Possible to have both DCIS and IDC?

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NancyHB
NancyHB Member Posts: 1,512
edited June 2014 in IDC (Invasive Ductal Carcinoma)

I'm so relaxed after my lumpectomy on Monday because I feel like I'm moving forward in healing, making all this great progress, so I grab my initial path report (after incisional biopsy) and see something I had never noticed before:

"Left breast biopsy:

- Invasive moderately differentiated ductal carcinoma measuring at least 1.3 cn in greatest dimension.

- Ductal carcinoma in-situ (DCIS), with intermediate grade nuclei"

My surgeon has told me on several occasions that I have IDC.  Now I'm seeing DCIS on my path report, too.  Is it possible to have both?  If so, what exactly does that mean?  

I'll give him a call for clarification tomorrow morning, but thought someone here might know?

Thanks, Nancy

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  • SheChirple
    SheChirple Member Posts: 954
    edited December 2011

    It's not just possible, it is quite frequent.  DCIS is "in situ" meaning it has not spread outside the duct.  IDC means that is is beyond the duct. Therfore, they will most frequently discuss the IDC component.  Mine is both.

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  • LeesaAnn
    LeesaAnn Member Posts: 222
    edited December 2011

    I had both, in fact, more DCIS than IDC (75% / 25%) IDC is the more advanced form, and therefore consitututes your diagnosis.

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  • MiniMacsMom
    MiniMacsMom Member Posts: 595
    edited December 2011

    Same here, I have a 9x6x5cm tumor with 60% being DCIS.  The rest is IDC.  IDC starts as DCIS and then spreads outside (most of the time from what I have learned).  Feel good about this, the more of your total tumor size that is DCIS the better :)

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  • NancyHB
    NancyHB Member Posts: 1,512
    edited December 2011

    Thank you for explaining that to me!  The surgeon has never mentioned DCIS so I was shocked to see it on the path report.  It did prompt me to read some journal articles that seem to indicate a lower recurrence than IDC alone, so that was actually a positive! 

    Sometimes, I feel so damned lost in all these reports, and everything seems to be happening so quickly (and yet, so slowly, too) that I feel like a spinning top.  Then I get *surprised* by a new (?) diagnosis and I feel so confused.  So thank you for your help!

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  • NancyHB
    NancyHB Member Posts: 1,512
    edited December 2011

    Thanks, LeesaAnn.  My report does not indicate what percentage is DCIS or IDC.  Hopefully this next path report on the lymph nodes will have more information.

    Geesh - I feel like such a reactionary patient sometimes!

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  • ketch
    ketch Member Posts: 157
    edited December 2011

    Well, my prelim path report is just the opposite. Mine says DCIS w/ a microfoci of invasive mammary cancer, single largest focu measures 3.1mm. The radiologist mentioned more about DCIS than the invasive. I heard her mention 3.1mm but thoguth she was still talking about the DCIS until I read the path report. I will know more about the components of it when I go to the surgeon on Wednesday after the M|R|I on  Tuesday.

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  • NancyHB
    NancyHB Member Posts: 1,512
    edited December 2011

    ketch, good luck. I'll be thinking good thoughts for you.

    Even with a path report in front of me, I don't feel like I have the answers I need.  I met with my surgeon today to review the results and when I said, "I see I have both DCIS and IDC" and said, "Yes, there are multifoci..." and I almost fell to the floor.  I never saw that before.  My IDC is 1.3 cm, but my "multifoci DCIS" is even larger.  I don't know...sometimes I feel kinda lost.

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  • peggy_j
    peggy_j Member Posts: 1,700
    edited December 2011

    NancyHB does your BS's office or cancer clinic or support center have a nurse navigator?  Mine spent a lot of time with me answering questions and helping me get educated. (my sense is that they want to educate the patients prior to meeting with the BSs) FWIW, I had both DCIS and IDC. In my mind, the IDC was the scary part since it can travel, so I almost forgot about the DCIS part.

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  • tarry
    tarry Member Posts: 156
    edited December 2011

    I had dcis with microinvasion. It was starting to leave the ducts. After the lumpectomy, the report said there were 'innumerable foci' of invasion. That sounds really awful



    BUT the inital cells have to do some stuff to start moving about and mine had done none of that. So the fact that the dcis is getting ready to kill you doesn't mean it has gotten very far at all. And even if the gets to the nodes, there's lots to battle it. And further down the road, plenty of medicines and people will do battle for you.



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  • withlove
    withlove Member Posts: 13
    edited December 2011

    my mom's pathology indicated 1.7 cm DCIS and 1.1 cm IDC on left breast.. the DCIS was also never mentioned to us?? does this make the prognosis any worse? any better? or of significance at all? 

