Hi Ladies...can I pick your brain?

Mur23

My Mother in Law has just been diagnosed with DCIS by a mammogram. My husband and her tend to not want to educate themselves about what is going on...and just listen to what the doctors say.

I, however am a freak when it comes to knowing about health issues, especially breast health. So, I am a little stumped here.

She had a regular mammogram last year, and after her mammo this year they called her back and said that she has DCIS. She then had a biopsy which I guess confirmed this and then met the Breast Surgeon who said "it has to come out".

She then told me today that they are going to take off half of her breast because the mass was so big? I said so they are not gong to do a Lumpectemy? She said "no...they are doing some Wedge something."

My question(s) is...

Why are they taking half of her breast?

How can she have such a large mass in one year?

Can DCIS really be diagnosed by a mammogram?

Thank you for any feedback...she is terrified, and I love her.

Corrie

Emaline

There was someone else on here recently who said her DCIS was diagnosed via mammogram, it is not something I have ever heard of, but I am fairly new.  From what I understand, and could be wrong, they can have suspicion of DCIS from the mammogram but until a biopsy is done, they do not know. 

On my mammogram, I had extensive microcalcifications.  Calcifications themselves are not cancerous, but they can point to one and from what I understand, it is very good at diagnosing DCIS.  Depending on what her BIRAD score (how they rate her mammogram), they obviously thought something was suspicious and needed further checking - which is usually a BIRAD 4 (which you have a 80% chance of benign). Sometimes however they can tell from the groupings that it is more then likely cancer - a BIRAD 5, at which point you only a 5% chance of it being benign.  

As for being fast growing, yes it can happen.  My friend was having mammograms every 6 months and in 6 month period, she went from having nothing to her entire breast being covered with DCIS.  

As for taking half her breast...I don't know. To me, it sounds like a rather large lumpectomy.  Why would they take half her breast, that must be the area that the cancer is in.  Mine covered over 7.5 cm.  so if they went with a lumpectomy it would have been huge chunk of my breast, and I would have needed reconstruction (if I wanted).  It was recommended due to size and being multifocal that I go with a mastectomy, which I did.

Just remember if she has pure DCIS, it is always non-invasive and it is stage 0.  They have caught it before it turns into something else.  However, to be upfront, you never know until the final pathology is in.  It happens in a few cases, but sometimes they find something else upon final pathology.

I would request a copy of your MIL pathology report from the biopsy, and that can you give more information.  Such as size, grade, etc.

Please keep us updated!

cinnamonsmiles

DCIS is an "in situ" cancer which stays within the milk ducts. Often times it can be spread thruought them and be in different spots of the breast,as well. I liken it to a tornado, striking one place, skipping another and landing at the next milk duct, or travelling along the milk duct pathways. There could be pre-cancerous cells within that too. If the cancer is high grade or agressive, it will be a faster growing cancer. But from all the posts I have read and information I received from my oncologist, DCIS is stage 0 and the "better" choice of breast cancer (if you can consider having any breast cancer lucky). When excising the tumor, surgeons need to have clean margins, which means there has to be an acceptable amount of tissue that is found to be non cancerous. As far as being diagnosed by mammogram, it could certainly look like cancer, but as far as I know, the only way to truly diagnose cancer is to biopsy a sample. If it were that simple, thousands if not millions of women would not have to go thru biopsies, either needle or surgical. Breastcancer.org has wonderful information on DCIS as well as the american cancer society webpage.

CandDsMom

Hi Corrie-

that is nice that you are such an involved D-I-L. Anyway, they can have strong suspicion of DCIS but can't know for sure until actual bx. Sometimes there are additional calcifications or other findings that are strongly suggestive of DCIS or IDC but it is not until the lump or Mx is done that the pathologist can definitively tell. Has you MIL had an MRI of the breasts? Sometimes that is helpful, or additional sterotactic (under mammogram guidance) or US guided (under ultrasound) guided biopsies to determine the extent of disease can help.

That being said, it is definitely possibly for DCIS to occupy a large area. My DCIS for example was 8x9x5cm in dimension. In a smaller breast (my pre-MX breast was DD++) that would mean a significant defect in the breast due a quadrantectomy or a partial Mx.

My DCIS (mostly not seen on mammogram - only the MRI revealed the true extent of disease) came up in 2 years, my mammo at age 32 was within normal limits and the second one at age 34 (delayed due to a pregnancy) showed a 7mm and 3 mm cluster of microcysts that both turned out to be DCIS. So yes, it can come up quickly.

Best wishes...

1Norman

I was Diagnosed with DCIS last year and pretty much the same thing happend to me.  The year prior no sign and in a year I had a mass the size of a golf ball, I had a double masectomy. DCIS can be seen in a mamogram or a a ultrasound but sometimes it is not detected because depending how the tumor lays it can act like a glass, which means you can see through it.  My tumor you could feel and see it on the skin surface but the mamogram you could only see a faint outline.  The great thing about DCIS is once it is taken out it doesn't grow back. Regular cancer has little feelers on the outside that makes it easy to attach itself to body parts or grow larger. DCIS doesnt have feelers so it can grow from the inside and become larger but doesnt have the ability to navigate through your body.  My doctor was amazing when we discused options and how turmors grow and what to expect.  Taking off the breast is not a bad thing, accually it is good to take it off and than replace what is loss with a implant.  I am happy today with my implants and my healthy breast.  What you have to remember a loss of a breast mean your health is not in jepordy and life is so much more important than something that can be replaced.  That is what kept me motivated to go through the surgery and I am 40.  I hope that puts you at some piece with the dicission. 

SJW1

Corrie,

DCIS is ususally found with a mammogram as often there are only microcalcifications and no lump. When I was diagnosed with it in 2007, they did a partial mastectomy (ie large lumpectomy). They do this when there is scattered DCIS to make sure they get it all. She probably doesn't even have a mass, but getting DCIS can happen in one year.

The good news is DCIS in non-invasive so your mother-in-law won't die from this. She will probably need a lumpectomy plus radiation. 

All the best to her,

Sandie

Lisa75

My left breast was lactacting and was initially told it was hormones during my cycle. In oct I noticed blood and knew something was wrong. mammogram and sonogram were fine except my left breast which was dense - they recommended a biopsy and then found it was DCIS. I have an MRI next week...havent had surgery yet, but was advised I wouldnt need the tamoxifen and maybe no rads...