New to site: DCIS with very dense breasts

coastalaggie

I was just diagnosed with DCIS. Age 40. Had mammo at 38 and microcalcs popped up in my right breast after only 2 years. I have dense breasts and so I am quite concerned as to whether they can detect future BC and whether they have accurately detected all the potential BC in my breasts at this stage. The lump I had, which was removed last week, was only detected with ultrasound. The mammogram missed it having only detected the microcalcs. I have a follow up appointment with my dr this afternoon and I will receive the full patho report. Still waiting on whether my margins are clean. I am struggling with what to do. The more I read that having very dense breasts puts me at increased risk of future new primary BC the more I think a prophylactic mastectomy would be a good choice. I am definitely going to ask them to check my left breast for lumps with ultrasound because they have not done that yet. Any other ideas/suggestions?

Moderators

Hi coastalaggie and welcome to Breastcancer.org,

We're so sorry to hear of your diagnosis, but we're really glad you found our Community -- we're the best place for information, support and advice while you gather your diagnostic information and make treatment decisions. Once you have your path report, you'll know more, and reviewing what each piece of your path report means with your doctor will help your discussion with next steps for screening your other breast as well as treatment options.

Please continue to let us know how you're doing and how your appointment goes today. We look forward to hearing more from you and supporting you throughout this process!

--The Mods

MTwoman

coastalaggie, Sorry you've had to join our club! If you fill in your stats on your sig line (and don't forget to make it "public" so we can see it), it will be easier for us to make recommendations that more closely fit for you.

I had DCIS diagnosed at age 38. I presented initially with a lump, which was visible on both mammo and us. After my lx and SNB, I got a second opinion on my pathology, as missing even a small micro-invasion could have made a difference. I used a leading expert in DCIS and he recommended that I get an mri (based on my age and dcis architecture type - which commonly presents as multi-focal disease). The mri actually found 2 more areas of DCIS that hadn't been seen either by mammo or us (although, honestly, the us may have mainly focused on the lump). So I ended up with mx instead of lx, but no rads and no endocrine therapy (I was tn).

So my recommendation would be mri on both sides. The other option would be 3D mammos, which are supposed to be better at dense breast tissue.

Please let us know if there is anything else we can do to help! ((hugs))

coastalaggie

So back from the dr.. worse than I had anticipated. The lumpectomy showed papillomas with DCIS all over the place. No clean margins. The dr began discussing MRI and I followed with what about just removing the breast. I thought I would be in for a fight but he said we are right behind you on that one. He said at your young age and with the level of activity going on in your breast tissue has me worried. He said that because I have such small breasts that by the time he took enough to remove it all I would be most of the way to a masectomy. As it is, he doesn't know if he can save my right nipple. This all feels surreal and Im pretty freaked out.

MTwoman

coastalaggie, We are here to help you. what do you need from us?

coastalaggie

Not much for now I suppose. I am just thankful to have this site for perspective. I am sure I will have more questions as I forward with the next steps.

MTwoman

Please PM me if there is anything I can do to help! ((hugs))

SiameseX2

Hi coastalaggie,

I'm sorry to hear your news. I'm about your age (41) and similarly have microcalcs in my right breast that were found with a mammogram. I also have very dense breasts, so normally ultrasound is indicated but this time we skipped ahead right to the MRI...

No screening method can catch 100% of breast cancers, but breast MRI is more sensitive than a mammogram. A lot of times, they can see additional suspicious areas in the other breast or different quadrants of the same breast.

I would suggest genetic testing and MRI because those can make you feel a lot more confident that you are making the right choice.

Lula73

coastalaggie- so sorry about your news. Please know we're here for you. My bc journey started with microcalcifications too. MRI was the next step for me. If nothing else they can get a better look at things than what mammo and ultrasound offer. Pathology report will also tell you more. It sounds like you're seriously considering mastectomy. I went that route and don't regret it at all. I opted for natural tissue reconstruction-let me know if you'd like more information about that from a personal perspective.

BringOn2017

Coastaluggi hi my story too started with microcalc on mammo on my right breast. I am 45 with a positive Family History. I did get an MRI even before sampling and this showed increased activity in both breasts globally....something known medically as bilateral global parenchymal enhancement. Sampling showed dcis in the area of microcalc.

By the time I did the biopsy I had already more or less decided on having bilateral mastectomy which I had on 22/2. Final histology was thankfully unchanged on the right. On the left side there was columnar hyperplasia.

Now two months on I'm doing fine. No regrets! I've finished my fills and hope to go back to fulltime work soon.

Take care and you can pm me if you need anything.