon told me it looked like it was only a 1.0 cm and I would only need radiation and nothing else after the lumpectomy. But because of the extra .2cm everything changed. I understand that invasive means it's possible for it to have gone somewhere else but maybe it didn't. That's why chemo is brought up. I was also sent to a Medical Oncologist to discuss my options which now included chemotherapy. According to her, after the radiation and taking tamoxifen my 5-year survior rate increases from 80% to 90%. Having chemo also would increase my 5 year survior rate 3% more to make it 93%. This dosen't seem like much until you do the math with 100,000 people. I personally didn't think it would make enough difference, I was afraid I would be too sick to work so I chose not to have chemo. I'm sure you'll have a chose too. Be sure you know all you can about your options so you'll feel good about your treatment too. After my 2nd Medical Oncologist was sure I was absolutley sure I didn't want the chemo he suggested I take Zoladex along with the Tamoxifen. It's a monthly injection taken for at least for two years. There has been 2 clinical trials on this combination. You can read about it in "The American Journal of Oncology Review" April 2003 issue. There are some factors first - you must be premenopausal and the tumor must be estogen positive. The results showed that the two drug compination is as good or better than chemo. This is good enough for my peace of mind but of course you should discuss it with your doctor. You can look up Zoladex on the internet for the side effects. I realize this is more than your question of what invasive means but your tumor size was so like mine that I had to add my experience with it.
  • DeeNY711
    DeeNY711 Member Posts: 476 Member
    Husbands and friends are great to have around, but neither ought to be debating what your best course of treatment would be. It only makes your plight more difficult. Your doctors are not going to think that you are stupid for asking a perfectly sensible question. Bring that question along with a list of any other questions to the oncology appointment. Feel free to call the surgeon for clarification prior to the appointment if it would be helpful to you. You don't have to decide anything until you have all of the information you need. Listen to what the oncologist has to say. I found the initial consultation with the oncologist the most helpful appointment of all of them. Your mind will sift through it all and gravitate in the direction of your choice. Hugs, Denise
  • No one would ever consider a questions here "stupid". I only had .8 invasive tumor, but had widespread DCIS so needed a masectomy. Nodes were clear, but I was estrogen negative. I chose chemo because the stats were in my favor - a 5% reoccurence vs. a 20% over my lifetime. I only 35, 2 kids also and wanted what I call my insurance policy. survived chemo. OK Worked through about 90% of it. Work people were very nice and understadning with me. Oncologists are definitely worth their money! I found mine to have much, much, more info. than any of the other surgeons, gyno, radiologist etc... Good Luck to you!!!! Go and get your stats and make the best decision for yourself!!!!
  • chemoqueen1
    chemoqueen1 Member Posts: 50
    I had a 1.5 cm mass, got clean margins on 2nd biopsy and negative nodes. The pathology of the tumor is an important factor when deciding on Chemo or no Chemo. I was ER/PR positive which means the receptors in the tumor tested positive for Estrogen and Progesteron, which did make me a candidate to take Tamoxifen for 5 years which can block those receptors. I was also what they call Her2 positive which put me at a higher risck of re-occurance. My Oncologist did tell me that even though my lymph nodes were negative some microscopic cells can get through to other parts of your body, to be absolutely sure that I did not have any remaining cancer I opted to go into a study for Her2 Positive breast cancer paitents with no evidence of spread. I was more frightend of not doing chemo and having the slightest chance that I still had some cancer cells than I was of Chemo. I have only 1 more chemo to go and am doing great, I handled chemo very very well. I would ask for a copy of the pathology report.
  • jamjar62
    jamjar62 Member Posts: 135
    Hi Laura,

    DCIS mean ductal carcinoma in situ or totally contained within the duct. Once it has spread outside the duct, it is no longer DCIS but invasive ductal carcinoma. It sounds like upon a pathology exam, your cancer had spread outside the duct. Surgeons and radiologist can guess that the cancer hasn't spread outside the ducts but only the pathologist can tell for sure. The good news is that your nodes were negative and margins clear! Once the cancer has spread outside the duct, even if your nodes were negative, oncologist sometimes recommend chemo based on your age, er/pr status, size of tumor and so on.

    If you are comfortable talking survival rates with an oncologist, make sure that is part of your decision. As Sharon said, chemo only increased her risk 3% which she decided wasn't worth the hassle and side effects. I had a 4.5 cm invasive tumor with 5/17 positive nodes so chemo was a no-brainer for me.

    My only "words of wisdom" to you would be not to let your fear of chemotherapy keep you from making that decision if the survival rates indicate it would be a positive thing for you to do. I don't want to make it sound like chemo was a piece of cake but I am also the mom of 2 and I want to be around for a long time so any side effects were worth it.

  • SilverT
    SilverT Member Posts: 2
    Dear Mom, Your story mirrors mine very much, and everyone has to make an individual, informed decision based on many personal factors. I chose chemo, and am so far able to work pretty much full time through my treatments. Nowadays, they have so many wonderful ways to stop or counteract a lot of the negative side effects, that it's nothing like it used to be, as far as horror stories go. Whatever you decide, God Bless, and don't forget to stay with this site and these people. It always makes me feel better when I come here, even if it's just to read.

    Lots of luck!
    SilverT aka Deb Allen/TX
  • jake10
    jake10 Member Posts: 202
    some of the explanations of the meaning of invasive seem to differ from place to place. Check it out with your oncologist. Be very sure of what every word on that path report means. This will help you make your decision and be confindent with it.
    I had a .6cm tumor - invasive adenocarcinoma in situ. On biopsey there were not clear borders so I opted for the mastectomy. It was ER/PR+ and HER- and negative nodes. So I needed no chemo or radiation. I had never read the path report until a few days ago. It kind of gave me the shivers. Good Luck. Beth