a bit confused with path

ketch

Initially, when I had my needle biopsy, they told me I had DCIS with a 3mm spot of invasive cancers & LCIS was also on the report. No one mentioned LCIS, all I focused on was cancer. When I went back and spoke with the BS, I asked about the LCIS and told them it had  not been mentioned. He said that it was there but the least of the reported cancers.

I opted for BMX which I had Jan 12th. My paths came back. ER+/PR+ HER2 neg. with a 1 cm of ILC. No node involvement (3 out of right arm, 6 out of left).BRCA negative, Ki67 = 4%, stage 0. No cancer in right breast but I did have atypical cells, so the NP said I did the right thing to get both. She said in the world of cancer results, these were the best results that I could've hoped.She even mentioned possibility of no treatments needed. I will take them as a ppreventative if recommended though.

I go back for the results from the BS and drain removals (yeah!!!) this week. I was shocked when she said ILC instead of IDC, and then again when she said 1 cm, where the mri and ultrasound showed only 4mm. NP said when they got it all it was 1 cm, but the doctor continually mentioned how early this was caught and how very small the area was after surgery. I am confused why it changed from IDC to ILC. I want to be ready for questions when I go back this week.

momof3boys

Tell them you want an Oncotype test done. And make an appointment with a medical oncologist. An oncologist is the one to decide if further treatment is recommended, not a BS (in my opinion).

ketch

I'll be going to the onco after thiis appointment. I am just confused as to why it changed from IDC to ILC.

Gitane

Hi ketch,  I just wanted to say that I had DCIS and ILC.  I didn't have any LCIS. That can happen.  

suzfive

Hi Ketch,

 Another ILC'er here. It probably did not change from IDC to ILC. The 3 mm of IDC that showed up on the needle biopsy may have been all the IDC that you had - hence it did not show up on the surgical biopsy.

As for the ILC, it does not always show up on imaging. I was told by my radiologist that mine measured 3 cm but that likely it could be larger when they did surgery. He said that if it shows up on the MRI it often times is smaller than it actually is on biopsy. I was fortunate that mine was 3 cm on MRI and also 3 cm on biopsy. On the other hand, I was told that nothing showed in my lymph nodes and ended up with 5/21 positive. ILC is sneaky!!! What showed up on your imaging was probably the DCIS/IDC/LCIS which may explain why they did not get any of the ILC with the needle biopsy since they use the imaging studies to know where to biopsy. The surgical biopsy gets the whole tumor/tumors and that is where you get the whole picture - thus the ILC.

I would second getting the Oncotype DX since you are node negative.

Good Luck!

GabbyCal

Hi Ketch -

You posed some good questions which you should ask your doctor at your appointment.

We can give you our practical experiences and share what we're learned, but only your doctor can give you the answers as they relate to your specific situation and your questions are all valid.

That said, it's always good to go into these appointments armed with some food for thought, so I'll share a couple things to that end. 

A diagnosis often changes between biopsy and surgery. The biopsy only gives them a small amount of cells to look at. The results from the surgery are more precise. One analogy I've heard is that the biopsy is like peeking in through a window while the surgery is like walking in the front door. 

I would definately ask about the change from IDC to ILC as it seems unlikely they were both there and the IDC was removed with the biopsy. 

As to the LCIS, my understanding is that's a "marker for increased risk of any kind of cancer in either breast".  Doctors always focus treatment on the highest level of cancer found. So, once they found invasive, they focused on that. 

Finally, your NP is right that your pathology is about as good as it gets so take heart and be optimistic! 

GabbyCal

Hi again,

I just re-read your post. Did your biopsy pathology report literally read "DCIS with 3mm spot of invasive cancers & LCIS"?

If so, it's possible that there were markers in that tissue for ILC and/or IDC.  It's possible they could see that it was invasive but couldn't differentiate which type.

All the best. 

ketch

the biopsy said DCIS w/ a 3mm multifoci of invasive cancer, LCIS. They probably could not tell which but, I am going tomorrow, so I may have some more answers.

I plan on asking about the oncotype testing. They may've already done it. Or they may be waiting for the oncologist to come aboard since this all I've seen so far is the BS. Either way, I intend to ask. 

Mainly, I will be glad to get these drains o-u-t!!

maggiesuzanne

Ask lots of questions!