DCIS and Chemo?

mssunshine71

My mom had breast cancer 3 years ago.  She said it was non-invasive, stage 2 and ER+.  Unfortunately that is all she can remember.  The thing is she had 4 weeks of radiation and was ordered 6 rounds of chemo.  She quit chemo after 4 rounds because she got so sick and almost died of a serious blood infection.  She threw out all her info and paperwork regarding the cancer and treatment so I can't even go back and read up on her true diagnosis.  She is completely amazed that If my pathology results come back as only having DCIS with no nodes involved that I will only need radiation.  It made her kind of upset thinking she had gone through all that possibly for nothing. She got 3 opinions all stating she should do the chemo. 

I told her there must have been more to her diagnoses than she remembers and asked her to find out her true dx.  She feels its because it was 3 years ago and tx may have changed since then.

Anyone possibly have any insight to this? 

Moonflwr912

Just a guess, but she might have been her2 positive, that would be an automatic chemo if the tumor was over 1cm.

mckenna

Dcis is considered stage 0. You said hers was stage 2. I don't think she had dcis. I have dcis and had lumpectomy and have 6 of 25 rads left. No chemo but start 5 years of tamoxifen on July 1.

dlb823

It's very common for someone to be dx'd with DCIS from a biopsy, then have the actual lesion contain not only DCIS but a bit of invasive cancer as well.  And if your Mom wasn't really paying attention to everything that was discussed at the time, which easily happens due to the stress, I can see how the invasive component might not have been adequately explained or understood.  That's just my guess re. what happened -- that she did have DCIS, but also an invasive component to the pathology.  Or, is it possible she's mixing up DCIS with IDC? 

But wouldn't her docs have her medical records?  If she's upset about it and can't let go of the question, perhaps she could just request a copy of her file from her onc.  That should justify the chemo recommendation.  Also, it seems highly unlikely that she would have gotten 3 recommendations for chemo if it hadn't been necessary.  This also makes me suspect there was more to her dx than DCIS.    Deanna 

Infobabe

I believe Stage 2 is invasive by definition.

Infobabe

mckenna

You have exactly what I have.  How are the rads going?  You are nearly done. 

I have the simulation June 11 and after that 25 rads.  I have been anguishing over the rads and for that reason I wanted the Oncotype test to avoid rads altogether if I had a low score. I cannot get my MO or RO to order the test.

I have started a thread for DCIS and rads.  So far no takers I would love you to post there.  I was Dx 3-15 but it has been slow going.

BLinthedesert

Infobabe, you don't have many takers on your thread because it is under the DCIS forum, and not "help me get through treatment/radiation" forum.  There are not many IDC folks who will find your radiation thread here - and so there are a smaller group of women to participate.

mssunshine71

Thank you all for the responses.  I felt there must be more tho her dx than DCIS.  Unfortunately she didn't want to know much and just wanted it over.  I wish I was more involved at the time but live 2 hours away and work full-time.  I saw her every other weekend.

She will definitely be looking into it though.  She wants to come to my first Onc appt. (I don't have one yet).  

I have 2 sisters and we all have daughters. 

cinnamonsmiles

If your mother had stage II breast cancer, it could not be purely DCIS and could  NOT be non-invasive. DCIS is Stage 0 and non-invasive. Anything greater than Stage 0 (stages 1-4) are invasive cancers. Chemo is not standard treatment for DCIS. I have heard thru the grapevine that maybe one person know someone who had it, but I would say it would be over treatment. As far as the HER2 component for DCIS, I have read rumblings that SOME doctors are looking into the relationship between that and DCIS, but the jury is still out on that.

Here is breastcancer.org's defintion of Stage 2 breast cancer:Stage II

Stage II is divided into subcategories known as IIA and IIB.

Stage IIA describes invasive breast cancer in which:

no tumor can be found in the breast, but cancer cells are found in the lymph nodes under the arm (axillary) OR
the tumor measures 2 cm or smaller and has spread to the axillary lymph nodes OR
the tumor is larger than 2 cm but not larger than 5 cm and has not spread to the axillary lymph nodes

Stage IIB describes invasive breast cancer in which:

the tumor is larger than 2 cm but no larger than 5 cm and has spread to the axillary lymph nodes OR
the tumor is larger than 5 cm but has not spread to the axillary lymph nodes

I think it is most beneficial for newly diagnosed to read up on the basics of breast cancer.

Both breastcancer.org and the American Cancer Society (csn.org) have wonderful information describing the basics of breast cancer and treatments.

Hindsfeet

Your mom might have destroyed her medical records, but the hospital and doctors who cared for her still have all the records. It's a matter of her asking for them.

mssunshine71

Thank you cinnamon and evabarry.  I passed on the info to my mom and she will look into it on monday

NanG

I met a girl recently who had dcis...and was given lumpectomy, chemo and rads just last year....? I was confused too bc I was always told it was no rads or chemo for this...? I guess it depends!

BLinthedesert

Nan, most people with DCIS have either a mastectomy  or lumpectomy + radiation.  There are a small subset of women that could have lumpectomy only, but it has not been "proven" how to select this group, NONE of the current metrics has been validated, so most women (unless they are over 70 or with other health problems) have radiation if they choose lumpectomy over mastectomy. 

There are also women who have microinvasion, or are very young, who may get chemotherapy -- but their diagnosis would be stage 1 and not stage 0.   

Beesie

Nan, my guess is that the person you talked to misunderstood her diagnosis.  That happens a lot.  It could be that the initial biopsy showed only DCIS but when surgery was done, some invasive cancer was found.  That would change the diagnosis from DCIS to IDC but often that's not explained to the patient so the patient still thinks her diagnosis is DCIS.

Or in talking about the diagnosis, the doctor might have mentioned "DCIS" and "infiltrating ductal carcinoma" or "invasive ductal carcinoma" (both are descriptions of IDC).  In a long explanation that's littered with all sorts of medical terms, "DCIS" seems to stick out like a sore thumb, and often it's the only thing that someone picks up. Well, they might pick up the word "invasive" too, which is why so many women come here saying that they have "invasive DCIS" - which of course is a diagnosis that doesn't exist. 

If the woman you talked to had chemo, then she did not have pure DCIS.  She may have had some DCIS along with some invasive cancer (it's very common to have both together) but these days chemo is simply not given to someone who has only DCIS. Chemo is a strong, toxic drug with lots of side effects and it's a systemic treatment, going into and through the whole body. Chemo is given when there is a reasonable risk that some cancer cells might have moved into the body from the breast - the role of chemo is to track down & kill off those escaped cancer cells, wherever they might be in the body. With DCIS, the cancer cells are confined to the milk ducts and therefore cannot travel outside the breast. So it makes no sense to give a patient with DCIS a harsh systemic treatment like chemo; with DCIS, only the breast needs to be treated. That's why radiation, which is targetted to the breast area, is used for DCIS, but chemo never is.