Microscopic DCIS found in margin on final pathology

Linosway

We just got the final pathology and in it it states a microscopic focus of ductal carcinoma in situ present at the new superior margin. Our surgeon was on vacation and we meet with his partner for post op check. He told us we would need to talk with primary BS on what we need to do moving forward. I am wondering because it is microscopic will we need a second surgery or will chemo and radiation be able to take care of it.

Path report was

invasive ductal carcinoma Grade 2

Tumor size 2.5cm

Ductal carcinoma in situ, Grade 3, comedo type (extensive)

Ductal carcinoma in situ present at the deep and lateral margins

Invasive carcinoma is less than 1mm from the closest lateral margin

During surgery on of the margins was not clear so they went back in for more

Final path on this was

Negative for invasive Carcinoma at any margins

A microscopic focus of ductal carcinoma in situ present at the new superior margin

Moderators

Dear Linosway, Welcome to the community. We are sorry that your diagnosis brought you here but glad that you reached out. While you are waiting for some responses you may want to check this link to more information about Your Pathology Report. Keep us posted and stay connected. The MOds

Molly50

Welcome Linosway, did you have a lumpectomy? I think it depends on your team and the rest of your pathology report. I had extensive lymph vascular invasion and two out of four margins not clear so my surgeon said I had to get back in for mastectomy. My pathology report after my umx was very large clear margins and only a small area of DCIS so thankfully all the cancer is gone. I still have to do radiation though even though they got it all.

peggy_j

I hate waiting to get test results, so it must be frustrating to get this new information but not get a recommendation on how to proceed. arg! I haven't had this happen, so I can't speak to the likelihood of what they will recommend. Since the surgeon you saw for the post-op didn't give a clear recommendation, it's possible this may fall into the category of being a judgement call where the patient evaluates the pros/cons and decides what's best for her. (i.e. is it worth-it to have another surgery to gain peace of mind that all the DCIS is gone?) If I were in your position, I might use this waiting period to consider getting a second opinion. I'd choose a doctor who is unaffiliated with the first doctor, since some practices, by nature, tend to share similar treatment philosophies. Good luck!

BeachLife

Sorry to hear about yr margin being +. My final report also involves + margin on DCIS (non-comedo）in addition to very close margins (0.5mm) for the tumor (1.8cm). My oncologiest/surgeon suggest reincision to revise margins. I m concerned if the cancer cells can be successfully located and cleaned out since there is no indication how extensive it is, and if there are other DCIS that are not identified, as I have dense breast and mammogram did not pick up my tumor in the first place, I found it myself. The doctors won't do MRI, the surgeon asked me if I'd go for mastectomy or 2nd lumpectomy, but does not seem to care enough to get the path report facts straight, she told me to ask the pathologist! Can you honestly have peace of mind with such a surgery performing yr surgery?... Good luck to you!

BeachLife

Can't agree more on the second opinion--choose a doctor who is unaffiliated with the first doctor. Otherwise, they either tend to agree with the first (the file sharing system in where I m makes this easy) , or they find a reason/way not to do the 2nd opinion at all.

Moderators

Hi Beachlife-

We want to welcome you to our community here at BCO. We're sorry that you find yourself here, but we're glad you've joined us, and hope you find the support you need!

The Mods

dtad

Beachlife May I ask why they won't do an MRI? I highly recommend it if you have dense breasts. Good luck in making a decision

BeachLife

I also really believe MRI is very important in my situation. However I am in Canada, either because of its high cost to the healthcare system or limited resources, doctors seem to be very careful about ordering MRI. People actually go to Seattle to do it, paying out of their own pockets. It is very concerning to decide on my second surgery based on not much info / tests, to the point thatI am reluctant to do it.