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laurakay
laurakay Member Posts: 109
edited June 2014 in DCIS plus HER2-positive Microinvasion
Obsessive googling actually brought what looks like good news today:  thought I'd share.  This is from foodforcancer.com Presence of DCIS is associated with less aggressive invasive breast cancerLast updated: May 20, 2010News type:Breast cancer studyPublication:British Journal of Cancer, April 2010Study name:Presence of an in situ component is associated with reduced biological aggressiveness of size-matched invasive breast cancerA new study has reported that invasive ductal breast cancer that co-exists with ductal carcinoma in situ (DCIS) tends to be less aggressive than size-matched pure ductal breast cancer. DCIS is non-metastasizing whereas the propensity of invasive ductal breast cancer to metastasize has been shown to be correlated with both the expression of the proliferation antigen Ki-67 and axillary lymph node status. The study included data from 1,355 breast cancer patients with ductal breast cancer. To determine whether concomitant DCIS influences ductal breast cancer prognosis, the authors compared Ki-67 expression and node status of size-matched patients either with DCIS (ductal+DCIS) or without DCIS (pure ductal). The associations of ductal breast cancer (with or without DCIS) with grade, nodal status, Ki-67, and ER/HER2 were calculated.

Size-matched ductal breast cancer+DCIS was found to be more likely than pure ductal breast cancer to be detected by screening, to occur in premenopausal women, and to be either estrogen receptor positive (ER+) or HER2 overexpressing, but less likely to be treated with breast-conserving surgery (lumpectomy or partial mastectomy). Tumor grade and proliferation index were found to be lower in ductal breast cancer+DCIS than in pure ductal breast cancer, and declined as the DCIS enlarged. Lymph node involvement and lymphovascular invasion in ductal+DCIS was found to increase with the size ratio of ductal breast cancer to DCIS. Five-year breast cancer survival was slightly higher for ductal+DCIS compared to size-matched pure ductal breast cancer (97.4% compared to 96.0%). The authors conclude that ductal breast cancer co-existing with DCIS tends to have lower proliferation and metastatic potential than size-matched pure ductal breast cancer, especially if the ratio of DCIS to ductal breast cancer size is high.
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  • Jaimieh
    Jaimieh Member Posts: 2,373
    edited July 2010

    I hope it is good news. I had both and was considered grade 2 after biopsy and grade 3 at the time of mastectomy.

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  • worldwatcher
    worldwatcher Member Posts: 205
    edited August 2010

    I have both also, but am not sure what this article is stating.

     I am post-menopausal.

    Path report says 2.2 cm of Invasive Ductal Carcinoma, nuclear grade 3, Nottingham score 2

    DCIS comprises less than 5% of lesional tissue, nuclear grade 1.

    My Ki-67 score is 8%, with ER 27%, PR 66%, IHC HER2  2.7 (equivocal) and FISH score 10.0 (amplified).

    It sounds as though the ratio of DCIS to IBC may not be favorable for my situation.

    I have wondered how the HER2 aggressive feature is affected by the low Ki-67 score.

    I was to have seen an oncologist last week, but the day before my appt. they called and he "isn't on my Medicare plan." and cancelled my appt.

     I have already seen a rads onc, so I plan to get started on rads rather than waste another 2-3 weeks waiting to see a medical onc. I am two weeks out from  a lumpectomy.

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  • Beesie
    Beesie Member Posts: 12,240
    edited August 2010

    "Tumor grade and proliferation index were found to be lower in ductal breast cancer+DCIS than in pure ductal breast cancer, and declined as the DCIS enlarged."  Interesting.  I'd read that usually the grade of the DCIS and the IDC will be the same when DCIS and IDC are found together.  But in my case, I had over 7cm of high grade DCIS with comedonecrosis (the type of DCIS diagnosis that is almost certain to lead to invasion) and yet my microinvasion of IDC was grade 1. So my situation didn't support the theory that I'd heard about first (that the grade of the DCIS and IDC will be the same) but it does seem to support what was found in this study.

    Yes, it is good news for those of us with microinvasions!

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  • amyob
    amyob Member Posts: 99
    edited September 2010

    This is wonderful news!  Thanks for sharing, Laurakay.  I had 4.5 cm DCIS, comedo type, nuclear grade 3.  My 1 mm of IDC was grade 2.  I wonder if the other T1mic ladies can support this information, as well... 

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  • laurakay
    laurakay Member Posts: 109
    edited September 2010

    Yes, I didn't even say, but my DCIS was grade 3, and my IDC was also 2.  Hope all's well!

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  • happymom8285
    happymom8285 Member Posts: 205
    edited November 2010

    Just saw this and am piping in.  My DCIS was large!  10cm.  I had 3 multifocal microinvasions where the largest size was .09mm.  I did opt for BMX (family history).  Turned out the "non" cancer side had a 4mm DCIS.  I was grade 3, comedo type.  However, I'm not on any kind of meds.  Discovered after menopause.  I'm 57.

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