DCIS: Focal Necrosis- How common, what does it mean?

shlee

Hello,

I have both DCIS and a 1cm IDC (low oncotype score/grade 1-2). I was told that the DCIS component (intermediate grade) has focal necrosis. I was worried it was part of the IDC, but now have been told its was seen in the DCIS. Can someone please help me understand how common this is with DCIS and what it means. I know necrosis means dead cells, but I would be interested in learning more about its relation to DCIS and what it can mean beyond this. Not really sure how the DCIS having focal necrosis will affect prognosis. 

My DCIS also has architectural pattern: solid; cribriform. Not really sure how important this is or what it means...

Beesie

Having some necrosis is quite common.  It's part of what's considered in determining the grade.  Is your DCIS grade 2 or grade 3?  When there is a lot of necrosis,  normally it would be grade 3.  So if your DCIS is grade 2, then you really don't have much necrosis at all... and that's consistent with having "focal necrosis", which means that it's just small amounts of necrosis. And "solid" and "cribiform" are forms of DCIS usually associated with grade 1 or grade 2.  I had over 7cm of DCIS, most of it with comedonecrosis.  My DCIS was grade 3. 

When a diagnosis includes both DCIS and IDC, it's the IDC that is the more serious condition so the staging, treatment plan and prognosis are all based on the IDC.  Other than ensuring that all the DCIS is removed, it doesn't need to be treated separately or any differently.  Anything that's done to treat the IDC will take care of the DCIS. 

Since your diagnosis is IDC Stage I, you don't need to worry at all about the DCIS, provided that it's removed (including it being out of the margins).