Now I'm Really Confused.....

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rn4babies
rn4babies Member Posts: 409
edited June 2014 in DCIS (Ductal Carcinoma In Situ)

I got a copy of my pathology report from my lumpectomy on Friday. It doesn't mention DCIS!! It just says inflammation from the biopsy (which was in early July) and atypical ductal hyperplasia. Could the origiinal biopsy report have been wrong or is it possible all of the DCIS was removed in the sterotactic biopsy? Is is possible that I won't need the radiation therapy or Tamoxifen now? I don't see my surgeon until Tuesday. I don't know if I can wait until then for some answers.

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  • cycle-path
    cycle-path Member Posts: 1,502
    edited September 2011

    Well, in short, yes, either could be true. There could have been an error in the biopsy, or the biopsy could have removed all the DCIS. I guess a third alternative is that the biopsy from the lumpectomy is wrong.

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  • Hindsfeet
    Hindsfeet Member Posts: 2,456
    edited September 2011

    If you have any questions get a second opinion on the biopsy...for peace of mind. Also, you may want to get a second opinion on what your options are.

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  • louishenry
    louishenry Member Posts: 417
    edited September 2011

    Cycle path is correct with her comments. It could have been any of those scenarios. However, it may have been removed with biopsy, if your DCIS was tiny enough. It's not the goal to do that, but sometimes that happens. It happened to me. My lumpectomy had nothing in except healthy breast tissue. I did get another opinion with another pathologist and another rads oncologist. It was interesting because the first path said 2-3 mm of DCIS in my 4mm sample, and the other said 1-2mm of DCIS in the 4mm sample. Under 2mm is border line for an assessment of DCIS. I guess it truly is in the "eye of the pathologist." I didn't make much of a fuss and get a third opinion because nobody recommended radiation. Tamoxifen was an option that I decided to try. It has not been an issue for me and I'm in my 4th year this month.

    I didn't read about your particulars but if your DCIS is under 5mm and lower grade with no  necrosis, you may look into no rads. DCIS is not one disease, and there is not just one way to treat it. Going without rads for a small amount is pretty common. Good luck.

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  • rn4babies
    rn4babies Member Posts: 409
    edited September 2011

    Mine was Grade 3, solid and cribriform with comedo necrosis.

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  • cycle-path
    cycle-path Member Posts: 1,502
    edited September 2011

    Grade 3 but they think they must have gotten it all in a biopsy? That doesn't seem real likely. Makes me think one of the pathologies is wrong. Does the final pathology say anything about ADH?

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  • rn4babies
    rn4babies Member Posts: 409
    edited September 2011

    Yes it did say there was ADH. The intial bx was supposedly confirmed by stains and confirmed by two pathologists.

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  • momoschki
    momoschki Member Posts: 682
    edited September 2011

    Sounds to me like the DCIS may have been completely removed by the needle biopsy and then the surrounding  tissue removed during the lumpectomy showed ADH.  You  should know, though, that dx-ing ADH and DCIS falls along a continuum and is often not clear cut.  In my case, I had my original slides from the first stereotactic biopsy analyzed THREE times by 3 different major hospitals in NYC.  The first analysis came back as DCIS, but the following 2 showed only ADH.  And, FWIW, after I had my lumpectomy, the pathology report showed only healthy tissue, so all the ADH was removed by the initial needle biopsy.

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  • cycle-path
    cycle-path Member Posts: 1,502
    edited September 2011

    momoschki, I get that high grade ADH and low grade DCIS aren't necessarily different, and I could understand the situation if rn4babies had had only grade 1 or 2 DCIS in the biopsy, but it seems odd that the biopsied tissue would be classified as grade 3 but then end up being so small that it was all removed in the biopsy. 

    However, since they did at least find ADH in the lumpectomy there clearly really was something going on. And if it was high grade ADH, it seems like it's a good thing it was removed anyway. 

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  • dixiebell
    dixiebell Member Posts: 280
    edited September 2011

    Because your tumor was so small it was probably all removed with the biopsy. This also happened to me!

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