Lumpectomy on Friday for DCIS - Can IDC be found after surgery?
I am having my lumpectomy for high grade DCIS on Friday. I had an MRI a couple weeks ago and it came back clear except for the DCIS (2 cm) found on the mammogram. I met with my radiation oncologist last week and she told me that there is a very slight, although rare, possibility that IDC can be found after the surgery. Has anyone had this happen? I am really hoping there is no invasive cancer, but I am scared now that could be a possibility. It's probably just my nerves talking...but I'm scared. Thanks in advance for any information.
Christine
Comments
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Hi Christine,
I am in the same boat and am wondering too. I've had a lumpectomy, partial mastectomy (within the past month) and in two weeks going in for a double mastectomy. I'm told this will be the end unless there is a hidden invasive cancer in there they can't see yet. I'm expecting the worst but hoping that the doctors will be right this time.
Michelle
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I had been diagnosed with DCIS from the biopsy but then afte the lumpectomy I was told that I also had invasive cancer. I can tell you I was somewhat prepared because I had read beforehand that it happens about 20 percent of the time. I also was a little concerned as I had found a large lump and had read that DCIS usually does not have a lump. Hopefully this will not be the case for you, but it is important for you to know that it sometimes happens.
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Hi Christine,
This can happen, and it did happen to me. However, you should be reassured that even if they find invasive cancer, chances are that finding will have very little effect on your prognosis and treatment. If the MRI saw nothing, then any invasive cancer is probably very small, and very small IDC generally doesn't need treatment above and beyond what you'd receive for DCIS. Specifically, you probably won't need chemo.
If you did have a small invasion (called a micro-invasion if under 1 mm), the only thing that might change about your treatment would be whether they removed and tested sentinel nodes. With a lumpectomy, they might not check nodes with the first surgery, but if they found IDC they would probably want to go ahead and remove the sentinel node(s) to be sure nothing has spread. However, the chances are VERY small that you'd have cancer in your nodes.
In terms of prognosis, if you had a small invasion you would have a very small (like 1%) chance of metastasis, but in general your prognosis would be about the same as for pure DCIS.
Christine
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Yes, it can happen but as the previous poster wrote, it'll likely be small -- mine was 1.75 mm -- and nothing changed except for having to undergo a second surgeon 2 weeks after the lumpectomy surgery to check the sentinel node(s). My lumpectomy surgery went fine and I had clean margins, which was my primary concern, plus I'd had an MRI which didn't show anything and nothing had showed up on any mammograms, so it was hard to learn at my follow-up meeting about a week after the lumpectomy that idc was listed in the final pathology report.
I was a little confused as to how this could have blind-sided us/me -- I'd been tested in every manner (ultrasound, mammo, mri, genetic testing) and have no family history or known risk factors and no lump but my breast surgeon said that in about 20% of the cases there's a little idc. My dcis was grade 2, I believe grade 3 may run a higher percentage and grade run runs a lower percentage. Guess you win some and you lose some, there's just no visibility.
edited to add that there's probably also a relationship between the more dcis you have and the more likely one is to have idc. Original poster, you don't have as much dcis as I did (mine was 3-4 cm).
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Hi Christine,
Was your DCIS found in a needle biopsy? I had a needle biopsy that just found "atypical cells" which required a lumpectomy. The lumpectomy found the DCIS, but only DCIS. I had a 2nd lumpectomy to get better margins, but thankfully, nothing else was found. I hope for the same for you on Friday!
Cindy
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I too, had a lumpectomy after the needle biopsy found DCIS, since then I have had a double mastectomy with reconstruction, and although painful, I would do it again... I just had my last fill 2 weeks ago, and still painful... but worth it, no treatment needed... no more breast cancer...
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Thank you everyone for your feedback. I am really hoping for the best after my surgery. I agree that is is better to know if there is any IDC now after the lumpectomy. I will do what it takes to get better and get on with my life. A dear friend of mine that is only a few years older then me (I'm 43) was diagnosed with Stage 3 breast cancer and I am devasted for her and her family. I just never dreamed I would be dealing with this at this point of my life. I have no family history at all except for my father's cousin and aunt. I don't feel sick either. Thanks again for your support!
Christine
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Cindy: My DCIS was found after a needle biopsy...I forgot to mention that in my previous posting.
Christine
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Christine, I'm so sorry you are going thru this. I am in the same boat hearing those same things. I don't have a surgery date yet. I have to have the MX due to multifocal DCIS-two spots. I hate this not knowing stage... Sending many positive thoughts to you for a smooth surgery and a quick recovery with no curveballs. Michele
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I had my lumpectomy yesterday and am doing okay other than some nausea and a bad headache. I am praying for the best on my path report when it come in on Wednesday. The waiting is always the hardest part!!
Christine
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