DCIS /Decision Overwhelmed

gc123

Newbie - learning to navigate this site.

Age 60 -Diagnosed with DCIS - Jan 9. Lumpectomy - Jan 18th.

Path report - microinvasion PT1mi
margins
invasive cancer: Negative. Closes distance to margin 5.5 mm from inferior
DCIS present New superior margin. Closet distance to other margins < 1mm from lateral inferior and posterior margins.

Extent margin involvement for DCIS Unifocal

Extensive intraductal component Present DCIS present in 5 of 11 slides

Lymphatic/vascular systems cancer cells not found

Surgeon suggest re excision to get clean margins and node biopsy.

She did say that if I was older she would just recommend radiation.

From what I have read percentage is low for microinvasion to occur with dcis
also percentage is low for node involvement.

I am going for a second opinion just to help make this decision.

Another surgery - lumpectomy??

Mastectomy? Do I choose this - because if I still don't get clear margins - will surgery just keep picking away at this breast.

Rague

Welcome.
Sorry I have no
Welcome.

Sorry I have no input for you as I know nothing about DCIS or IDC. (Other than if you have any questions - a second or even a thrid opinion is the way to go.) I'm IBC, Stage III, ER+ PR-, HER2-, so big difference in DX and TX. There are other Pink Sisters here who will be able to give you input.

Thoughts and prayers.

Susan
(I'm older than you - 65)

tufi000

Tough one
After 2 lumpectomies I wound up with a double mastectomy due to invasive cancer in a totally different area that they never picked up due to dense breast tissue preventing discovery with mammos and sonograms. I think it depends on where you are going for treatment and if they are primarily cancer oriented with coordination of treatment, or merely very skilled docs with multiple specialties.
I am now 63 and this was in 2002. If I hadn't moved to where I am now in
Dec 2002 the invasive cancer would have never been discovered.
Though this was a horror story of misdiagnosis for me, it does not mean you have the same problem. But consider the focus of the docs where you are, a second opinion might be a good idea and the lack of nodes involvement is a great sign that gives you time to appraise this diagnosis further.

Lynn Smith

WOW this report
WOW this report is something I know nothing about but have(or had) DCIS Stage 0, non invasive, 1/2 centimeter tumor.No chemo or radiation.Just Tamoxifin for 5 years.This was the report from my doctor.He took my situation to a conference and said this is the best treatment. I was 62 when dx in 2009.I also had another surgery to check margin 3 weeks later.Clean but a benign tumor was found. There has been 3 benign tumors found since my dx.Thankful they are benign but a worry everytime.

Honestly I just pray all the time for me and for all of us.It gets me through alot.I've had other serious illnesses/operations and prayer got me through those.I have 2 friends who were dx one with a fast growing tumor and the other with Stage 3 BC with some node involvement.One is a 17 year survivor the other a 7 year survivor.

I did talk to my family doctor and my oncologist about the decision of no chemo or radiation and they said it was fine.They know of other patients that are living long lives with my dx with no problems.My problem is I get benign tumors. Not cancerous but scary.

I'll be 65 in March and I'm happy about this birthday.So many people complain about getting older but not me. I'm happy about every year I survive and every single birthday.My goal is to be a 30 year survivor.

My mother was a 60 year bc survivor.Dx at 21 in 1941.She had her left breast removed(masectomy). Passed in 2001 but it wasn't cancer that took her.I was born 6 years later and so far I was dx with bc at 62, my niece at 30 and my cousin has a history of benign tumors.Breast cancer runs on my mom's side of the family

Yes get a second opinion and please inform us on what you find out.

Lynn Smith

cinnamonsmile

Hi gc123,I am so sorry to
Hi gc123,
I am so sorry to hear you have cancer. And not having clean margins sure does complicate things.
I sent you a private message for you to read, but looking at your pathology report, I see something additional.

It is conflicting. It states that it is negative for invasive cancer, which is not completely true.

It states that you have a micro-invasion. This means that some of the DCIS has broke thru the milk duct and has become invasive. I found this statement on breastcancer.org regarding that:

DCIS-MI (DCIS with microinvasion) means that a few of the cancer cells have started to break through the wall of the duct. This is considered to be a slightly more serious form of DCIS.

The question is now, how much more is there within the breast tissue? That could be all the has broken through the duct wall, or there could be more.

I still think an MRI before any more surgery would be a good thing to have. An MRI can pick up more than a mammogram. Especially with the micro-invasion.

It will also be important to know if your cancer is estrogen or progesterone positive,what grade it is (1,2, or 3 being more agressive cancer) and if the micro-invasion is Her+. That will play an extremely important part in your treatment now. I don't know much about Her, but I do know that is a more aggressive cancer. All those factors are important to know for your treatments.

