Pathology question

Alison78

Hi...I have a history of breast cancer in 1/06. I had a left mastectomy and 4 chemo treatments. I have been being monitored with mammo/ultrasound and MRI every year. My breast MRI showed an area in my left axilla and I followed up with an ultrasound and core biopsy on the left axilla (my left mastectomy side). The final diagnosis on this core ciopsy is Atypical Epithelial Proliferation. There is a note under this dx that reads "The specimen consists of fragmented portions of a papillary epithelial proliferation that is most suggestive of a papillary intracystic carcinoma. Evaluation for invasive malignancy is difficuly b/c of the fragmentation. Although the specimen is from the axilla, no lymph node structures are identified. I am going in for an excision of this area in the axillary tail on Tuesday. Does anyone know what this is? My onc. says it is a variant of DCIS??I'm so nervous:(

Alison78

Nobody??

kira1234

Alison, I can't answer your question, but when it says suggestive of a papillary intracystic carcinoma it does sound like DCIS as your Dr. seems to feel. The only way to know is with a biopsy , which is what you surgeon is doing.

I'm so sorry you're having to deal with all of this again after almost 5 years. I hope some of the great ladies with lots of knowledge will come along to help you out.

Alison78

Thanks so much!! Im so nervous about it:(

CandDsMom

Hi Alison- So sorry to hear you are going through this. BC really sucks.  Are you sure however that the initial diagnosis was a DCIS variant without any invasive component? I am certainly no expert but I was not aware the DCIS in any form required chemotherapy but I know that DCIS associated with an invasive component certainly might...  Perhaps the ladies on the IDC or other boards can be of more help.  Hopefully someone with more insight will come along.  Beesie? 

kira1234

Thinking about you. Let us know how the biopsy goes.
Diagnosis: 6/1/2010, ILC, <1cm, Stage Ib, Grade 1, 0/1 nodes, ER+/PR+, HER2-

cincilady

I was just diagnosed with intracystic (or encapsulated) papillary carcinoma after a lumpectomy on 10/25.  I too had a core needle biopsy first but it only indicated atypical papillary cells.  Because of the core needle biopsy the cyst shows that it had an opening so I will have sentinel lymph node checked.  Had this not been the case, they would have recommended radiation only.  As long as the sentinel node is negative, I can have either full radiation or brachytherapy, which is a local 5 day radiation.  I am not going to have the sentinel node surgery until after Thanksgiving.  I am first going to have an MRI on Friday to check two other cysts that were near the tumor.  My radiation oncologist talked to the pathologist about the type of cancer I have.  It appears that there are some pathologists that believe that intracystic papillary carcinoma is a type of DCIS and others that believe that it is it's own thing.  In either case, they all agree to treat it like DCIS.  I have read as much as I can on the internet.  All sources say that it has a 100% or nearly 100% 5 year survival rate so I feel very lucky.  I was also told that it is almost always ER+/PR+ which mine was, so I will be taking tamoxifen for 5 years.  I'm so sorry to hear that you have to go through this again.

Jelson

CanDsMom, I don't believe Alison78 says in her post above that her initial diagnosis in 06 was DCIS and if you click on her name, you will find Alison's recent posts where she clearly states that in 06 she was treated with chemo for Stage 1 BC. She is only NOW dealing with a variant of DCIS on the same side she had a mastectomy.I guess we can wonder is this a recurrence or a new cancer? In any event,Alison, so sorry you are facing this again, but so glad that you have been monitored  diligently and it was identified and is being dealt with.  If it is like DCIS then as cincilady says, the prognosis is good. 

Julie E

kuchagirl

Hi,

I'm sorry I am late to this topic.  I was diagnosed with Intracystic Papillary Carcinoma in 2007.  Mine was fragmented due to biopsy, also.  I was told it is a controversial type of cancer - not about whether it is Intracystic Pap Carc (which all doctors agreed on), but whether to treat aggressively or not.  I went with partial-breast radiation & Tamoxifen, which my naturopath deemed "aggressive choices."  It's got a good prognosis, but there have been some studies lately that think it might have more potential to invade than previously thought.  I had a shock when, 4 years after treatment, my Rad Onc doc said that she doesn't offer radiation to patients with this diagnosis anymore, as she has changed her mind since 2007.  She said I am cured, with 100% probability of no mets because the cells can't travel.  Another onc told me that she has only seen this diagnosis be troublesome when it had been really really neglected.  It all seems good.