DCIS UNDER CHEMO

karreen · June 2011

hi everyone! im 24 yrs/old, diagnosed with DCIS .

im currently under chemotherapy (WITH doxorubicin, cyclophosphamide and docetaxel) on my way to my 4th cycle on the 7th of june. ive been researching about my condition and found out that chemotherapy is not necessary for my condition. im getting all confused now,thinking that i may have been overtreated. im planning to have my treatment stopped after the 4th. am i doing the right decision? anyone who is familiar or has similar diagnosis as mine, please help me..

karreen · June 2011

i was able to locate a lump in my right breast (feb.13) and had it removed immediately on feb 18. .on my march 1, biopsy result came out with final pathological diagnosis of DCIS, comedosubtype with necrosis. other details are that, ER-,PR-, hER2+, tumor size 3.5 cm, High grade malignant cells. i was suggested to have a mastectomy and so i did,just three days after the biopsy result came out. my right breast that was removed was again put under biopsy and the final pahologic report stated:;
NO RESIDUAL TUMOR, FIBROCYSTIC DISEASE
EOSINOPHILIC MASTISTIS
NEGATIVE FOR TUMOR, MARGINS OF EXCISION AND NIPPLE AND AREOLAR COMPLEX
FOLLICULAR HYPEREPLASIA, LYMPH NODES
Microsections disclose no residual malignancy.
i was advised that chemotherapy is done to "make sure" that there will be lower risk of recurrence.. what do you think?

mom3band1g · June 2011

I have NEVER heard of chemo for DCIS. Are you sure you didn't have some amount of IDC or ILC?

karreen · June 2011

ms. mom3band1g, im quite sure i didnt have those because i have a copy of my test results at hand. and besides my right breast (which was removed in mastectomy) was declared clear from residual malignancy and negative for tumors.

Babs37 · June 2011

From all that I have read on the HER2+ status, I am pretty sure they suggested chemo because of the size of the tumor (more than 1cm) and because of the HER2+ which tend to be a more aggressive type of cancer.

karreen · June 2011

thanks ms. babs37, im learning so much here.. Smile

CAROLMARIE427 · June 2011

I have to agree with mom3band1girl. Chemo is not normally given for pure DCIS. The HER status in DCIS does not really play a role either. I am thinking that the only reason you are receiving Chemo is the fact that you are very young and your doctor is taking this into account. Aside from that factor, I would personally ask my doctor why Chemo was suggested for you. Best of luck to you.

cycle-path · June 2011

Note that kareen says her path report states "Microsections disclose no residual malignancy." I take that to mean that there was originally some malignancy, and therefore she was not DCIS stage 0. Additionally she states that she is HER2+, which I think means there was an invasive component.

I think a lot of doctors use the term DCIS when they really should be saying IDC, and I wonder if kareen's case is one of those. It would certainly explain the chemo.

sunshinegal · June 2011

I am pretty sure the term "malignancy" can apply to DCIS. It's not a benign condition, that's for sure!

That being said, I am confused as well, because the final biopsy report text the OP included almost seems to indicate that there was no cancer found in the removed tissue at all! Can someone with medical background interpret it?

Chemo is a systemic treatment designed to kill off cells that may have spread from the original cancer site. Pure DCIS is non-invasive and biologically cannot metastatize elsewhere in the body, which is why chemo is never, ever indicated for treatment of DCIS. HER2 status of a DCIS lesion is irrelevant. (I was diagnosed young (36) and with a large (9.5cm) and high grade tumor. After mastectomy, my margins were slim so we talked about doing RADIATION, which I ultimately declined. But chemo was never once part of the conversation, as I had no invasions, micro- or larger, to indicate a need for systemic treatment.)

In the OP's situation, it seems to me that either there is/was some presence of invasive disease that led the OP's doctor to recommend chemo, or the OP is dealing with a doctor who is not following standards of care with respect to DCIS...and is majorly over-treating the OP!