Some oncologists will treat DCIS with micro invasions that are Her positive differently than DCIS alone.

Have your surgeon or an oncologist explain all the components of your pathology report and make sure to include the hormone and Her components.Those should have been tested as well by the lab.

Please let us know how you are doing and keep coming back to ask questions or just unload anything you need to get off your chest.

Fitzpatrick

cinnamonsmile said:

Hi gc123,I am so sorry to
Hi gc123,
I am so sorry to hear you have cancer. And not having clean margins sure does complicate things.
I sent you a private message for you to read, but looking at your pathology report, I see something additional.

It is conflicting. It states that it is negative for invasive cancer, which is not completely true.

It states that you have a micro-invasion. This means that some of the DCIS has broke thru the milk duct and has become invasive. I found this statement on breastcancer.org regarding that:

DCIS-MI (DCIS with microinvasion) means that a few of the cancer cells have started to break through the wall of the duct. This is considered to be a slightly more serious form of DCIS.

The question is now, how much more is there within the breast tissue? That could be all the has broken through the duct wall, or there could be more.

I still think an MRI before any more surgery would be a good thing to have. An MRI can pick up more than a mammogram. Especially with the micro-invasion.

It will also be important to know if your cancer is estrogen or progesterone positive,what grade it is (1,2, or 3 being more agressive cancer) and if the micro-invasion is Her+. That will play an extremely important part in your treatment now. I don't know much about Her, but I do know that is a more aggressive cancer. All those factors are important to know for your treatments.

Some oncologists will treat DCIS with micro invasions that are Her positive differently than DCIS alone.

Have your surgeon or an oncologist explain all the components of your pathology report and make sure to include the hormone and Her components.Those should have been tested as well by the lab.

Please let us know how you are doing and keep coming back to ask questions or just unload anything you need to get off your chest.

I had DCIS
I had 2 lumpectomys, could not get clear margins. The surgeon wanted to do a mastectomy, but I insisted on a 3rd lumpectomy, received only one clear margin. I then had a double mastectomy (double by choice). You are not safe until you get clear margins. The 2nd lumpectomy did not make too much difference in my breast size, the 3rd lumpectomy made a tremendous difference.

gc123

cinnamonsmile said:

Hi gc123,I am so sorry to
Hi gc123,
I am so sorry to hear you have cancer. And not having clean margins sure does complicate things.
I sent you a private message for you to read, but looking at your pathology report, I see something additional.

It is conflicting. It states that it is negative for invasive cancer, which is not completely true.

It states that you have a micro-invasion. This means that some of the DCIS has broke thru the milk duct and has become invasive. I found this statement on breastcancer.org regarding that:

DCIS-MI (DCIS with microinvasion) means that a few of the cancer cells have started to break through the wall of the duct. This is considered to be a slightly more serious form of DCIS.

The question is now, how much more is there within the breast tissue? That could be all the has broken through the duct wall, or there could be more.

I still think an MRI before any more surgery would be a good thing to have. An MRI can pick up more than a mammogram. Especially with the micro-invasion.

It will also be important to know if your cancer is estrogen or progesterone positive,what grade it is (1,2, or 3 being more agressive cancer) and if the micro-invasion is Her+. That will play an extremely important part in your treatment now. I don't know much about Her, but I do know that is a more aggressive cancer. All those factors are important to know for your treatments.

Some oncologists will treat DCIS with micro invasions that are Her positive differently than DCIS alone.

Have your surgeon or an oncologist explain all the components of your pathology report and make sure to include the hormone and Her components.Those should have been tested as well by the lab.

Please let us know how you are doing and keep coming back to ask questions or just unload anything you need to get off your chest.

thankyou all
cinnamonsmile
ER/ PR negative . I've emailed my surgeon about HER2 but I believe his was neg or it was too small to evaluate.

I appreciate everyone's interest. I can talk to family and friends but they mean well but really don't completely understand.

gc123

cinnamonsmile said:

Hi gc123,I am so sorry to
Hi gc123,
I am so sorry to hear you have cancer. And not having clean margins sure does complicate things.
I sent you a private message for you to read, but looking at your pathology report, I see something additional.

It is conflicting. It states that it is negative for invasive cancer, which is not completely true.

It states that you have a micro-invasion. This means that some of the DCIS has broke thru the milk duct and has become invasive. I found this statement on breastcancer.org regarding that:

DCIS-MI (DCIS with microinvasion) means that a few of the cancer cells have started to break through the wall of the duct. This is considered to be a slightly more serious form of DCIS.

The question is now, how much more is there within the breast tissue? That could be all the has broken through the duct wall, or there could be more.

