DCIS Low Grade no other health issues no surgery??? or surgery??

chiky1959

Hi I am new to this board and from Canada. Just recently been diagnosed and with DCIS low grade and was told to have lumpectomy and get it done. However there is no other cancer of any kind in my family and I am pretty healthy 56 year old. I have been reading so much and I am leaning towards no surgery at all. But cont'd surveillance with mammograms, is there anyone else here of like mind and have had results. My other question is should I get a 2nd opinion. My family Dr. admitted that she is unfamiliar with this form of cancer.

Any feedback will be greatly appreciated

Thxs

AZ85048

chiky1959 - Follow this link:

https://community.breastcancer.org/forum/68/topic/...

and read this awesome explanation of the ins and out of DCIS written by one of your fellow Canadians, Beesie. She is our 'resident expert' on DCIS and I think her post will answer a lot of the questions that you're facing right now. Good luck to you!

PoppyK

Hi,

I was diagnosed at 49, with no health issues and no family history of breast cancer.

DCIS is ductal carcinoma in situ, which means the cancer cells are still inside your milk ducts. It hasn't spread to the surrounding breast tissues. It is considered stage 0. Treatment is warranted. A lumpectomy with radiation is standard treatment. Find a breast surgeon who treats breast cancer patients.

Here's a link to info about DCIS:

http://www.breastcancer.org/symptoms/types/dcis/sy...

It's great that your family doctor is so candid with you. So many docs don't want to admit what they aren't familiar with.

Wishing you the best.

keepthefaith

second opinions are good!:) From what I know about DCIS, there is (currently) no way to determine if and when it may become invasive. Some do, some don't. For me, surgery would keep me from constantly worrying, rather than the watch and wait. Mammos have their own risk, also. I'm sure you have time to make your decision We are all different. You have to do what works for YOU! For what it's worth, my LX was easy peasey! Good luck!

SummerAngel

I recently read an article about this, I went back to find it for you: http://www.elle.com/culture/news/a28636/a-radical-...

When I was first told on the phone that "a little bit of cancer" was found inside the fibroadenoma I had had removed, I assumed it was DCIS and I was going to leave it at that - excision only. (Obviously if you look at my signature that's not what happened in my case, though.)

You have every right to decide for yourself what kind of treatment you want for this. Hugs to you.

BarredOwl

Hi Chiky:

In addition to her excellent introduction to DCIS, Beesie has written an informative post about low grade DCIS in response to a similar question by MillyQ, which you will find here:

https://community.breastcancer.org/forum/68/topic/...

During biopsies, typically only small samples are taken. When surgery is performed, a somewhat larger area is removed, and subjected to pathology. This can lead to the discovery of additional areas of DCIS, possibly of higher grade, or even small areas of invasion, as explained by Beesie. Thus, the diagnostic picture may not be the whole picture. This is a factor which might support seeking surgical treatment.

Surveillance has some limitations. Although I was 52 at diagnosis, I had one heterogeneously dense and one extremely dense breast. Density (which appears white against the black background of fatty tissue) can interfere with mammography because areas of concern appear white and therefore cannot be seen in white/dense areas. In some states in the US, patients must be informed of their density and its impact on the effectiveness of mammography. If you do not know whether or not you have dense breasts, you should inquire and factor this in to any decision and future monitoring (with or without surgery). Also, keep in mind that density is also a risk factor for breast cancer.

Another issue is the art of interpretation of mammograms. As I learned, the experience and skill of the radiologist plays in. I obtained a second opinion in Boston, and the review found an additional DCIS in the opposite breast that was missed by my quite reputable regional hospital.

In addition, the interpretation of pathology slides presents another area of uncertainty. Here is a link to a recent study of interest:

http://jama.jamanetwork.com/article.aspx?articleid...

The above JAMA article was summarized by breastcancer.org here:

http://www.breastcancer.org/research-news/study-on...

On the one hand, we must rely on radiologists and pathologists. On the other, if aware of some limitations, they can be addressed. If possible in your health care/insurance system, you may wish to seek a second opinion. The second opinion will entail a review of all your imaging (mammograms, ultrasound, and MRI (if any)), all associated written reports, and a fresh review of the actual pathology slides (which are sent overnight to the other institution), plus an independent recommendation regarding your treatment options. There may be additional testing recommended. This process can give you confidence in your decision-making, makes you better informed, and can make some decisions a lot easier.

BarredOwl

Bendi

I Am in Canada (BC) and am wondering if you were referred to a surgeon after diagnosis? Even though my biopsy was negative there was a minor issue and I will see a surgeon for further analysis. The BC Cancer agency is all over follow ups...I am surprised that the family doctor is left with this.

I wish you the very best

CAMommy

most breast cancer has no family history. Something like 75% of breast cancer patients have no family history. If it were me I'd get the lumpectomy. My dermatologist cuts things out of me all the time that aren't cancerous now, but could change so why risk it. I look at it similarity with DCIS. If you are grade 1 maybe you can forego radiation and hormonal therapy.

chiky1959

Hi Bendi

Yes I had the biopsy then my family dr called with the news and then I spoke to the surgeon. I did a lot of reading prior to all this and still am. He did not give me any options just laid it all out that I would have a lumpectomy and it would be determined then if I would need radiation/meds etc. I told him I was unsure of all this and asked about BCRA etc and he told me that because I was "low grade" it would not be necessary. I think I am going to ask for a 2nd opinion.