another odd question....

RegulJ is correct that CAN happen but doc's have not yet proved that all DCIS turns into invasive.  It is strongly suspected that DCIS spreads through the ducts and will progress from grade 1 thru 3 and then on to invasive so your Grade 3 is an improtant factor.. but even with Grade 3 the medical community cannot say with certainty that when it comes to the end of the duct or fills up the ducts that it will then go on to become invasive.  There is some other catalysts that they haven't found yet - whether you have a genetic pre-disposition or you were exposed to some chemical that set the DCIS to invasive is just all a guess right at this moment in time.

Personally I do tend to believe that it does progress from Grade 1 thru 3 and then on to invasive but I don't have proof of that and so I want you to know that that is not a "proven theory" yet..  Good Luck and by the way that isn't an odd question as a matter of fact I might venture to say it is very common!  Take care!  Deirdre

sweatyspice wrote "From what I understand, Grade 1 DCIS becomes Grade 1 invasive cancer; Grade 3 DCIS becomes Grade 3 invasive cancer. . .."

whoa!!!!!!!!!!!!!!!!!!!!!!!!!  Thats not what I understood at all.   My understanding is they suscpect there is progression but that nothing is known for sure. . . .

yargh.  time to call my oncologist and have that tamox sit-down and ask her this question as well... so much for my mental space today. . . .

I know it's not known...but I'm just not quite convinced DCIS turns invasive and I have ABSOLUTELY no background in the medical field. My feelings are only based on, why is it that someone with calcification of 1cm be diagnosed with IDC and someone who has 10cm 'spread' of DCIS not have any invasion?

It's unlikely someone with a diagnosis of DCIS would want to be part of a study to see if their DCIS would 'turn' invasive?

Just my thoughts...
-catherine

DCIS does turn invasive.  One person may have a  non-aggressive DCIS that spreads out as extensive DCIS but takes a long time (maybe never) for an invasive component to occur.  Someone else may have a more aggressive DCIS that rapidly becomes invasive.  The amount of cancer and ratio of DCIS to invasive can vary greatly. 

What is known is that a very large percentage (approx. 80% - 90%, I believe) of IDC starts as DCIS.  So DCIS definitely does become invasive. 

What's not known is whether all DCIS eventually becomes invasive.  Some cases become invasive almost immediately, some cases become invasive within a few years and some cases become invasive after 25 years (yes, there are studies that show this).  What is known is that of those who have surgery for DCIS but who eventually have a recurrence, in 50% of cases, the recurrence won't be found until the DCIS has evolved to become invasive. So that suggests that by the time we find DCIS (remember that it might be in our breasts for 5 years or 10 years before it's large enough to be discovered), in many cases it's within a few years of becoming invasive.

Many of the articles that talk about only 40% (or whatever percentage they quote) of DCIS ever becoming invasive look at populations over a 5 year or 10 year time frame - this is simply not long enough.  Additionally, most of these studies focus on women who have lower grade DCIS - this is because those who have high grade DCIS almost always have it removed surgically, so there is no possibility of measuring how long it might take to become invasive (if it were left in the breast).

There have been recent studies that have shown that grade 1 DCIS tends to becomes grade 1 IDC, grade 2 DCIS tends to become grade 2 IDC and grade 3 DCIS tends to become grade 3 IDC.  There are exceptions to this - I had grade 3 DCIS and a grade 1 microinvasion.  But after this study came out (about a year ago, I think) someone here did a poll and it turns out that most of the women who had a combination of DCIS and IDC did have the same grade DCIS and IDC. 

What this means is that those who have grade 1 DCIS do have a risk that their DCIS could develop into a low grade invasive cancer.  However because grade 1 cells are less aggressive, obviously this risk is much less than it is for someone who has grade 3 DCIS.  Perhaps grade 1 DCIS might develop into grade 1 IDC after 15 years but grade 3 DCIS might develop into grade 3 IDC within months or just a few years.  The most important thing to realize however is that whether you have grade 1 DCIS, grade 2 DCIS, grade 3 DCIS or DCIS with comedonecrosis, if all the DCIS cancer cells are surgically removed and/or successfully killed off (with radiation and/or Tamoxifen), then this is no risk of developing IDC from this DCIS.   

Patricia, I read your other post and know that you have new calcifications.  These may not be DCIS - in fact, it's much more likely that they aren't DCIS than that they are.  Radiation can cause benign calcs so given that you've just had radiation, that's the most likely cause.  And if that's not the cause, since these are new calcs that weren't seen in your breast previously, chances are that they are unrelated to your earlier diagnosis. If that's the case, then as with all calcs, there is a very high chance that they are benign. 

As for whether this could be a recurrence, of course that's a possibility too - but it would be odd to have a recurrence in a different part of your breast.  In the unlikely event that these calcs do turn out to be breast cancer, then this could well be a separate primary breast cancer, perhaps one that was already there when you were first diagnosed, but was too small to be detected. 

With regard to the radiation treatment that you had, hopefully it did kill off any cancer cells that may have remained in your breast after surgery, but there is always a possibility that it didn't. The simple fact is that no treatment is 100% successful.  Sometimes cancer cells are left in the breast after surgery (either a lumpectomy or mastectomy) and this can lead to a recurrence.  Radiation is given to reduce the risk of recurrence, but it only reduces the risk by 50% - radiation is not a 100% guarantee.  Tamoxifen is the same - it reduces recurrence risk by about 50% too.  No matter what treatments we have, we all face some level of recurrence risk.  With each treatment we add, we reduce the chance that there might be any cancer cells left, but we can never eliminate the risk completely.  In the end, for most of us, our treatments do successfully kill off all the cancer cells, but unfortunately there will always be a small percentage of cases where the treatments were not successful and in those cases, these women will have a recurrence.  Chances are that this isn't what you are dealing with, and hopefully it's something you won't ever have to deal with, but it's something that you - and all of us - always need to be aware of.  That's why it's important, after our treatment finishes, to continue to be monitored regularly. 

Hoping that your calcs are benign!