DCIS - dealing with emotions

hai anybody from Canada ? i living at quebec, my name is marta. i just get diagnostic

type histologique : Carcinome papillaire infiltrant avec differenciation mucineuse, multifocal

dimension tumorales : 1,1cm de diametre maximal

grade histopronotisque : 2/3 (grade combine de Nottigham)

distance entree la tumeur infiltrante et la marge la plus proche (sur le specimen de mastectomie) : 1mm

invasion lymphatique/vasculaire : non identiffe

type de CCIS : papillaire et papillaire solid, sans necrose, avec foyers de carcinome micro-invasif, grade nucleire 2/3 (contigent intracanalaire massiff, diffus) marge la plus proche : 0mm

Classificaation tnm : pT1c NX MX

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histological type: Papillary carcinoma with infiltrating mucinous differentiation, multifocal.

tumor size: 1.1 cm maximum diameter

SBR grade II / III

distance between the infiltrative tumor margin and the closest (in the mastectomy specimen): 1 mm

lymphatic invasion / vascular: Unidentified

type of DCIS: papillary and papillary solid, no necrosis with foci of microinvasive carcinoma, nuclear grade 2 / 3 (quota intraductal solid difussion) nearest margin: 0mm

TNM: PT1C NX MX

my doctor suggest me to do masectomy, so far i've get any treatment at all, please if anybody can share with me DCIS ?

marta 

Ma_rta,

I do not know much about your diagnosis, but I will quote to you from Dr. Susan Love's Breast Book, she mentions papillary carcinoma only on 1 page out of 635 pages... she says:

"Other names for cancers may also appear on the pathologist's report.  For the most part they're variations on invasive ductal cancer (IDC), named by the pathologist according to the visual appearance of the cells under the microscope....Mucinous (or colloid) carcinoma is a form of infiltrating ductal cancer that is gluey-looking ("colloid" is the Greek word for glue).  Papillary carcinoma has cells that stick out in little fronds (fingerlike projections).  These special cancers tend to have a better prognosis than do typical invasive ductal or lobular cancers, but they are treated according to the same principles."

Her chart states that 70% of breast cancers (as of 1989?) are IDC, 10% are ILC, 5% are DCIS (half ductal, half lobular), and only 3% are Mucinous and only 1% are Papillary.  

I believe papillary carcinoma often has a DCIS component (meaning it is confined to within the duct), but it may also be invasive (outside the duct).

It sounds like you had a lumpectomy to get this diagnosis, and they were not able to obtain "clean margins"?  That is how I understand the 0mm anyway.  And Grade 2/3 means that it appears to be intermediate to high grade (1 is the least aggressive, 3 being the most aggressive).  

As far as your further treatment, I would recommend to just read everything you can find here and on other sites / books, and perhaps ask your surgeon for resources in French that may be helpful to you to better understand your diagnosis.

Good luck!

Ma_rta:

It seems to me that you have a diagnosis of DCIS with microinvasion, and the specific cancer cell types are papillary and possibly also mucinous. 

DCIS means that the cancer has not yet escaped the milk ducts to become invasive, a microinvasion means that the cancer has just begun to escape, but only by a very small amount.

Multifocal means there is more than one area of cancer in the breast, probably close to each other.  If the cancerous areas are in very different parts of your breast, that's usually called multicentric.

The cancerous area seems to be 1.1 cm in diameter.

As XmasDx has said grade 2-3 means it's intermediate to high in terms of aggressiveness.

There's no evidence so far of the cancer cells in your lymph system or bloodstream (lymphatic/vascular)

No necrosis means that there aren't any dead cells in the cancerous area.  Sometimes it's growing so fast that there's not enough food supply to keep all the cells alive, so some die.  The dead cells are the necrosis. 

When they remove the cancerous area, they want to make sure they get all of it out.  The distance between the cancerous tissue and healthy tissue is the "margin."  Usually surgeons want margins of at least 2mm. I'm not sure what treatment you had to get this report, if it was a biopsy or a lumpectomy....but there was no border of healthy tissue, so they'll want to remove more.

Hope this is helpful, and ladies, please feel free to correct me if I'm wrong about something. 

hai ladies, greetings from montral ^-^

tomorrow i'll have MRI, then on friday i'll have to meet breast specialis again, if i need MX or else, MX decision can not make just one day or week, big decision he said that's why he'll have meeting reagrding my case and will inform friday based on my MRI test too

i'll inform you soon i get result from my breast specialis

marta