While I'm waiting for my appointment

hyphencollins

I was diagnosed on Tuesday with IDC (grade 1) and DCIS (grade 3) in what I think are separate quandrants (4 o'clock and 2 o'clock).  The IDC was a palpable lump, which brought me in to the doctor in the first place although I was "sure it was nothing" (I'm 40 and I had two benign lumps removed almost 20 years ago).   I have appointments later next week with surgeon, radiation oncologist, medical oncologist (the BC I go to schedules a meeting with all team members first).  At that point, they've called this probable stage 1 IDC and stage 0 DCIS and I am ER+, PR+, and HER2-.   The report indicated that the IDC was suggestive of tubular.  My questions are: can I expect more testing before surgery?  does the initial pathology report typically align with the final report after surgery? (I'm wondering could I have tubular oris it just IDC that is somewhat tubular?) Are IDC and DCIS typically related or independent of each other or depends?  Finally, is DCIS considered a tumor (I  know it isn't invasive but not sure if it is considered a tumor or no). Thanks!

Moderators

Dear hypencollins, Welcome to the BCO community. There are many wonderful, supportive and knowledgeable members who can answer many of your questions. While you wait to hear back you may want to check our site for more information on Types of Breast Cancer. Let us know how things go at your upcoming appointments. We will be thinking of you. The Mods

mjm1

Hello,

Sorry you've had the diagnosis, but glad you've found your way to this site.

I can't answer all your questions, but I'll have a go at some of them.

1) The amount of testing varies depending on your medical centre and diagnosis. Mum didn't have any other testing on the breast done before surgery, so the rest of the information about exact size, pathology and nodal status came after her surgery. Hers was rather large and she opted to have bone & organ scans done asap to make sure it hadn't spread.

2) Initial results are usually somewhat in line with final results, but the exact size can change a bit as imaging and palpation are not 100% (mums IDC component was slightly smaller than first thought and the DCIS bigger)

3) I don't know about tubular question.

4) IDC can grow out of a DCIS when it develops an enzyme that lets it break out and invade other tissue. 2 o clock and 4 o clock are pretty close together, so this may be possible. Or it could be 2 separate tumours. DCIS I believe is considered a tumour, but aside from surgically removing it they pretty much concentrate on the IDC component - eg size and stage of main diagnosis will relate just to the IDC (I was worried that Mums stage would be really far along due to the large DCIS, but no).

Hope this helps a little. It's such a tough time in the beginning til you really know the whole picture and treatment is underway.

juneping

after the biopsy I had a MRI, my BS ordered it. And she checked my lymph nodes no swelling so no scan. I think some had pet scan also but I didn't.

Like the person above said usually the path report is similar to the biopsy but the size of tumor is different and any lymph nodes involvement. MRI didn't detect my nodes so only sentinel nodes dissection can confirm. 

Basically you cannot have a real pic of your tumor before the path report. And I don't know what scenario that docs recommend chemo prior to surgery. My tumor was huge and that surprised my med team but I wasn't recommended any MO before surgery. I don't know if it's a hospital thing or regional thing.

njmae

Regarding tubular IDC.  It has a distinctive architecture and usually is low grade and tends to be a smaller lesion.  When cancer is graded, tubularity is a feature that is considered and the more tubular cells the better.  When my IDC was initially diagnosed by biopsy, it was noted as "mainly tubular."  The surgical biopsy had the same good score as far as tubularity of cells, but it stopped short of saying it was a tubular cancer.  I can't recall the exact percentage to be considered a pure tubular cancer, but it is over 90% I believe.  I have read other posts that said their path reports had "tubular features".  That's probably what mine was.  You can do a search on "tubular" on this site and get personal details.  You can also search on google for tubular cancer.  Pure tubular is fairly rare, maybe 2 percent of cancers, but it is certainly one of the least aggressive.  It tends to be highly estrogen positive. If you've got to have breast cancer, you could do a lot worse.  If sent for Oncotype testing, the scores for recurrence tend to be low.  Mine was not sent out.  Even if yours doesn't turn out to be pure tubular, a lot of tubularity, and hence a good score for that part of the grading, is beneficial.    Good luck to you.

vbishop

Hyphen -

For me, test went like this:

Sentinel lymph node biopsy (I wanted to do reconstruction w/surgery, so my BS ordered it ahead of surgery so I could meet and schedule the PS the same time as my surgery)

CT scan to check for mets (my onc thought I was stage 2a or possibly a three)

My path reports were VERY different that the biopsies, so maybe I'm the odd man out. 

Diagnostic mammogram found three tumors and a suspicious fourth. 

Actual path found SIX tumors.  The largest tumor DID NOT show up on the diagnostic mammogram.

Final staging was a 1a, not the 2 or 3 that the doctor suspected.

Best wishes for a "good" outcome!  Hugs!!

 

hyphencollins

Thanks everyone for the helpful info and concern.  This site and the discussion boards have been tremendously helpful in teaching me more about the diagnosis and various treatments and I feel a lot more prepared for my appointments next week.  They told me not to google but I can't imagine walking into an appointment without some prep!  I wouldn't be able to follow the discussion!  At this point, I'm feeling fairly upbeat; just anxious to get a plan in place - whatever it ends up being.  Thanks again and best wishes to all!

aviva5675

Gather questions from the legit info here on bco. Stay away from sites like ohmygodihavecancer.com...stick with Mayo Clinic and similar to get info.  Go in with a list of questions- dont assume they will tell you everything.

juneping

aviva - lol @ the omgihavecancer.com....haha. you cracked me up