DCIS & IDC-What Were Your Grades?

I had 1.1 cm IDC pure tubular grade 1 with 3% DCIS component grade 1.  

I had high grade DCIS and grade 3 IDC.  The DCIS was in random sections.

I just met with a new oncologist on Friday to get another opinion--

As we went through the pathology report, she explained that my 9mm IDC tumor was actually grade 1, not 3 as I had understood from my first breast surgeon (long since given the boot by me), and that >25% of that 9mm tumor was DCIS, nuclear grade 2.

Hi - haven't been on in a bit - busy! How is everyone?

Wishiwere:  Just saw the Q - I was told that the tumors distance from each other is reason for multi-centric, multi-focal - then that because they were in same quadrant and that recurrance was 25% + that they combined to justify chemo (?)  I would have chosen anyway to give myself some assurance in being as aggressive as possible to attempt to avoid recurrance.

Really experiencing Chemobrain (fog) - short term memory loss is having a very humorous effect - I baked cupcakes last night for the office - got to work and did not recall baking or the fact that they were sitting in car most of morning until I grabbed a cup of coffee and thought something sweet would be nice ...

Tomorrow is my 3rd Chemo - and I just don't really want to go - I will, but I don't want to - Onc put me on heart med for water and palps -

 Anyone dealing with fear of mets or recuurance?  I have been researching and now just trying to find peace in the fact there really are no guarantees in life and all we have is today...

My pathology report does not state what grade the DCIS was.  It just speaks to the IDC portion of grade 3.  I'm curious too, but figured that because the IDC portion is what is being treated, they just don't focus on the DCIS because it's incidental.  Anyone else have this situation?

I am new to this.  No lump, no family history & in 10/07 mamm was clean so I was totally blind-sided. Stereotatic Core biopsy report 12/5/08.

DCIS --solid & cribriform type, nuclear grade 2 with luminal necrosis.

IDC ---Nottingham combined histologic grade:  Tubular grade:3, Nuclear grade: 2, Mitotic grade: 1.    Overall tumor grade 2, moderately differentiated (6 points)

Majority is DCIS w/small foci of IDC measuring 1mm max.

ER + with total score of 8; PR + with total score of 4

Will make surgeon appt today.

Radiologist doctor said they will inject something into the area about 3 hours b4 surgery so they can tell which lymph node the duct drains into and I think he said they would  take samples of that lymph node at the time they do the surgery??  I hope I can see the surgeon very soon.  I have already decided on a mastectomy because I don't want to chance going through this again. I will be 55 in 2 weeks and post-menopausal for 9 years.

Any thoughts, advise or sharing of information that you wish you had known before visiting the doctor or b4 surgery is most welcome either in reply to my post or through a private email (I don't know how that works but I saw others mention that!)  I have read all weekend and now have information overload with everything becoming a blur.

tnsue,

it sounds like you are going to have a good surgeon that is going to inject die before surgeory to detect the sentinel node and onlyu remove the 2 or three nodes and than he will see if cancer has spread to nodes, if not you won't have to have all the axcillary nodes removed, which is really good. If in fact he detects spread to the nodes, he will take lymph nodes. but this is a great procedure one that everyone now a days should be getting. good luck my friend i wish you well, i hope for the best news.

IDC is grade 2, stage 3a; DCIS was very small and says low grade on the path report. 

My DCIS was "nuclear grade 3 of 3"

and my IDC was "histological grade 2 of 3"

IDC grade 1

10% of tumor DCIS grade 1

 1.5 cm tumor

My first pathology report says that I have IDC and DCIS.  My IDC tumor is 4 CM.  The path report says that both the IDC and DCIS is low grade. 

HOWEVER, my MRI that was performed yesterday showed 2 more acreas of enhancement in my left breast where my IDC is located and 2 areas of enhancement in my right breast that did not show up on the mammogram.  One lymph node might be abnormal according to the MRI.

My bone scan came out looking good according to the tech but I haven't heard back from the radiologist.

I am scheduled for another ultrasound next Tuesday and they will take more biopsys out of both breasts.

So I can't tell you for sure where I really stand as far as grading is concerned because I am still in the testing stage.

If you are still node negative after surgery and with the pos ER/PR and neg Her2, your onco or BS can send the tissue for oncotype testing.  That allows them one more thought on whether chemo is sugggested or not. As for the surgery....Prayers and good thoughts you only have the one cancerous lump and don't have to make the decision to do a mast.  Good Luck on the final status of your tumors and sx

Oh, the tamox used to be first line of defense but with the Ai now they often start post-meno out on an Ai right off the bat instead.

I had fairly extensive DCIS, about 5 cm in maximal extent. Grade 2 and 3, type was mixed cribriform and solid with some necrosis. The IDC component was grade 2 (tubules 3, nuclear 3, mitosis 1). There was one 8 mm tumor, one 2 mm tumor and some others which weren't listed in my summary report, however, when added together the invasive component was "not more than 20 mm". It was all in one quadrant of the breast. Had a sentinal node biopsy which was negative (node negative). ER and PR positive both 80% and HER2 negative (1+). No lymphovascular. Stage 1.

I had lumpectomy and re-excisions which eventually achieved 1 cm clear margins, and was able to avoid mastectomy which was what I wanted since my son was breastfeeding at the time and I didn't want him to see that. 

An oncotype dx test was done on the 8 mm tumor and it came back with a score of 13, which is a risk of distant recurrence of 9% over the next 10 years provided I take 5 years of tamoxifen.

I opted to do chemo, 4 cycles of TC because of my young age, my little son and I also did IVF stims after surgery. Also I believe that having multifocal disease may increase the risk of having systemic tumor cells despite being node negative. The tumor was not very highly hormone positive and was HER2 negative (1+), so I expect to derive some benefit from chemo, hopefully. I have my last chemo today actually. Side effects have been fairly minor so far. Did have neulasta shots for cycles 2, 3 and 4.

I also took zoladex to protect fertility since I only got a few embryos before starting chemo. I also don't really want to go into menopause too prematurely as I don't think it's good for heart, bones etc. Particularly for a low risk tumor. The zoladex is no fun. 

I had distended ducts with my DCIS which helped me to find my tumor. It felt quite big, maybe 3 cm or more, but what I was feeling was distended ducts and an 8 mm tumor. 

I have read at least one study which reports an higher survival for a high DCIS to IDC ratio, due to that type of breast cancer being less aggressive in general, but of course there are many exceptions, population based averaging effects, and you have to make a decision based on your own circumstances.

Please post your DCIS/IDC results. We need to share information. 

I have high grade (3) DCIS with extensive comedo necrosis that cancerizes the lobules also.  I was re biopsied and they found 9 mm of high grade (3) IDC, waiting for Her2 results and bilateral mastectomy. My DCIS takes up 3/4 of my large breast so lumpectomy not an option. I am choosing to get rid of the other one, even though nothing was seen on 1 view mammogram.