Need help understanding DCIS path report

kittymama

Hi ladies! I think I may be joining your group, at least I hope it doesn't turn into something more serious.  I'm 45 years old, live in Toronto, married, no children. 

Anyway, I received my path report and am a little confused about the language.  It states "Sections show breast tissue with an intraductal proliferation forming a cribriform pattern and papillae.  Central comedo necrosis is evident focally.  The constituent cells show a moderate degree of pleomorphism.  No stromal invasion is seen.

The features are diagnostic of ductcal carinoma in situ (of an intermediate grade)."

My question is: does this mean that the type of DCIS is cribriform or comedo?  It states both.  From what I've researched so far, comedo is different from cribriform.  Also, from what I've read comedo is high grade, but my path report is intermediate grade.

Any clarification or comments would be greatly appreciated.  Thank you! 

helenap

i also had grade 3... you can many different cell patterns.. the worse is the comedo. ( the final patholgy for me was 2-3 grades)..they are the most agressive but good news you have DCIS.. research research. learn all you can. the size of the tumor is important. read all you can.

Beesie

There are several different types of DCIS and it's possible to have more than one type.  I think I had every type - papillary, micropapillary, solid, cribiform -  all mixed together. 

Comedonecrosis is more commonly found with Grade 3 DCIS but sometimes small amounts of comedonecrosis will be found in Grade 2 (i.e. intermediate grade) DCIS.

This website provides some good information about DCIS: http://www.breastcancer.org/symptoms/types/dcis/

kittymama

helenap, I think I've surpassed the monthly limit on my data plan researching this disease.LOL.

Beesie, I don't know how to thank you for your invaluable input.  Just saying thank you doesn't seem adequate.  You are 1000x better informed than my PCP, that's for sure. 

The only positive thing I can say about her is that she referred me to Dr. David McCready, whom I understand is one of the best breast surgeons in Toronto.

After almost three weeks of waiting for my path report and having to track it down myself, my PCP made me come in for an appointment, couldn't answer one question I asked, then scared the bejesus out of my husband by saying "It's BAD news."  (with major emphasis on BAD).  First time I've seen him cry in 10 years.  I had to calm him down, poor thing.

Beesie

kittymama, I had Dr. McCready.  He's definitely the surgeon that you want!  When you meet with him, because PMH is a teaching hospital, usually a Resident will come in first and ask you questions and answer any questions you have.  Then the Resident will brief Dr. McCready and he will come in.  On days when everything is running late (the sort of day where you have to wait 2 hours to get into your appointment), Dr. McCready may seem rushed and not all that personable, but be sure to ask him anything you want to ask - I never had a situation where he was so rushed that he wouldn't answer questions.  On days when everything is running on schedule, he's quite a different person, very personable and much more talkative.  So if the first time you see him he's kind of brusque, don't worry about it - it just means that he's running behind schedule. 

What I really liked about PMH was all the support that was there. I didn't use most of it but it was good to know that it was available if I wanted it.  One service I did use was telephone access to a nurse who works only with breast cancer patients. You'll meet her before your surgery - they have a pre-surgery session for all patients so that you know what to expect and what services are available.  I had a question a couple of days after my surgery so it was great to be able to call and get an answer immediately. 

Good luck and let me know if I can help in any way.

helenap

when I first heard, i said take them off but as i calmed down and researched more, i decided on a lump and mammosite radiation... so this is the hardest part for sure. the waiting.. until it is all done and the final pathology.. can you rest...

they can cut out the cancer but it remains in the heart and mind.. i have found the emotional part much harder to deal with than the physical side.

angel80

I can totally relate, I had a lumpectomy for 2 areas close togeather end of sept..I had 5 day radiation with the contura balloon.  But the emotional part is so hard, or is part of this the hot flashes and side effects from tomoxefen??  I'm not sure but good to know I am not alone... We need to hang in there.