Does DCIS count as tumour size when deciding on treatment?

Wooki

Hi ladies I hope that you can advise me please, as I've got a terrible nagging doubt that I have rushed into the wrong treatment in my desire to be rid of this dreadful disease!!!  I am 55 years old and I was diagnosed early in September - lumpectomy, re-excision as margins weren't clear and then chemo and I'm almost half way through chemo TC X 4. Chemo is due to be followed by Rads in Feb 2018 assuming my genetic test, which I finally had last week, comes back negative.  The tumour (triple negative) was a 15mm IDC plus 1mm DCIS, with no node or vascular involvement. Both my surgeon and my oncologist are adamant that inspite of the fact that the Path Report said whole tumour size was 25mm, and reported a preliminary stage 2, that the "key" tumour size is the IDC at 15mm and I am stage 1a and that the DCIS "doesn't count". My main concern is that I have a less aggressive chemo regimen on the basis of a stage 1a diagnosis. Can anyone advise if DCIS counts as part of overall tumour size please and how that would affect choice of treatment protocol / chemo? 

Many thanks for your advice.

xxx

DLJ46

Hi Wooki,

I am in a similar diagnosis as you. TNBC, 9mm IDC plus area of DCIS larger than yours. I had asked my surgeon if the size of the IDC was added to DCIS to get a total size for staging. He replied “No, only invasive carcinoma size and nodal involvement" factored into staging. Also, I had lumpectomy, TC chemo, and radiation for my stage 1 TNBC. Several times I questioned the oncologist about the AC-T chemo protocol. For me, he felt TC was the best choice in terms of benefit vs risk. I hope he was right.

Take Care

Cpeachymom

I wasn’t even told the amount of dcis, just that it was “extensive” in addition to a 4+cm tumor. I don’t think it affects treatment options

KathyL624

All my reports state that I had an 8mm tumor made up of both IDC and DCIS. My biopsy actually said at least 5mm of invasive cells, so I assume in my case they added the two types. My post surgical report says 8mm tumor and mentions both IDC and DCIS

LisaAlissa

You will, of course, want to be guided by your medical professionals on this, but given that chemo is not given for DCIS at all, it makes sense that the extent of your DCIS wouldn't affect the treatment decision on the chemo to be used for your IDC.

Hope that thought process helps,

LisaAlissa

Wooki

Many thanks to your all for your responses. It is much appreciated and gives me a great deal of reassurance.

To DLJ46 - Regarding my own treatment, my Onc's rationale for avoiding AC-T or FEC-T was to avoid anthracycline agents in the chemo due family heart history and some pre-existing minor heart problems on my side. I also researched TC and found numerous on-line citations recommending TC for early stage TNBC as an alternative to AC-T if anthracycline agents need to be avoided due to risks. I hope this gives you some reassurance. I would have perhaps accepted risks of anthracyclines if my tumour size or stage had been higher - hence my question about size.

Many thanks again to you all for responding.

best wishes

xxx