DCIS W/ IDC?
So, I had my second MUGGA today and a follow-up with my surgeon. After meeting with her and having a discussion about whether or not I need to go through radiation, I pulled out my pathology report and started going through it with new (and wiser) eyes. The last time I had looked at the report I didn't really understand much other than I had breast cancer. Looking at the report now, I see I had a significant amount of grade 3 DCIS as well as my grade 2 IDC at 4+cm.
I had not been told that I also had DCIS. Is this common? What does this additional component mean for my recovery and hope that this won't come back? I have to say that I had initially read it as my IDC being grade 3, so i'm glad to find that the invasive portion is a grade 2. At this point i'll take whatever I can get, but i'm concerned about the addition of another type of cancer!
Comments
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Having DCIS and IDC together is very common. Most IDC forms from DCIS, so about 80% - 90% of women with IDC also have some DCIS. Don't worry about it. Other than needing to be removed, the presence of the DCIS won't change your prognosis or treatment. DCIS is a less serious condition than IDC so your staging, treatment and prognosis are all based on the amount and type of IDC that you have. The DCIS doesn't factor in, and that's why it often isn't even mentioned by doctors when they talk about your diagnosis.
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I second what Bee said. Kiri has pretty extensive DCIS - they figure that is where the tumor growth starts, and while it remains in the ducts it's encapsulated and not a threat to metastasis. Once it blows out of the ducts it becomes IDC. As Bee says, the only significance is that it has to come out, which is why K will probably end up with a mastectomy rather than a lumpectomy after her neoadjuvant chemo is done, even if the tumor shrinks considerably, because typically DCIS is not affected by chemo (the ducts protect it).
The way it was explained to us is that after surgery the chemo attacks rogue cancer cells that may have spread outside the breast, and the radiation attacks any cancer cells left in the breast.
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I too had lots of DCIS along with the IDC. I had a very large tumor,- mammogram showed 6 inches! and just before the surgery my surgeon came to see me, very quiet, and I said "you're concerned about metastases" and he just said yes (perhaps thinking all along this poor woman she's a goner).
Early next morning he comes to see me with the good news - "looked like a whole lot of DCIS mixed in with the IDC and it was only 4 inches." This was to cheer me up, and it did. My path report? no node involvement, no vascular involvement, margins clear. Yahoo! And knock on wood, 2 yrs later, me just fine as far as I know, and no recurrence.
I believe I have read somewhere that DCIS and IDC go in and out in phases, as the cells try to proliferate while the body is defending itself. It's a street battle. So what was once IDC may revert to DCIS. Please jump in & correct me if I'm wrong.
Best of luck to you, heathermcd!
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I have never heard of IDC reverting itself to DCIS, but would love to hear more about it.
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Hi Gutsy - will scratch my head and try to figure out where I read that. Something about people being diagnosed with IDC but one month later it was not there. a study? hm......will urge grey cells to get to work.....
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