SaraP · June 2011

Karreen

I do know someone personally with DCIS....who did recieve chemo and Tamox. Though this was about 6 years ago. I noticed you are E/P negative -as I am. But I was told no chemo and no Tamox. Still feels like a bad dream....at times. You know I've joined a Dragon Boat racing team...the team members are breast cancer survivors. A wonderful group....and they kick butt! Not an easy sport..endurance, teamwork....physical strength,,, best of all a group of ladies banding together -just like this forum. Thanks to all..

karreen · June 2011

wheiw! im all encouraged right now because of all your comments. i really have to have my chemo stopped before all harsh side effects could sink in... Thanks everyone for all the information. ill be having an appoinment again with my onco on tuesday and will be discussing these matters once again. im just really relieved right now knowing that my situation is not a matter of life and death. thanks to all.. still, id very much appreciate if there are someone else out there who could share some more info..

mom3band1g · June 2011

karreen, I hope you are able to get some answers! The typical regime for DCIS is lumpectomy or mastectomy) and radiation. Sometimes, even with a mastectomy margins are not good and radiation is still reccommended. Tamoxifen is given for many women. You are very young but it sounds like your surgeon got good margins. You being given chemo is very puzzling. Good luck.

cycle-path · June 2011

Sunshinegal: true DCIS (stage 0) is a "non-malignant neoplasm." Also, regarding DCIS and HER2, I suggest reading the "Micro-invasive DCIS that is HER2 positive" forum. The bottom line is that if it's HER2 positive it can't be pure DCIS -- there has to have been at least a microinvasion.

Mantra · June 2011

It's odd that the original biopsy report shows DCIS yet your post surgical doesn't even mention DCIS. I too also find it odd to have chemo for DCIS. I'm not sure why they would want you to have chemo since DCIS isn't invasive. I'd definitely ask for a second opinion.

CAROLMARIE427 · June 2011

Hi Just wanted to say that true HER2 positive status can occur in pure DCIS without an invasion. There are many studies out there regarding HER status in DCIS. Beesie has discussed this on many of her posts. It is still unsure what role HER status plays in DCIS. However, you will find that in my scenario, and other women on these boards that had pure DCIS had also HER 2 positive. Just wanted to clear that up.

cinnamonsmiles · June 2011

The American Cancer Society defines DCIS as a true cancer that is non-invasive:

Carcinoma in situ

This term is used for the early stage of cancer, when it is confined to the layer of cells where it began. In breast cancer, in situ means that the cancer cells remain confined to ducts (ductal carcinoma in situ) or lobules (lobular carcinoma in situ). They have not grown into (invaded) deeper tissues in the breast or spread to other organs in the body. Carcinoma in situ of the breast is sometimes referred to as non-invasive or pre-invasive breast cancer.

Non-malignant would mean non-cancerous.

Ductal carcinoma in situ (DCIS): This is the most common type of non-invasive breast

cancer. DCIS means that the cancer is only in the ducts. It has not spread through the

walls of the ducts into the tissue of the breast and so cannot spread to lymph nodes or

other organs. Nearly all women with cancer at this stage can be cured. One of the best

ways to find DCIS early is with a mammogram. (cancer.org).

Breastcancer.org also defines DCIS as a true cancer where the cells have mutated past pre-cancerous stages such as atypical ductal hyperplasia:

Ductal carcinoma in situ (DCIS) is the most common type of non-invasive breast cancer. Ductal means that the cancer starts inside the milk ducts, carcinoma refers to any cancer that begins in the skin or other tissues (including breast tissue) that cover or line the internal organs, and in situ means "in its original place." DCIS is called "non-invasive" because it hasn't spread beyond the milk duct into any normal surrounding breast tissue. DCIS isn't life-threatening, but having DCIS can increase the risk of developing an invasive breast cancer later on. (breastcancer.org)

I don't understand where people are getting there information from that DCIS is not a true cancer.

mom3band1g · June 2011

mycinnamon- it is the great debate. I cannot stand when people say DCIS isn't cancer...really gets me upset. You are so correct, it's cancer but not invasive....yet.

karreen · June 2011

HI EVRYONE. went to the onco yesterday for the 4th chemo, and said that shoukd be my last. ive got very informative insights from you all and those are enough for me to stay calm despite my condition. thanks so much for all the info. im looking forward now to my fast recovery from all these hairloss and taste change.. thanks again..

mom3band1g · June 2011

Did you get any answers as to why you were given chemo for DCIS?

karreen · June 2011

mom3band1g, my onco said that i was given chemo because i was her2 positive, and that is quite aggressive.. but i think ive read enough information about it so i decided to have my chemo stopped. i read dcis.info many times, and it was said there that " chemo is not necessary for DCIS". IM JUST SO GLAD that im done with treatment.. thank you all for your support..

mom3band1g · June 2011

I'm glad you got an anwer! I don't think they routinely check her2 status for DCIS here! Best of luck to you and I hope you are able to move past this soon....it's not an easy road.

DCIS UNDER CHEMO

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