Can anyone decifer this?

Jules824

I finally got lab papers today when I got my tats for rads. Im somewhat confused. Will try to type some of it here for decifering.

DCIS in SITU Comedo type grade 3, largest tumor "fragment" 7MM Microcalcifications associated with DCIS...NO invasion tumor seen...Benign lymph node (took 1).

As far as margins I dont get all that. The lab has down measurements of Inferier, Superior, Posterial, Lateral with numbers in cm and X signs. (very confusing) How do you decifer the margin?????

TIA

Jules

Kathy044

I have ILC not DCIS, but as far as margins go I would like to know the meaning of these directional terms too.

I did read the definition of these terms somewhere before my surgery but can't remember where, it wasn't in either of my two bc books, could it have been somewhere on bc.org?

Also what is the meaning of reporting the distance from nipple, is this significant in any way or just another locational marker.

Jelson

http://www.breastcancer.org/symptoms/path_report/index.jsp is where info about pathology reports can be found on bco check the upper left of the page and there are links to word definitions and other stuff.

You inspired me to look at my pathology report from my May 09 lumpectomy, the first time this month! I guess I am moving on.....(and so will you)  My report is broken up into sections, Under diagnosis, the important stuff was summarized, among other things it says margins negative for DCIS, Distance of DCIS to closest margin:in my case... Approximately 1.5 mm from the anterior margin (block 3 level L3)  This seems to be the only mention of the clear margin, the smallest one. The other measurements seem to pertain to the nodule/tumor itself and are in the Gross description.

Under Gross Description, the pathologists describe the sample as inked with blue representing posterior and black representing anterior I know anterior is the margin closest to my skin. 

There is another section labeled microscopic description, this describes the way the tissue was cut up into blocks and in which blocks the dcis was located.

I am assuming you have not yet talked with your physician about your pathology report? This is something you might want to do before you start your rads.If not the breast surgeon, then the radiation oncologist. It sounds like all are proceeding under the assumption that you have nice size clear margins. My 1.5 mm was iffy. We would have preferred 2 mm. I asked that it go before the hospital tumor board and they agreed that it was ok to proceed with radiation without additional surgery. If my smallest margin had been 10mm, (1cm) I may have considered not having radiation.

you have a right to have your pathology report explained to you, EACH WORD, until you understand it. it is describing a part of your body and is the basis for your future treatment.

I hope this has been helpful

Julie E

swest

Jules,

If I'm not mistaken, DCIS is contained (that is what insitu means).  You would automatically have clear margins if they removed the DCIS.  Now if it was IDC (invasive) you would need to be concerned about margins.  Again, I'm no expert so double check with your breast surgeon.  His/her nurse will help you!

Good luck!

Sonia

Mantra

My report said my closest margin was 1.5 (I had DCIS). It didn't talk about the other margins at all. Just said "clear". My understanding is that if the margins are clear, then the size isn't given. However, what is considered clear can vary depending on what that particular hospital. I think my surgeon said that 2 mm is considered clear and if it is 2 mm or larger, they just say the margins are clear.

whippetmom

YOU WROTE and I added in italics:

DCIS [Ductal Carcinoma In Situ]  in SITU Comedo [there are two types of DCIS - non-comedo and comedo] type grade 3, largest tumor "fragment" 7MM Microcalcifications associated with DCIS...NO invasion tumor seen...Benign lymph node (took 1).

As far as margins I dont get all that. The lab has down measurements of Inferior,[LOWEST PART OF THE STRUCTURE]  Superior [UPPER PORTION OF STRUCTURE], Posterial [BACK OF THE STRUCTURE], Lateral [OUTSIDE EDGE OF STRUCTURE] with numbers in cm and X signs. (very confusing) How do you decifer the margin?????

This will further explain your type of DCIS:  Read entire section.

Types of Ductal Carcinoma in Situ

The term, ductal carcinoma in situ (DCIS), refers to a family of cancers that occur in the breast ducts.  .  The term, comedo, describes the appearance of the cancer.  There are two categories of DCIS: non-comedo and comedo, When comedo type breast tumors are cut, the dead cells inside of them (necrosis) can be expressed out just like a comedo or blackhead on the skin.

The most common non-comedo types of DCIS are:

• Solid DCIS: cancer cells completely fill the affected breast ducts.
• Cribiform DCIS: cancer cells do not completely fill the affected breast ducts; there are gaps between the cells.
• Papillary and micropapillary DCIS: the cancer cells arrange themselves in a fern-like pattern within the affected breast ducts; micropapillary DCIS cells are smaller than papillary DCIS cells.

Comedo type DCIS (also referred to as Comedocarcinoma) tends to be more aggressive than the non-comedo types of DCIS.  Pathologists are able to easily distinguish between comedo type DCIS and other non-comedo types when examining the cells under a microscope because comedo type DCIS tends to plug the center of the breast ducts with necrosis (dead cells).  When necrosis is associated with cancer, it often means that the cancer is able to grow quickly.  Necrosis is often seen with microcalcifications (tiny calcium deposits that can indicate cancer).  

Now you are armed with information to take to your breast surgeon to ask some additional questions.  Did you have a lumpectomy?

Deborah

Jules824

I read and re-read. I dont see "clear" in the wording, but after surgery I remember him telling me he got a clear margin. Im just going to call my surgeon in the morning and ask. Thank you. You know, all the people on here are more informative than the doctors. You rock!