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  • drwendy
    drwendy Member Posts: 47
    edited December 2011

    The DCIS is just the non-spreading form of IDC, the "in situ" part means it hasn't invaded the ducts to head out into the big wide world.  I personally don't think there's much significance at all to the DCIS part, what matters is the IDC which is looking to spread, that's what the chemo/rads will be for.  I would be willing to bet that all IDC has some DCIS component to it, since that's how it has to start out.

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  • pupmom
    pupmom Member Posts: 5,068
    edited December 2011

    Yes, I had both.

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  • Annessister
    Annessister Member Posts: 13
    edited December 2011

    I had both as well as being ER+/PR+ and HER2-. The chemo and radiation will take care of it. I had bilateral mast so as not to have to do this all again. I had dense tissue and had several MRI guided biopsies. So brutal I knew I would have the surgery to prevent ever having that done again. The chemo is not nearly as bad as you imagine it to be. The antinausea drugs are great and before you know it your done. Good luck and just look forward to getting through it. My sister reminded me you can do anything for a little while. This is just a detour.

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  • NancyHB
    NancyHB Member Posts: 1,512
    edited December 2011

    peggy_j:  I think I've heard about Nurse Navigator's at our cancer center - great suggestion!  I meet with the radiation oncologist on Tuesday, and the chemo nurse/center on Friday (I met with the medical oncologist last Friday and, barring an Oncotype test result of 0, will be starting chemo on January 6th), and will ask for a referral then. 

    I feel like I'm on information overload, and all signs point in every direction.  Smile  I have more information than I know how to process, and so much of it goes out of my head (I'm calling it Cancer Brain these days).  I want to make the right, and best, possible decisions about treatment, but there are so MANY.  I'm used to doctors saying, "Oh my, you have an ear infection, take this antibiotic and you'll be better."  No one ever gives you a choice about that, you just do what you're told.  Have a hernia?  Need an operation.  Break your arm?  Let's put it in a cast.

    But now we're talking my life, the chance of recurring cancer, and he wants to give me a choice?  I'm supposed to make the decision?  Seems like a no-brainer, right?  I don't know...it's a tougher choice than I thought.

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  • bojo
    bojo Member Posts: 74
    edited December 2011

    Nancy,

    I have a similiar diagnosis, although this is my second time around.  First DX in 2005 40 years old my left breast, DCIS, 2X Lumpectomies and 37 RADS.  Fast forward 6 years, DCIS they also found some IDC although very small amount, 3mm in my right breast.  Good news 0/3 nodes.  But now as i sit here from my 2nd lumpectomy and SNB i am trying to figure out if i will need chem this time around.  I don't meet with MO until the 3rd.  I am ER+/PR+, HER 2 -.  But i am grade 3 and the HER test was originally a 2+, but then they sent out for FISH and came back neg but if i am reading the pathology correct is was borderline.  I am very confused and second guessing why i just didn't get a MX.  Sorry for rambling i am not having a good morning.Cry

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  • SheChirple
    SheChirple Member Posts: 954
    edited December 2011

    Nancy:  I have followed your posts, and read your biography, as we have such similar diagnosis.  I see in this thread you indicate you are having chemotherapy beginning in January, barring OncoDx of 0. 

    The only apparent difference in our diagnosis/treatment is that I had a double mastectomy, whereas you had a lumpectomy.  However, like me, you had clean margins and no lymph node involvement.

    I have been confirmed no chemo, barring an OncoDx of a higher number.  At this point our treatment vears.  Like you, I'm on info overload and so fra doing tons of research has kept me informed and I feel like I'm making good choices.  On the chemo there was not any recommendation for chemo with all my tests. I am now concerned, as you have such a similar path.

    Is there really that much difference between lumpectomy and mastectomy that chemo results from one and not the other?  Arggg

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  • KiwiDiana
    KiwiDiana Member Posts: 18
    edited December 2011

     Hello to all my cancer sisters :) 

    I'm 55 and from New Zealand and have had almost the same as you, bojo, only opposite breasts: 2X Wide Local Excision, small margins, so Quadrantectomy for DCIS in Rose 5 years ago this month,  and now Lumpectomy for IDC in Lily, which just happened  Monday 19/12 with SNB. I won't need Chemo because it was grade 1, N0.  I've yet to find out the exact tumour size, though I believe the mammo indicated around 1cm. and I will learn more of the details on Friday, ie hormone receptors.  I will need radiation in a few months, and scar revision by the end of next year (roads I've been down before).

    The new road though, is the one called 'breast lymphodema'.  Where is all the breast lymph fluid meant to go when its drains no longer exist? 

     So, my sisters, how many of you are dealing with this issue, and do you have any tips? 

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