DCIS high grade, 8cm?

Catrina

Hi all, 

I was diagnosed on January 26 with high grade, comedo type DCIS on the left side.  I did have sypmtoms, lump, pain and swelling in the breast.  Had a mammogram and called back same day for ultrasound.  The radiologist told me right after ultrasound that this was very likely malignant, and had a biopsy a few days later, the radiologist that performed biopsy also told me that it was very likely malignant.  Pathology came back with above diagnosis.

Had an appointment with a breast surgeon the next day, and she requested MRI.  MRI result showed the area to be close to 8cm, overlapping two quandrants.  I had really hoped to be able to treat this with lumpectomy, and radiation if needed, I have done a lot reading about making the choice between that and mastectomy and had already made the choice. This was before MRI results.  But, am told by radiologist and surgeon it is not possible to do that with the size of the cancer, and mastectomy is indicated.   Surgeon is also concerned that there could be some invasive cancer mixed in as well.  Everytime I speak with her I ask if it is at all possible to treat this more conservatively and she very nicely says, it really would not work, and we can't take the chance.

MRI also indicated some problem areas on the right side, and will need MRI guided biopsy on that side too. 

 I do like and trust both the radiologist and surgeon very much, but wondering if anyone has had any experience with this size DCIS and able to have breast conserving surgery? 

Thank you

Emaline

Mine was over 7cm and while my BS felt confident that I could get away with a lumpectomy due to the size of my breast (was very large breasted), he was overruled by the tumor board.  He told me that if I wanted, he would still perform the lumpectomy but I had to understand that if I didn't get clear margins, he would then want to go back and do a mastectomy.  Mine was only grade 2 though, so I don't know if that makes any difference.  I opted to do a mastectomy but while I don't necessarily regret it, I sometimes wish I had at least tried a lumpectomy.

Have you asked for a second opinion?  I wish you the very best of luck.

Angelfalls

Mine was 8cms and the breast surgeon told me that mastectomy was the only option, even though I had large breasts. With a lump of that size, you have to consider how much of your breast would actually be left if you had a lumpectomy rather than a mastectomy. And that's quite apart from the further risks involved (chest wall, skin, etc.).

Good luck, whatever you decide to do.

Angelfalls xx

Catrina

Thank you for your replies. I did not get a second opinion, but 2 radiologists and the surgeon said the same. My sister had a similar diagnosis a few years ago and she was told the same. After seeing the area of cancer on the MRI image, I know what they are saying makes sense, I had just had my heart set on a lumpectomy throughout this journey and was somewhat crushed to find out it wasn't a choice I was going to make. I realize it could be alot worse. Hoping for good results on the right side this week. I hope you are both doing well after your surgery.

Tatina123

Finding out you need a MX is heartbreaking. My DCIS was 6mm, multifocal. With my strong family history of breast cancer I had a bilateral MX. In the middle of reconstruction right now. Although it's rough, I know I made the right decision. We will get through this one day at a time.....



Take care,

T

sunshinegal

My grade 3 DCIS was 9.5 cm, a solid tumor that took up pretty much my whole breast. Lumpectomy wasn't an option for me!

lago

My tumor was mostly IDC but had some DCIS (didn't know about the DCIS till surgery). They initially thought 7cm, MRI showed 6.5cm. I think it ended up being around 6-6.5cm with DCIS.

My BS told me the same. I had small breasts (34B in a not so full bra). I kinda expected that though when I heard how big it was.

I too had some suspicious stuff in the other breast. My BS told me I would have to have it biopsied every year and recommended the BMX. I didn't even bother with the biopsy. It ended up being a small amount of LCIS. I have no regrets.

Beesie

My initial mammo showed two areas of DCIS.  After an excisional biopsy that left me with positive margins all around, we knew that there was obviously more DCIS than what the mammo showed.  A follow-up MRI showed that my breast was full of "stuff". My surgeon, knowing how much I wanted to avoid having a mastectomy, did offer to try a re-excision lumpectomy, but he warned me that we would probably end up still having positive margins and then I'd have to go back into surgery for the mastectomy.  So to avoid having the extra surgery, I accepted that a mastectomy was my only realistic option.  That turned out to be true, since I had so much DCIS throughout my breast.  The good news was that the MRI showed that my other breast was clear, so I felt comfortable having a single mastectomy only.  That was over 6 years ago, and so far, so good. 

Catrina

Thank you so much everyone for your input. Both my husband and sister, who saw the MRI images with me, think I'm crazy to even think there is any way out besides a mastectomy. So I have pretty much resigned myself to the treatment plan for this side. Really hoping for negative or more easily managed results on the other side that I'm having biopsied tomorrow. Good news is that a funky looking lymph node biopsied last week came back negative!

Good luck to everyone in their treatment, I do realize that in putting this in perspective, I am very lucky that this is very close to curable and could be much worse.

akmom

Catrina, I admire your outlook. Good luck with the biopsy tomorrow, hoping you have better results on the other side.