Please help me understand my pathology report.

suntree

Help me please. I am under the gun here to make a decision because the window for doing partial breast radiation is closing.  Both my surgeon and rad/onc said I am a candidate for contura which is like mammosite but it has more lumens.  My pathology report says I have invasive ductal carcinoma 4 mm with extensive dcis.  The dcis involves 30% of the tumor.  This is very confusing.  I have asked several different people and I get a different answer as to what extensive dcis is and how much do I really have.  I read that, one is not a candidate for partial if you have extensive dcis.  I have been told by my rad/onc that extensive means more than 25% of the tumor. I have received differing answers as to what the tumor is.  Some say it is the invasive cancer, others say it is the invasive cancer plus the dcis, others say extensive pertains to the the amount contained in the invasive and additional extension into the surrounding tissues. The pathology report is not clear.  I even called the pathologist and they will not talk to patients.  My surgeon said that it just means that the dcis is not focal.  Can anyone tell me what  the definition of extensive dcis really is.  If so I will be forever grateful. 

ejlj

wish i could give you  a clear answer, but am unsure as well.

MarieKelly

MAMHOP -

The phrase "extensive DCIS" means something entirely different than IDC with an extensive intraductal component (EIC) - the later being what Suntree's rad onc is describing by telling her that "extensive means more than 25% of the tumor."  

EIC by definition is when in situ cells occupy 25% or more of the infiltrating tumor mass. It describes a single mass containing both IDC and DCIS in which the DCIS portion of that mass contains at least 25% in situ cells. That mass could be very huge or it could be very, very tiny. Someone who has IDC with an EIC might have, as Suntree apparently does, only a very tiny amount DCIS in one specific area of her breast.

In contrast, someone who has "extensive DCIS" might not have any IDC at all, but will have DCIS spread throughout a large amount of breast tissue...or have multifocal DCIS.