Bilateral breast Ca.: DCIS in one breast and IDC in the other.

Rosa_Aurora184161

Hi.

I was wondering if life pronostic for those with a bilateral breast Ca. is the same as for those with just one side breast Ca.

How rare is having bilateral breast Ca.?

In this case: Bilateral breast Ca. diagnosed at the same time:

One side: IDC, 1 lympth node with Ca out of 8 lympth nodes removed. (T1c N1 M0)

The other side: extensive DCIS with sentinel lympth nodes removed. (3 nodes, none of them with Ca.) (T0 N0 M0)

Both sides are ER+/PR+, HERC2-, grade 2.

Have you had something similar?

What was your experience?

What do you think about it?

Many thanks.

Romanticrose

Hi Rosa...

At diagnosis I Had infiltrative Lobular carcinoma in right breast as well as infiltrative Ductal carcinoma and ductal carcinoma in situ right breast...thought I was the only one unlucky enough to have multiple types cancer all at once...Thats why I was on here today searching.... Sorry we are in a similar boat but please to meet you.

Beckers

Hi Rosa and Romatic,



I had the same as you and it is rare. I also have had the same questions and In researching, it seems they once believed the prognosis was worse for us, however, now it is closer to the same as having one breast cancer. I get stuck in wondering, since characteristics are same for both cancers, could it be distant met vs a new primary? My MO just says they treat us based on the most advanced. Some nights I find myself searching the web for answers.

Karen3

Hi Rosa,

I have had breast cancer in each breast - but unlike you I had just over a year between each diagnosis. I had triple negative invasive breast cancer in my right and later DCIS Er-Pr- in the other. It could have been there all along because it was invisable to mammograms and ultrasound! I agree with Beckers - you need to see each diagnosis as being an individual BC. What it DOES show however is that, for whatever reason, your breast tissue is prone to cancer. My breast surgeon told me that my breast tissue had 'turned bad'. He is a strong advocate of breast conservation and I had a lumpectomy first time round. The second time he recommended a bilateral mastectomy. Of course it was a little complicated because my second BC was 'invisible' to screening so they had no idea what they would find. They only did a biopsy because I noticed a raised area in my opposite breast and I had a history of BC. Anyhow, over a year on and I am doing fine. All the best to you X.

Blessedteacher37

it's comforting to know I'm not alone.in 2010 I was diagnosed with invasive ductal carcinoma; after lumpectomy, radiation and three years of Tamoxifen I was diagnosed with DCIS in the other breast. Had same surgery, and just finished radiation. Probably going to change me over to Arimedex. Hard to understand since I live a  healthy lifestyle (well I could exercise more). Have recovered pretty well but two diagnoses and treatments in less than 4years has taken the "wind out of my sails"l. Hang in there..we will count our blessings and keep on going!

BookWoman

I am similar to Blessedteacher37. I had DCIS on the left in 2010 and Tubular carcinoma (a form of IDC) on the right in 2012. Lumpectomy and radiation for both and am now on letrozole. I also had endometrial cancer in 2009. Having 3 cancers in less than four years does make you wonder! But, I seem to be doing fine and I too "count my blessings and keep on going!"

stage1

blessedteacher37.  So sorry to hear about your second diagnosis.  I was reading your post on the Arimidex  thread.  I just went on tomox after being on Arimidex.  I changed due to bad SEs, but hearing your story makes me think I may have made a bad choice. 

MomtoIrishQuads

Hi all,

I have had both.....3 years apart.  First, right breast with DCIS (did partial mastectomy and radiation) - then IDC, Stage 1 on the left (mammogram didn't catch it, but I insisted on an MRI which caught it) - did lumpectomy, 1 round of chemo 2.5 weeks ago (not good - dropping it after 1 tx) and will start radiation next week and Arimidex.  Mine is highly estrogen driven so hoping that I can tolerate hormonal therapy OK. 

Not sure what having it twice means - trying to figure it out.  I do know that lifestyle changes (per Keith Bloch's book) are in order, though.  Thank goodness chemo knocked my sweet taste buds out (hopefully for awhile!).

Jazzygirl

Hi folks- I had bilateral cancer diagnosed in 2012. A small 0.4 cm mass found in my left breast that was IDC. They did an MRI of the other breast and found a larger area of DCIS (1.3 cm). Due to some other major surgery that had occurred around the same time, there was no way I could handle a BMX. So they did double lumpectomy and internal rads on both side. No chemo based on stage, grade and oncotype score.

Cancer on both sides at the same time is very rare. It is usually considered to be genetic, yet I have no real strong history in my family and have had multiple genetics tests that come up negative. My doctors said they treat the higher one (IDC) and project your rates around that. My reocurrence rate is based on the Oncotype score for the invasive side is15%, cut in half on arimidex). DCIS can turn into invasive cancer, but understand it does not always. 

I had an older aunt (not blood relative) who had DCIS and they just watched it and never did anything based on her age and the pathology. This was back around 15 years ago. Later she came up with lung cancer and I often wondered if somehow her lung cancer was not related, but never asked the family. The lung cancer took her quickly. She was also a smoker. 

I think there is a lot they just don't know about the rarer type scenarios, but know once the switch has been flipped, we are at risk for cancer in either breast again or elsewhere in our bodies, beyond the possibility of mets. So pay attention to everything going on with your body.

I am a year and a half out from treatment and just went through my third six month follow up and doing fine so far. Grateful for each day and trying to take super good care of myself.

