The trouble with second opinions

jadeblue

So, the staff at the surgical ongologist's hospital (my seccond opinion team) reviewed my test results and pre-exicision biopsy tissue slides. I was having this little fantasy they'd call to say, "Hey, we don't think it's as bad as the first hospital thought," but it was the opposite: they told me today that they see evidence of micro-invasion. They can't say it's definite, or if so how far, but they did find "clusters of infiltrating cells" and are now proceeding with me as a stage 1 patient (making SNB mandatory -- not optional -- although I wouldn't reisist in light of that news). I feel this just gets worse and worse: high grade, ER-/PR- and now this. Ugh.

Anyone else have evidence of micro-invasion on pre-excision biopsy? If so, how did that square with what was ultimately found? And how did it change your treatment plans? They say I'm still good to proceed with lumpectomy as my area is believed to be only about .8 cm, but I'm feeling pretty unsafe with that. Also, my oncologist already warned me that we'd be having the "chemo talk" for micro-invasion because I can't take Tamoxifen.

Of course I'm glad I got a second opinion. It's better to know what lurks under those rocks, but I was feeling happier and more optimistic when there were more stones unturned. -JB

geebung

Hi Jadeblue,

You are at one of the worst times in this journey and my heart goes out to you. Your optimistic attitude is similar to mine. When I was first diagnosed, I thought it was all a storm in a teacup and expected the first biopsy would show nothing worse than ADH. I think the denial helped get me through those first stressful weeks of waiting for definitive results.

I had a lumpectomy to begin with and the path report came back saying "several areas suggest microinvasion" and  high grade. It also said that the area of DCIS was "at least 6 cms". I then had a mastectomy with SNB. When I was in hospital following the the mastectomy, my surgeon visited me and told me that pathology report from the lumpectomy had found "some real cancer" in amongst the DCIS and to prepare for the possibility of chemo if the mastectomy path found more extensive invasion. My breast care nurse visited me on a separate occasion and told me virtually the same thing.

Fortunately for me, the mx report came back clear. I have always thought that I had pure DCIS because of the mx path report but perhaps I didn't? Anyway, that all happened 4 years ago and I am healthy and doing well.

I had no further treatments and was relieved that my surgeon didn't suggest Tamoxifen.

Hugs,

Jane

jadeblue

@geebung: Yes, it does sound like your situation is similar to mine (or to how I hope mine turns out to be). Your message was extremely helpful just now: both the reminder that the news might not be terrible, and that this is one of the hardest parts of the journey. Thanks so much for taking the time to write. -Jade

rianne2580

Hi Jadeblue,

I have some grade 1 DCIS and grade 3 DCIS a needle biopsy showed 4 mm of IDC. I sent my path slides to Johns Hopkins for a 2 nd opinion and they said I only had a microinvasion of IDC, not 4 mm. All said and done, my surgeon called me and said the only thing that matters is what we find in the MX tissue. My tumors are in 2 seperate quadrants of my breast and I am very small, so I need a unilateral MX. The appt. is next Tues YIKES. I've been dodging it for months. But I'll go through with it mainly because I read testimonies of women who are way futher along, and it's not pretty.

shannonW

With my initial diagnosis after the core biposy the radiologist said there could be evidence of microinvasion and he recommend I ask the surgeon to do a SNB. I had a BMX(only right with DCIS but was small chested and a worrier) and SNB. My final path report said med/high grade DCIS and no invasive cancer seen.