Can DCIS spread outside of the breast

LisaThompson

Can high grade DCIS spread to lungs, bones, liver, and brain?  My mom was first diagnosed with DCIS, high grade in 2010 and she has just had a recurrence and has IDC now.  I am afraid that DCIS cancer from 2010 can return anytime soon and spread to her bones, liver, brain, or lungs as well since it has already returned in her breast again.  This terrifies me.  The first DCIS was small, the size of a dot.  If DCIS can return in the bones and other parts of the body, why don't doctors prescribe chemotherapy treatments?  My mom refused radiation the first time it was offered to her in 2010.  This second diagnoses she said that she will do what the doctors say this time and take the treatment.  My mom is now triple negative. 

juniper17

Hi Lisa,

I'm sorry your mother and you are going through this again. DCIS by definition is non-invasive. It hasn't developed the ability to metasticize (spread throughout the body), so if your mom had pure DCIS in 2010, there is no possibility that it spread. That's why no chemo was prescribed. I'm glad your mother is going to get treatment now. I wish you both the best.

LisaThompson

Thank you Juniper.  I had been trying hard to convice my mom to take the treatment after she kept refusing.  I let her know how much her children and her husband need her, and want her to take the treatment so she can be here alive with the rest of the family.

Beesie

"Can high grade DCIS spread to lungs, bones, liver, and brain? "  NO, it can't.

The only place DCIS can recur is in the breast.  When that happens, in about 50% of cases the recurrence is another diagnosis of DCIS while in the other 50% of cases, the DCIS will have evolved to become IDC by the time the recurrence is discovered. So DCIS can recur as IDC.   

Do you know if your mother's cancer is a recurrence or a new primary cancer?  If the location is the same, then it's likely to be a recurrence of the DCIS (but now it's IDC); if the location in the breast is quite different, then it's more likely to be a new primary.

Whatever the case, your mother now has IDC in the same breast where she previously had DCIS so her previous diagnosis of DCIS is pretty much irrelevant now. 

redsox

As juniper said, pure DCIS is noninvasive and cannot metasticize, but it can become IDC and then IDC can metastacize.  Sometimes the IDC step in the process may not be detected, and a patient who had a DCIS diagnosis will subsequently be diagnosed with metastases without an IDC diagnosis in the middle.  Your mother now has the IDC diagnosis and still has the oppportunity to get treatment before it metastacizes. 

lisagwa

I don't understand the 2nd sentence above. Can you explain how someone "with a DCIS diagnosis could subsequently be diagnosed with metastasis without an IDC diagnosis in the middle." Thanks.

redsox

"Sometimes the IDC step in the process may not be detected, and a patient who had a DCIS diagnosis will subsequently be diagnosed with metastases without an IDC diagnosis in the middle."

DCIS cannot metastacize without becoming IDC as an intermediate step, but in some rare cases the IDC may not be diagnosed in the intermediate step period before it metastacizes.  None of the diagnostic tests are 100% accurate and with any single test an IDC or DCIS could go undetected and undiagnosed. If the patient has regular monitoring, it is highly likely that IDC would be detected before it becomes metastatic.   If the patient does not have regular testing, missing the intermediate step of IDC becomes more of a real possibility. 

In the OP's situation her mother had high grade DCIS treated with lumpectomy alone.  We can't tell what her probability of recurrence was but it was probably pretty high with a high chance of IDC.  Unfortunately, she had a recurrence that is IDC, but the chance of metastases at this time are very low.  With DCIS you usually do have a second chance at treatment.  

cycle-path

Have you ever had moldy cheese? Sometimes when the cheese begins to get moldy I cut off the moldy parts and keep the rest. But the mold usually comes back on that piece of cheese anyway, because some mold spores got loose and started growing again after I cut off the mold I could see.

It's the same with cancer. The docs cut it out but there's always the chance some cancer cells get loose. That's what radiation is for -- it's intended to kill off any cells that escaped.

While it's possible to get a new cancer in the same breast after a lumpectomy for DCIS, it's rather more likely, since your mom didn't have radiation, that her original cancer started growing in the breast again because some cells were left behind.