This is just surreal ...

KnicKnac

Hello All ... it took me a little bit to get brave enough to post. I have been lurking for about a week, reading a lot and taking comfort in knowing I am not alone.

Like many others have expressed, this came out of nowhere. I feel like I am functioning well, I have a great network of family and friends for support but I still feel like I am in a daze.

I just turned 59 last month. For reasons that are too complex to explain at the moment, I got my first ever mammogram on 08.13.21. They found something on my right breast and asked me to come in for an ultrasound, which I did on 09.07.21. Calcifications confirmed that required a biopsy which I got on 09.15.21. My primary delivered the results to me on 09.18.21 and sent a referral to an oncologist and a surgeon.

I had the oncologist appointment this past Wednesday (10.06.21). I have a surgeon appointment on 10.13.21.

I want to go ahead and put the diagnosis here for memory sake:

ER/PR Negative (NO HER2)

Final Pathologic Diagnosis

• Right breast heterogenous area 11:00, needle core biopsy, DCIS, high nuclear grade, comedo and cribriform types
• Tumor measures 9.0mm (off the slides)
• No definite invasive tumor is identified
• Associated dystrophic calcification and tumor comedo necrosis are seen

Comments

• Immunohistochemistry stains for smooth muscle myosin and p63 are performed on blocks A1 and A2
• Smooth muscle myosin; positive around neoplastic glands
• p63: positive around neoplastic glands

I am still trying to figure out what all the different terms mean.

I was told by the oncologist that this type of cancer doesn't qualify for "hormone" treatment, instead it is treated by surgery and possible radiation. He kept telling me I was going to be "just fine" and that I was lucky this was caught early.

I don't feel so lucky. However, I am holding my head up and I just keep doing the next indicated thing.

In the past, with every big challenge I have had to take on, I always looked for support of people that are experiencing similar issues. I think I found my home.

Emily21

I know it is a very scary position to be in but your diagnosis is a very manageable one. There is no invasion, therefor it is confined to the ducts this is the best news and should require surgery, radiation and yearly mamagrams. Try not get too scared, follow your teams advice. Best wishes.

Beesie

KnicKnac,

I'm sorry that you've joined us here.

From your biopsy report, it appears that you have DCIS. DCIS is Stage 0; it is a non-invasive cancer that some experts actually consider to be a pre-cancer. The size from the biopsy is 9mm; do you have a size estimate of the area of calcification from the mammogram?

Because your DCIS is ER-/PR-, as your oncologist indicated, you will not benefit from anti-hormonal treatment. This treatment, a pill taken usually for 5 years or up to 10 years, is only given to those who have ER+ and/or PR+ cancers.

HER2 testing is not usually done on DCIS.

The one thing that you should know is that in approx. 20% of cases when DCIS is found in a needle biopsy, the final surgical pathology includes some invasive cancer as well as the DCIS. So it is possible that your diagnosis will be upgraded, but in most cases when this happens, the diagnosis remains early stage and often the treatment doesn't change at all.

Read here for more information about DCIS:

Topic: A layperson's guide to DCIS

This is scary, but as your oncologist said, you will be fine.

Jelson

KnicKnac - do not beat yourself up for not having previous mammograms. I think it is amazing that your timing ending up being perfect!! I too was diagnosed at 59. A month after an all clear routine mammo - I sensed, didn't feel with my fingers, just sensed something strange in my left breast. My PCP thought he felt something, I had an ultrasound - nothing, I was offered the option of coming back in 6 months or seeing a BS, a friend who had recently finished BC treatment encouraged me to see her's who also didn't feel anything but seconded the idea of another ultrasound at which point an enlarged/clogged duct was found. A biopsy revealed DCIS grade 3. By the time my next annual mammo was due, I had had surgery and radiation. I bet IF the DCIS were to have been discovered in that next mammo, I still would have been ok. DCIS is a funny beast - there is controversy, if it is small and low grade whether it is possible to just monitor and perhaps it will go away or never change. With grade 3 and comedo necrosis, all of that is off the table and you can proceed with the standard care - at least that is how I thought and found the decision making process much easier as a result.

LivinLife

Just want to welcome you KnicKnac! Your area is also small though that and the DCIS are both good even if high grade. I had a very large area and they expected invasion - there wasn't any thankfully. I hope that is true for you as well!

Jellydog

I have a very similar diagnosis to you except I have 2 areas of grade 3 DCIS. One is a 3.4 linear non-mass lesion and the other is a 1.5 cm non-mass lesion. They are both ER-/PR- and stained positive for p63 and SMMS (I don't know what that means). I also have Paget's Disease of the nipple which is also ER-/PR-/HER2+. My Paget's has been present for at least a few years. It had been misdiagnosed by my dermatologist and OBGYN for quite some time. I'm scheduled to have a DMX and immediate DIEP Flap on October 26th. I've already had a sentinel node biopsy which came back negative for carcinoma, and I've gotten multiple opinions from breast surgeons who all told me it is highly unlikely that I'll require radiation which is why I feel comfortable having immediate DIEP reconstruction. I was told there's a small chance I'll need chemotherapy, but it is highly likely that I won't require any additional treatment beyond surgery. It sounds like there are some very knowledgeable people on this thread. I'd love some feedback!

forcove

I’m having trouble understanding exactly how to navigate this forum. I am “pre-cancer” and have just started Aromasin/Exemestane. I’ve started to have significant stomach/intestinal discomfort w. Very slight nausea. I can’t figure out how to see if anyone is in the same boat of taking drugs to hopefully ward off it becoming cancer. Onco thought she would be putting me on Tamoxifin but I asked her to consult with my cardiologist. Thus, Aromasin. I also just turned 75 but am working 30 hrs/wk office job. I want to understand better what to expect for side effects. This discomfort (similar to ulcer like feeling) isn’t mentioned. Thx for anyone responding

Jelson

there are two boards here that might have discussions mentioning your symptoms which might be from Aromasin: Hormonal Therapies and Managing Side effects. You can also try using the search function specifying those boards. It would be helpful for you to provide your diagnosis as "pre-cancer" can cover a range of conditions. For example, there is a board High Risk for breast cancer right at the top of the community page and two others DCIS for ductal cancer in situ and LCIS for lobular cancer in situ. I did not take an AI, but from what I have read here, there is more than one and people who have had annoying symptoms with one, have successfully switched to another, so a discussion with your MO might be very helpful.