Multifocal DCIS in margins after IDC removal?

1982M

I got my pathology today but my surgeon hasn’t called to explain. Given that it is a long weekend I wonder if they will.

The invasive tumour (triple positive) was smaller then estimated and came out to 8mm (yeah!). 4 lymph nodes were clear. Margins for IDC clear. Unfortunately it’s grade 2 now, not grade 1.

However, DCIS was found. It says 7 blocks out of 25 examined with cribriform and solid patterns. Grade 2, and expansive comedo necrosis. They called the DCIS multifocal on the inferior margin.

I’m wondering if my breast sounds like a ticking time bomb for more tumours? Does this sound straight to mastectomy? Anyone with similar experience?

LivinLife

Since you're diagnosed with IDC, the DCIS will be the least of your worries tho I realize is an additional concern to your initial cancer..... DCIS is pre-invasive even considered pre-cancer by some. The expansive comedo necrosis adds to the seriousness of the DCIS though the IDC is the real concern. Great on the invasive tumor being smaller than anticipated and nodes being clear. I think whether lumpectomy or mastectomy is still your choice - talk with your onc for their thoughts and suggestions so you can weigh all of this out in toto..... treatment options in either case, etc. Please keep us updated.......

1982M

Thanks LivinLife.

Update for others- they are recommending mastectomy bc my DCIS is multifocal and didn’t show up on screening.

TB90

DCIS is definitely less serious, but still needs to be addressed. Chances of recurrence increases significantly with remaining DCIS. When attending to IDC it might be tempting to minimize the risk of DCIS, but that could be a mistake. Goal should be to surgically remove all of it. All the best.

LivinLife

Not surprising they recommended mastectomy. I had DCIS Grade 3 with expansive comedo necrosis and had mastectomy (actually BMX) due to not being able to have radiation.... I had decided on the mastectomy prior to knowing for sure I could not have rads.... It's just important YOU are comfortable with your decision. That's really key! Sounds like you're comfortable with your team as well which is really important too! Thanks for the update!