Jo6202

Hi,

I was diagnosed with IDC and surgeon found a second tumor while removing the IDC. The second tumor had not shown on mammo or ultrasound. She took it out and it was tested and it came back DCIS.  So thankful my surgeon saw it. She said it was not hard to find it was laying right beside the other tumor.

pansylady

I was diagnosed with DCIS in left breast, found on mammogram, in October 2013- decided to get a second opinion, and on MRI, they discovered a stage 1 tumor in my right breast. I had lumpectomies and bilateral external radiation, which was completed in March. The tumor on the left was estrogen-negative, and the one on the right was estrogen-positive.

With better diagnostic testing, I expect that more cases of bilateral breast CA will be discovered in early stages.

LindaVS

I had a bilateral mastectomy on July 3, 2014.  I was found to have both invasive ductal carcinoma and invasive lobular carcinoma.  They also placed tissue expanders at the time of mastectomy for reconstruction.  My concern is does the fact that I have two different kinds of breast cancer in both breasts with no positive lymph nodes increase my risk of recurrence?  I'm on anastrozole therapy.  I was told I am a Stage I, but that was based on the largest tumor, not on the fact that I had multiple tumors and multiple kinds of cancer.  

Moderators

LindaVS, Welcome to the BCO community. We are sorry about your diagnosis but glad that you found us. You have joined a caring and well informed group of others who can provide personal experiences and compassion to those who are traveling this journey. While you are waiting for some responses you may want to check out or do a search on our home page to find out some information on IDC and ILC. Again we welcome you and look forward to hearing from you. The Mods

kathy1925

hi

I was diagnosed in 2010 with dcis grade 3 in my right breast and was scheduled for a lumpectomy. Prior to the surgery my breast surgeon ordered bilateral MRIs  Something showed up in the left breast so an excisional biopsy was performed while I was having the lumpectomy . The left breast had a .4  IDC grade 1. A month later I had a BMX  followed by 5 yrs of Arimidex which I'm almost through. Based upon the IDC I was staged as 1a.

suzygirl

After an excisional biopsy last Sept. I was diagnosed with IDC (mixed mucinous type)  and extensive DCIS (6.5 cm) in my right breast. My surgeon ordered an MRI to try to gauge the extent of the DCIS and to check the left breast -- and three suspicious areas were identified there and biopsied. In the end, following a BMX in December,  pathology found another IDC tumor in the second breast, as well as a small amount of DCIS and a larger amount of LCIS in that second breast. The pathologist doing all the biopsies kept stressing "you have very active breast tissue." He said that such tissue is often familial. "Synchronous" (at the same time) bilateral breast cancer is pretty rare -- 2 to 4 percent of cases, I read -- and my oncologist says that prognosis is based on the "worse" tumor. Fortunately, both invasive tumors were Stage 1a, grade 2, and the sentinel nodes on both sides were clear. The larger tumor was sent for OncotypeDX test, and recurrence risk is 5 percent over 10 years if I take endocrine therapy -- which I am, anastrozole. No radiation, no chemo. However, the 5 mm tumor in the other breast was not tested, and I worry slightly about that. Also, although the very few recent research papers on bilateral breast cancer seem to concur that survival is no worse in bilateral cancer, I find it hard not to worry that some fundamental disease process lead to so much pre-cancer and invasive cancer in both breasts. But, so far, so good. I've had relatively few side effects from anastrozole and am feeling pretty much back to normal physically and psychologically (but minus a couple of breasts).

LindaVS

Hi Suzygirl.  I understand your concerns.  I too had a bilateral mastectomy on July 3, 2014, for 3 different kinds of breast cancer..  I'm not locating any statistics on something that happens so very rarely.  They started me on anastrazole less than a month ago and so far so good.  Just hope this is adequate with my extensive diagnoses.  Wish there was more literature to help those of us with rarer situations.  I too am doing well, but still in the skin healing stage 8 weeks after surgery.  I will have reconstruction completion in December.

LindaVS

Not sure if you are still using this web site, but I too have multiple kinds of breast cancer involving both breasts.  I had a bilateral mastectomy on 7/3/2014 with reconstruction expanders placed.  I have 3 different types of cancer, with 4 different sub-types.  I am having a very hard time finding any literature on my situation.  It was graded Stage 1 based on my largest/most aggressive tumor, but I am concerned about the fact that I have so many different kinds..  DCIS, invasive ductal, invasive lobular, and invasive tubular carcinomas.  One breast was full of b-b size tumors as well as the largest of my tumors.  Where did all of this start?  I'm on anastrazole, started a month ago, but I'm worried that this isn't aggressive enough.  I have clear margins and no positive lymph nodes, so there is nothing to radiate.  Anyone else on here with so many different cancers?

Gatorgrl

I had a small area of invasive ductal carcinoma in my right breast along with an larger multi focal area of high grade DCIS in the same breast. I made the decision to remove both breasts. Although my left was prophalaytic, a small area of high grade DCIS was found in the left on biopsy. I am glad that I made the choice I did. All were ER /PR +. I am on Arimidex now and going through reconstruction. It appears that many of us may have more than one type.

Warrior50

I was diagnosed with ILC and LC in my left breast in August 2013 and went through chemo, radiation and a mastectomy. I tried to get my surgeon to do bilateral but she was very against it. My Plastic surgeon said don't worry we will schedule it with reconstruction so I did. The surgeon still was trying to talk me out if it the day before. The pathology of the right breast came back with a tubular tumor and lcis. I had been on anastrozole for 6 months and had had a clean mammogram. I was very glad I stuck with my decision.

I have no family history of BC either, but I did have dense breast tissue and fibrosistic breast decease in both breasts