Just diagnosed in NYC
Hi. I had my routine mammogram on Thursday, Feb. 24, was scheduled for stereotactic biopsy the next day because of suspicious pleomorphic calcifications in right breast (later found the radiologist classified findings as bi-rads 5). Biopsy results on Wed. March 4, found DCIS grade 3 comedo necrosis. it is not multifocal but radiologist suggested MRI. I also have dense breasts according to the radiologist report. The lesion on mammogram is 40 mm x 35 mm x 20mm at 6:00. I have appointments with a breast surgeon at MSK and one at Columbia Presbyterian next week. I am concerned about the extent of lesion and classification of dcis and fear that lumpectomy may not be possible. This is happening very quickly. All of my prior mammograms were clean (last one 20 months ago) and I don't have a family history of bc. It's great all of my appointments are being scheduled so quickly but it is also a bit alarming. I would appreciate hearing anyone's thoughts on MSK v. Columbia Pres. Also anyone's experience with similar size and classification of DCIS lesion. Thanks.
Diagnosis: 3/2/2011, DCIS, 4cm, Stage 0, Grade 3, ER-
Comments
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I spoke with both and I will tell you I love, love, love Dr. Sheldon Feldman, Chief of Breast Surgery at Columbia-pres. He is an incredible surgeon and a total mensch (sp?). Just can't recommend him highly enough. Good luck! Any questions, just pm me.
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Hi, Valnyc,
I had my mammo at Lenox Hill radiology in Nov, couldn't get a stereotactic until late Dec...diagnosed w/ DCIS grade 3 comedo necrosis a few days later. I too have dense breasts. My gyno is on the UW-side and was adamant that i go to MSK...but I recently moved to the NJ burbs and was eager to find a team out here. Once great piece of advice my gyno did give me is that when you meet the right surgeon/team "you will know" - you will feel it in your gut. She was right and I trust that you will feel the same when you meet with surgeons. I met an amazing, passionate, caring breast surgeon - Dr. M. Michelle Blackwood - who moved from MSK to found a breast center in Stamford, CT and later the Breast Center at St. Barnabus out here in Livingston, NJ. After meeting w/ her both my husband & I overwhelmingly knew she was the right surgeon for me. I have completed all of my secondry testing (MRI which showed no additional areas of suspician & genetic testing which showed a VUS on my BRCA 1 gene) and am scheduled for a unilateral mastectomy on Tuesday. Lumpectomy is the "standard" surgical treatment, but i have small breasts and removal of the DCIS lesion w/ clear margins would not leave a favorable cosmetic result. B/c of my age (41) and family history we decided that a mastectomy w/ immediate lat-flap reconstruction would be best. Continue to reach out to those in the NYC DCIS community, read (Dr. Love's book is great of course) and know that with DCIS you have the blessing of time to make your decisions! Your cancerous cells were detected early and you are in an area full of amazing resources.Wishing you good health!
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Like you, I have no family history, and the diagnosis came from a routine mammogram (in my early 40s) showing micro-calc. that either weren't there the year before, didn't show up due to dense breasts, or just human error last year in not detecting. Although they say that dcis is slow growing, and mine was grade 2, guess I'll never know why it wasn't detected the year before ... just glad it was detected.
Your bs will likely have you undergo some additional testing in order to get a better comprehension of your situation; mine had me do an mri and genetic testing, and based on those results, we moved forward with a lumpectomy (followed by rads.) rather than mastectomy.
Hang in there, the waiting for results can be so stressful, but better to not jump into a decision that you may regret.
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Hi Val,
I went through a very long decisionmaking process and saw at least one breast surgeon at all the usual hospitals (Beth Israel/Columbia/MSK/Roosevelt/Cornell/NYU). There are pros and cons to each place, and surgeons opinions can vary WIDELY. I would suggest you learn as much as you can, get several opinions, and listen to your gut. I'd also strongly suggest you get an MRI, and different surgeons/institutions also seem to have differing opinions on that. I think MRI is something you need to do, period.
I sent you a PM so you can contact me if you'd like to discuss surgeons/hopsitals/all this awful crap, in greater detail.
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Update. MRI showed no DCIS in rest of breast, in nodes or in other breast which was a huge relief. I have read a lot about false positives in MRI's but am hoping there are not many false negatives. First surgeon consult at Sloan was a nightmare (in my opinion) No clear guidance as to treatment. Husband thought he was recommending mastectomy but it was really not clear. In all fairness, Sloan surgeon did not have MRI results but it was not a good meeting. I was really angry afterwards. Second surgeon consult at Columbia Presbyterian was much better. He was clear and had an opinion that he was willing to articulate. He is recommending lumpectomy with immediate reconstruction that will include a lift and also a lift to left breast for symmetry. According to him, since my DCIS is in lower quadrant, lumpectomy without anything more can result in bad cosmetic results. While I am not thrilled about surgery to both breasts, this seems like most efficient approach and even has an up (lifting) side. Will meet with the plastic surgeon next week.
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Im also a patient of Dr. Feldman and love him. Can you tell me which PS you saw at Columbia?
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hi- I can across this today and I was just diagnosed with DCIS and I too am using Michelle Blackwood..if you have time, seems like you are a few years out, I would love to know how everything went and how you felt about Blackwood's team.
Thanks
Katie
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