Qs - recurrence, grade, necrosis

Options
azul115817
azul115817 Member Posts: 98
edited June 2014 in DCIS (Ductal Carcinoma In Situ)

Hello!

Since I was diagnosed with DCIS last September, I've been constantly reading about BC and trying to gather as much information as possible.  These boards on their own have been a great source of both information and comfort!  I still had a few questions that I wondered about and thought someone here might have some answers.

1)  I had a bmx after the having narrow margins with my lumpectomy.  I know my risk of recurrence with mastectomy is 1%-2%.  My question is that If there is a recurrence, does that mean that there was undetected DCIS that didn't get removed that then eventually grew to the point that it was detected?  Or is it that I just happened to develop cancer again in the little bit of breast tissue that was left behind?  Since our cells mutated into BC in the first place, are we more likely to have them do so again?

2)  My DCIS was grade 2.  I've never seen a breakdown of what % of DCIS (or invasive cancer) is Grade 1, Grade 2 or Grade 3.  I was just curious how common each grade was.

3)  The pathology from my lumpectomy indicated that my DCIS was all grade 2 with some necrosis.  My surgeon did not mention comedo necrosis.  I know there have been threads on this, but I still am not sure - can you have necrosis that is not comedo-necrosis?

I never asked for a copy of my pathology report, which I really need to do.  It seems as though many of you all have a copy, but I wasn't offered one and didn't think to ask at the time.

Thanks for any help!

Heidi

· Share on FacebookShare on Twitter

Comments

  • Beesie
    Beesie Member Posts: 12,240
    edited January 2011

    Heidi, to your first question, it could be either.  If BC develops again on the same side, this might be a recurrence of the previous cancer, which would mean that some cancer cells were left behind and continued to grow, or it might be a new primary BC, unrelated to the original diagnosis.  

    I don't know the answer to your 2nd question.

    As for necrosis, this means that there is are some dead cells.  With just small amounts of necrosis, the grade can remain grade 2 but with larger amounts of necrosis, usually the cancer will be Grade 3. Comedo is a type of DCIS. Other types of DCIS are papillary, cribiform and solid. Comedo is sometimes referred to as comedonecrosis, because this type of DCIS is made up of necrotic (i.e. dead) cancer cells.  I don't know if the presence of a small amount of necrosis within a grade 2 tumor would be considered the same as having comedonecrosis, which would be classified as grade 3.  So that's a bit of an explanation, but it really doesn't answer your question.

    http://www.breastcancer.org/symptoms/types/dcis/diagnosis.jsp 

    · Share on FacebookShare on Twitter
  • Deirdre1
    Deirdre1 Member Posts: 1,461
    edited January 2011

    Also Heidi:  To your question about your pathology report - I say it is vital for your understanding of your dx as well as to help guide you towards your treatment that you have a copy of the report.  I had to ask for mine and there was no hesitation by the bs to give it to me.  You didn't mention a second opinion on your tissue slides either and often that can help with understanding of your Grade as well as, sometimes, getting you to a place of comfort as you choose your treatments.  Getting a second opinion on your slides is easy - just identify the pathology lab or cancer center you want your bs to use and make the request of your breast surgeon...  I know that having a cancer center, one with a strong background in bc, helped me to accept my dx... Best of luck, Deirdre

    · Share on FacebookShare on Twitter

Categories