DCIS with Microinvasion = Stage 1
This is my first post and I would like to say that all the information here and the support that is offered is phenomenal. There are many concerned and caring ladies here!
I am postmenopausal and was initially diagnosed with multifocal DCIS in my left breast. A mastectomy was recommended. Since I already had fibrocystic disease and microcalcifications on the right, I opted for a bilateral and choose reconstruction with TE.
The final path report showed 1.5 and 1.4 cm of DCIS and "rare foci of microinvasion, none of which measure more than 1 mm." I'm Er+ and Pr-; no evidence of lymphovascular invasion; SNB was clear. Margins were .7 cm for the microinvasion and .5cm for the DCIS.
How does this microinvasion change things from pure DCIS as far as chance of recurrance or distant recurrance? I read on another site that it would be unusual for an ONCOTYPE to be done on less that 1mm of microinvasion and nothing was shown on HER. I wonder if I should ask for these to be done. My onco said no chemo or radiation but I could take Tamoxifen and then Arimidex if I wanted. I think I would have felt better if she had been more adamant about treatment. Anyone have experience here?
Many thanks!
Jan
Comments
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Hi Jan,
I would not take Tamoxifen or Arimidex before having a separate biopsy for the microinvasion. The microinvasion is a separate entity - it may have different biomarkers than your DCIS.
There is an interesting thread that I follow and that may be interesting to you - especially at the beginning. Those women had DCIS with microinvasions that are HER2 positive and still did not have any additional treatments.http://community.breastcancer.org/forum/111/topic/748406?page=1
Regarding the chance of recurrance or distant recurrance, you may follow the earlier Beesie's posts - particularly those where she explains why she did not decide for Tamoxifen.
Jenna
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Hi Jenna,
Thank you for your response. That does make sense to ask about the pathology of the microinvasion. If it's not ER+, Tamoxifen would not be effective. I do remember reading Beesie's post about her decision not to take Tamoxifen. I'll reread that; she is amazing. Thanks again. I hope you are doing well!
Jan
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I also had <1mm microinvasion, and it seems to have changed nothing--except my mental health!! I also had close margins. But no radiation, and my doc highly discouraged tamoxifen, but I finally managed to wring Evista out of him. I've been on a quest to get a worse prognosis, I guess--second opinions, etc. If you get any further information or anything, I'd be very interested, and I'll le tyou know what my next round of doctors say, too!
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In the DCIS forum I just bumped up a thread about microinvasion for you. All my best!
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laurakay,
Thank you for your post and bump. Like you I seem to keep searching for more information about the microinvasion. Just not satisfied yet. My doctors are 4 hours away so I am going to try to see an oncologist here for another opinion. On the Ask an Expert on the John Hopkins site I found a post that addressed DCIS with <1mm invasion. It was reassuring for me but I'm still asking questions!
http://www.hopkinsbreastcenter.org/services/ask_expert/viewquestions.asp?id=999805220
Thanks for keeping me in the loop. I will also let you know if I find anything else. Good thoughts and wishes coming your way!
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bump
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