I still think an MRI before any more surgery would be a good thing to have. An MRI can pick up more than a mammogram. Especially with the micro-invasion.

It will also be important to know if your cancer is estrogen or progesterone positive,what grade it is (1,2, or 3 being more agressive cancer) and if the micro-invasion is Her+. That will play an extremely important part in your treatment now. I don't know much about Her, but I do know that is a more aggressive cancer. All those factors are important to know for your treatments.

Some oncologists will treat DCIS with micro invasions that are Her positive differently than DCIS alone.

Have your surgeon or an oncologist explain all the components of your pathology report and make sure to include the hormone and Her components.Those should have been tested as well by the lab.

Please let us know how you are doing and keep coming back to ask questions or just unload anything you need to get off your chest.

" get off your chest"
Thanks for the smile even if you didn't intend it!

I need to get cancer off my chest!

cinnamonsmile

cinnamonsmile said:

Hi gc123,I am so sorry to
Hi gc123,
I am so sorry to hear you have cancer. And not having clean margins sure does complicate things.
I sent you a private message for you to read, but looking at your pathology report, I see something additional.

It is conflicting. It states that it is negative for invasive cancer, which is not completely true.

It states that you have a micro-invasion. This means that some of the DCIS has broke thru the milk duct and has become invasive. I found this statement on breastcancer.org regarding that:

DCIS-MI (DCIS with microinvasion) means that a few of the cancer cells have started to break through the wall of the duct. This is considered to be a slightly more serious form of DCIS.

The question is now, how much more is there within the breast tissue? That could be all the has broken through the duct wall, or there could be more.

I still think an MRI before any more surgery would be a good thing to have. An MRI can pick up more than a mammogram. Especially with the micro-invasion.

It will also be important to know if your cancer is estrogen or progesterone positive,what grade it is (1,2, or 3 being more agressive cancer) and if the micro-invasion is Her+. That will play an extremely important part in your treatment now. I don't know much about Her, but I do know that is a more aggressive cancer. All those factors are important to know for your treatments.

Some oncologists will treat DCIS with micro invasions that are Her positive differently than DCIS alone.

Have your surgeon or an oncologist explain all the components of your pathology report and make sure to include the hormone and Her components.Those should have been tested as well by the lab.

Please let us know how you are doing and keep coming back to ask questions or just unload anything you need to get off your chest.

Microinvasion
For some reason, I can't edit my post. I have been looking things up. I do think DCIS with micro invasion is classified as stage 1. There is a lady who is very knowledgeable about DCIS and she has DCIS with a micro invasion that is classified as stage 1 cancer.

Alexis F

Fitzpatrick said:

I had DCIS
I had 2 lumpectomys, could not get clear margins. The surgeon wanted to do a mastectomy, but I insisted on a 3rd lumpectomy, received only one clear margin. I then had a double mastectomy (double by choice). You are not safe until you get clear margins. The 2nd lumpectomy did not make too much difference in my breast size, the 3rd lumpectomy made a tremendous difference.

I had a lumpectomy with
I had a lumpectomy with clear margins and then had rads. I don't know what to say about your situation. I think a 2nd opinion might be helpful?


Good luck,

Lex

disneyfan2008

I had DCIS but I never heard
I had DCIS but I never heard any info like you know...(posted above) NO #s, margines, size etc...I had lumpectomy followed by radiation and now tamoxifin..

if unsure second opionion for sure...can't hurt...and feel about your decision.

Denise

jnl

cinnamonsmile said:

Microinvasion
For some reason, I can't edit my post. I have been looking things up. I do think DCIS with micro invasion is classified as stage 1. There is a lady who is very knowledgeable about DCIS and she has DCIS with a micro invasion that is classified as stage 1 cancer.

A 2nd opinion can always be
A 2nd opinion can always be a good thing. Your doctors will give you their expert opinion on what surgery you should have, but, you need to weigh all of the information and do what is best for you. I am thankful that I could have a lumpectomy with rads.


Hugs, Leeza

skipper54

disneyfan2008 said:

I had DCIS but I never heard
I had DCIS but I never heard any info like you know...(posted above) NO #s, margines, size etc...I had lumpectomy followed by radiation and now tamoxifin..

if unsure second opionion for sure...can't hurt...and feel about your decision.

Denise

Was IDC stage 2
My surgeon offered a lumpectomy after the chemo shrank the tumor but I'm a scardy cat and opted for the mastectomy to increase the odds that it would not crop up again later. He removed 9 lymph nodes with 3 showing invovlement so I was glad I went the way I did. My PET scan after surgery was clear but we went ahead with radiation. Each story is a little different. Go with your gut and your second opinion. Or third if that makes you feel better. We're all here for you!