DCIS and IDC
Can anyone explain how someone can have both DCIS and IDC? I was told I have both and am waiting for MRI and surgery in the next few weeks. I noticed that a few but not many have both of them listed in the bottom of their posts. I see most people have one or the other.
Comments
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I had both, Mine were about half an inch apart. I don't know how it is possible, but there are quite a few women who have this. Hope you have good results with your MRI and surgery. Tami
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Hi, Blondie -
Actually, a combo of IDC and DCIS is very common. I had both, as do a lot of women I know. It is just that the site makes you "choose" when you enter you diagnosis and most put down the IDC as that is the more "severe" of the two. While DCIS should be taken very seriously, and often results in serious surgery, when you have both, it is the IDC portion that folks pay attention to because it is the part that CAN (not necessarily will) result in more intensive treatment such as chemotherapy. Chemotherapy is rarely indicated in DCIS.
In my case, the DCIS portion was quite extensive and the IDC portion was kind of tiny, but it was an aggressive tumor that caused my docs to recommend chemo, radiation and herceptin. If I had been diagnosed with DCIS only, it would have meant radiation only.
Basically, the difference is that DCIS remains in the ducts where IDC has managed to "break the walls" of the ducts, which means it is free to roam about the body via the lymphatic system (not that it necessarily does - I was node negative - but it can).
I hope that helps.
Jill
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Ductal carcinoma is a cancer that starts in the ducts. When it first starts, it usually stays in the duct and that is called DCIS, ductal carcinoma in situ (in situ = in place; it has stayed where it started). As the cancer grows, it will break out of the duct into the surrounding tissue - this is IDC, invasive or infiltrating ductal carcinoma. So usually when you have IDC you also have some DCIS.
The bigger the IDC, the more opportunity it has had to spread beyond the obvious tumor so as Jill said, it is usually the size of the IDC and the aggressiveness of the cancer cells that determine what treatment you need.
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Usually when you have both, it began with more than one DCIS and one of them turned into IDC. If this is the case, your pathology report will have phrases like "associated DCIS'
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I also have DCIS and IDC... So I ended up having a lumpectomy for the actual IDC tumor and some DCIS ,then they could not get all clear margins so I had a second re-excision. That didn't do the job either, there was more DCIS. So I had a bilateral mastectomy. I needed it for sure on the right side, and I elected to do the left as well. My IDC and DCIS were close to eachother too.
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This DCIS/IDC issue is becoming more and more interesting to me as I move along in this journey. I had 3 cm total of both with 1.2cm IDC. As I envision from the path "they were admixed", what started as DCIS then broke out as Blue described. But then, couldn't it have been the other way around? Tumor right outside duct infiltrated duct? Didn't not think so until reading of the varying opinions of the severity of DCIS. I had tons of calcifications and in my mind I thought "if only they followed up in six months" then maybe I would not have had that invasive component when I went for my annual? But then again, being HER2 pos, maybe it wouldn't have mattered.
I dunno, just started asking myself these questions and wondered whether anyone else asks same? It's not as if I'm living in that "what if", it is what it is. But this is subject matter that is worth understanding to help others in my life who may be diagnosed moving forward.
Blondie- Surely you have gotten your answer. You are in very good company. I wish you the best of luck in your own journey.
xoEllen
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I have both also. And I just found out I might have ILC also. I was followed up in 6 months. Aug. 08 I was told I have 2 cysts that they wanted me to come back to check in 6 months. I went back, now like I said I have DCIS, IDC and possible ILC. It has also gone from 2 cysts to the entire upper outer quad, with possibles in the upper inner quad. We need better tests!
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I recently asked my ONC about this, she said that anyone who had IDC would have had to have DCIS, her answer was that the IDC started as DCIS and then became IDC. Is this information correct, or is it not that simple?
Shelley
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Blondi45,
I too have both and was also surprised that one could have both, at time of DX last June, I didn't even know there were different kinds of Breast Cancer ~ this is like learning a whole new language on a different planet! Keep posting and asking questions. I am through my mastectomy & chemo, not taking Tamox(refused) and now in middle of reconstruction. Ask questions, and keep asking until you get answers!
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Hey Vision-
I'm curious if you were on the low side of estrogen positive? If not, are you doing anything else to lessen estrogen? I'm trying to prepare for the big AL talk with the Onco. and looking for any ammo to avoid them! I was high ER/PR though- 90% both.
Thanks, Ellen
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