Mom Diagnosed with DCIS during Transplant Evaluation

blaketots

My mother had to undergo a breast mammogram at the Mayo Clinic as a part of her liver transplant evaluation. All of her mammograms from her home clinic have always came back BIRADS: 1 with no issues ever. She is 63 years old.

The mammo at Mayo showed some microcalcifications which they compared to her previous mammograms from back home (which also had calcifications which were not told to her) and decided she needed a biopsy. We got a call from the transplant nurse today stating she has low grade DCIS. That's all we know right now.

My biggest concern is how this will affect her ability to be put on the transplant list. Anyone else have experience with this? Would love to hear from you.

She has liver cirrhosis due to fatty liver disease, but has a low MELD score and isn't quite sick enough for the transplant list yet. I don't think she can handle harsh treatments and we are of course concerned that she will have an invasive cancer once they do more evaluation.

Beesie

In about 20% of cases where DCIS is found in a needle biopsy, invasive cancer is found once the surgery is done. The risk is higher for high grade DCIS and lower for low grade DCIS. So the odds are very much in your mother's favor that the final diagnosis will be pure DCIS.

If the final pathology is pure DCIS, given that it is grade 1 and given your mother's unique situation, if she has a surgical excision with wide margins, a reasonable option at that point would be to do nothing else. As a non-invasive condition (and by some definitions, a pre-cancer), I wouldn't imagine that treating this DCIS diagnosis with surgery alone would jeopardize getting her onto the transplant list.

Of course if it turns out that she has a lot of DCIS and some is higher grade, or if the final diagnosis is invasive cancer, then treatments such as radiation and endocrine therapy (if the DCIS is ER+) may be recommended. But those treatments are always optional - surgery to remove the cancer is the most important treatment.

Will your mother be having a lumpectomy?

AliceBastable

I have a fatty liver, and it was mentioned in a post here somewhere that Tamoxifen and fatty livers are a bad combination. I'm currently on a break from the meds, after doing further research. If your mother is prescribed Tamoxifen, make sure her other doctors are aware - an AI might be safer, although they also have side effects that might be difficult for her.