DCIS on Dr. Oz show

msippiqueen

Also, as the definitions from the mayo clinic sited above note, both LCIS and DCIS are abnormal cell growths that orginate and are contained in their respectives sites in the breast.

I also have the understanding LCIS is more likely to stay in situ than DCIS. LCIS is an indicator of a more likely occurence of either IDC or ILC in either breast while DCIS tends to convert to IDC at the same spot.

Wouldn't all ILC start out at the earliest as ALH or LCIS? Just like IDC springs from DCIS that springs from ADH? What am I missing here?

I have also read over and over that the lobular conditions are the sneakiest.

Please correct me anyone, especially Bessie if my understanding is incorrect. I feel like I'm missing something in how I look at the precancer conditions.

Beesie

msippiqueen, I don't have enough of an understanding of LCIS to answer your question. What I do understand quite a bit about is DCIS.  And what I know is that it is the DCIS cell itself that becomes the IDC cell.  That's why it's almost always recommended that DCIS be removed from the breast and why it's important that the margins are clear.  If all the DCIS cells are not removed, there is a high risk of recurrence and in 50% of cases, the recurrence will not be found until the cancer cells have converted to invasive cancer.  This is why DCIS is considered by most experts (although not all) to be a pre-invasive cancer - because DCIS eventually becomes invasive cancer.

With LCIS, there appears to be less of a concern that the entire area be excised or that the margins be clear.  My understanding is that this is because the LCIS cells more often don't convert to become invasive cancer. From my limited reading about LCIS, it's my understanding that LCIS has been reclassified over the past few years from being a pre-invasive cancer to being a precancerous condition or a marker for breast cancer, and the name LCIS has been changed to Lobular Neoplasia (although I know that there isn't universal agreement on this).  I would guess that reclassification came about because it's not the LCIS cell itself that converts to becomes invasive which means it would not be accurate to call LCIS a pre-invasive cancer. I'm sure that there are cases where LCIS does become invasive but I gather that this is not what usually happens. 

I do understand that someone who has LCIS is at much higher risk (than someone with DCIS, for example) of developing ILC.  However I also understand that if someone with LCIS develops BC, it could be IDC and not ILC.  Additionally, if ILC does develop, I believe that it may be somewhere else in the breast (not where the LCIS was) or in the contralateral breast.  So I really don't understand the connections and whether ILC generally develops from LCIS which develops from ALH.  That does seem logical but that certainly doesn't seem to be how it always works. I just don't know.

There are some women on this board who have LCIS and who are very knowledgable on the topic; they are a much better position than I to talk about what LCIS is or isn't.  I'd suggest that this is a topic probably best transferred over to the LCIS discussion forum on this board.

msippiqueen

I will delete my posts regarding LCIS as I don't know how to tranfer and I'll save the mod's some effort. I appreciate your response, Bessie.

Much is unknown about LCIS and the opinions from the experts change rapidly as knowledge is gained. A large question for a woman diagnosed with an in situ set of abnormal cells is: How the heck do I put as much distance between in situ and invading. Reasonable people disagree and findings change. We're a long way from black and white.

Beesie

msippiqueen, sorry, I didn't mean for you to delete your posts.  I was simply suggesting that you'll get better information and more insightful comments about LCIS in the LCIS forum.  Just as I've spent a lot of time researching DCIS and DCIS with microinvasions, which is my diagnosis, there are women who frequent the LCIS forum who've spent lots of time researching LCIS.  So when it comes to LCIS, they know a lot more about it than I do. 

I did think that your question about the progression of LCIS was really interesting.  We know that IDC develops from DCIS which develops from ADH, so is it not also true that ILC develops from LCIS which develops from ALH?  Great question, particularly given what appears to be a difference in how DCIS and LCIS cells behave.  I haven't checked the LCIS forum to see if you've posted the question there, but I hope you do and I will follow the discussion. 

And I agree with you completely about how things change as more knowledge is gained. I've seen lots of changes in what we know about DCIS in the 5 years since my diagnosis.  And while right now the majority of experts say that LCIS is not cancer (today I scanned about 25 articles & websites; all but two said "pre-cancer" or "a marker for cancer"; there was less consensus on this 5 years ago), it's entirely possible that as more research is done and the understanding improves, the pendulum might swing back and opinions might change again.  We have to make our decisions based on what is known at the point of time when we're diagnosed.  And we have to accept that new information might change some of those assumptions/understandings in years to come and at that point there will be nothing that we can change about our treatment..  We have to make the best decisions we can with the information we have.   

By the way, while you can't transfer a post from one thread or forum to another, you can highlight a post or a section of a post and then copy and paste.  That's the only way I know to do it.

cosbon

Just an observation regarding whether DCIS is a pre-cancer or a cancer.   Prior to my having my surgery, I got comfort in any description of DCIS as a pre-cancer.  I needed to think that way before the surgery to keep my sanity.  Had I walked around for almost 6 weeks thinking I had cancer, I would have gone crazy.  So I told myself it was a precancer, and that it lacked the biological ability at that point to kill me (which is true.)    However, now that I've survived my bilateral mastectomy and dealing with all the healing and potential issues and complications that come with it, I comfort myself with the thought that I had cancer, I dealt with at as best as I can, and now I can move on.  I guess whatever mind games we need.  Just a thought.

beacher4209

cosbon, i was just diagnosised 1 week ago stage 0 DCIS, and im thinking like you... i would alway worry if i did not remove all of it,i would always wonder what is going on in there.

cosbon

Beacher, welcome and I'm sorry about your diagnosis.    Do you know when you will be treated?  good luck with all of your decisions to come. 

beacher4209

i am pretty sure within the next two weeks.i notices how my spelling of diagnosis ooops,think im too afraid to think that much about the word. But one thing i cannot find on my copy of my "diagnosis" is the grade?  Do u think U know where i would find that on the report?

msippiqueen

Bessie,

Last night I distilled down what I wrote and tried post it on the LCIS board and it just vanished. Poof! I was out of steam by that point. The ILC forum may also be a really good spot for this topic. Thanks again, especially for your kindness. 

Thanks everybody for bearing with this diversion, this is a great thread and I got carried away!