worrisome wording in path report

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llrfort86
llrfort86 Member Posts: 3
edited June 2014 in DCIS (Ductal Carcinoma In Situ)

I have been stewing about some wording from my pathology report following my recent mastectomy.  DCIS closely approaches superficial margin (<1mm) of the lower outer quadrant in multiple foci.  That I understand.  It goes on to say, "a focus where microinvasion cannot be excluded is present within 1mm of the superficial margin."  (Involved 2 quadrants, grade 3, solid/cribiform/comedo with necrosis present.)

 The second page tries to go on to clarify the microinvasion non-exclusion statement with "while microinvasion cannot be excluded, no definite invasive carcinoma is identified.  Immunohistochemical stains for myoepethial markers P63 and smooth muscle myosin heavy chain were attempted.  However, the suspicious focus disappeared on deeper tissue levels."

 I just don't know what to think about this, any thoughts from anybody out there?

Many thanks.

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  • thatsvanity
    thatsvanity Member Posts: 391
    edited November 2011

    I'm not sure what it means, maybe you can ask your doctor to explain it, I've tried to understand those pathology reports and it's not easy, it's like reading a foreign language.

    Good luck,

    Amy

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  • mom3band1g
    mom3band1g Member Posts: 817
    edited November 2011

    I would guess you will be sent for radiation. 

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  • llrfort86
    llrfort86 Member Posts: 3
    edited November 2011

    Thanks for your replies.  I was just trying to take everything in when I met with the breast surgeon and when I left I thought it was the greatest report ever.  Then I kept reading it and I felt like, this isn't the great report I had hoped for (although of course I am very fortunate compared to others I just still feel like the most completely healthy person inside and out). 

    I have an appt with radiation oncologist today I will see what she has to say about it - I guess my main question is do I consider myself to have microinvasion, since they can't exclude it, or still just DCIS (I guess in my head I need to categorize myself for various reasons).

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  • Beesie
    Beesie Member Posts: 12,240
    edited November 2011

    I agree with mom3band1girl. With such a narrow margin and with the possibility that the cancer near the margin might have included a microinvasion, I think you will be sent for radiation.  I'll be quite surprised if that is not recommended. 

    Given the uncertainty of whether a microinvasion was present or not, if it were me, I would assume that there was a microinvasion.  I'd do that in order to stop wondering - I'd just choose to believe that it was there and then I'd be able to move on. It's likely that it won't make any difference in the treatment plan. The one change would have been if you'd not had an SNB - with a microinvasion it's necessary to check the nodes - but you've already had the SNB. With the narrow margin, radiation probably would be recommended whether or not there was the possibility of a microinvasion. From a treatment and follow-up standpoint, nothing else will change.  I say this from experience, as someone who had a microinvasion. 

    The other difference is staging.  With a microinvasion, the staging is changed to Stage I.  The implication of that is that there is a small - very small - risk of mets.  Honestly, from what I've seen on this board, most DCIS women initially worry about mets anyway, even thought technically it's not a possibilility with pure DCIS.  So the way I looked at it, the presence of the microinvasion gave me a legimate reason to have that tiny bit of concern that I was going to have anyway!  For the first 6 months or so after I was diagnosed I worried that every headache or any ache or pain was mets - however I suspect I would have thought that whether I had the microinvasion or not. After about 6 months, a headache went back to being just a headache.  A pain in my arm went back to being a strained muscle and not bone mets.  The fact that I had the microinvasion is not something I spend any time worrying about it or even thinking about it.  

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