DCIS and waiting?

Karen,

DCIS comes in a lot of different forms. As a general rule most experts believe that the timeframe to invasion for a tiny (< 5mm, for example) single focus of grade 1 DCIS might be very long, possibly as long as 15 to 20 years - and there are some who say that it might never become invasive at all.  But there is no guarantee of this; there have been women who've come through this board who've had mammos and biopsies that showed small, low grade DCIS but then when the surgery pathology came in, it turned out that they already had invasive cancer along with the DCIS.  This risk is much higher for those who have a large amount of high grade DCIS. Upon removal of the entire mass of DCIS, it might be found that in one area the DCIS has already evolved to become invasive. In about 20% of cases where DCIS is found in a needle biopsy, the final pathology shows invasive cancer, changing the diagnosis. 

Having said that, generally most experts will say that with DCIS you don't have to rush into surgery.  It's not unusual to see women here who've waited 2 - 3 months.  My needle biopsy was inconclusive so I had a surgical biopsy which uncovered both the DCIS and a microinvasion of IDC.  Because there were no clear margins, it was pretty obvious that there was still DCIS left in my breast after that first surgery; I didn't have the second surgery, my mastectomy, until 2 1/2 months later.  The mastectomy uncovered a lot more high grade DCIS but fortunately no more microinvasions.  So the wait didn't change my diagnosis or cause me any problems.   

When I was diagnosed with DCIS my breast surgeon and I were on it immediately.  I didn't want to wait -- I canceled a vacation and had my BMX with immediate recon within 10 days of the diagnosis.  My strong family history of breast cancer pushed me through those operating room doors sooner, too.

Take care,

T 

Interesting. I had been comtemplating waiting til early next year for my own treatment as I have too much going on currently.

Hi Karen, I have kind of a unique story. I waited one year and 10 months. I did all the natural healing, detox, risk reduction things you can do while "waiting." Jan 2010 I was diagnosed with int. grade DCIS with a positive margin after wide excision biopsy.  I did not do any further conventional treatment until Oct 2011 after "highly suspicious" mamogram and MRI. Had partial mastectomy then a re-excision, but still have 1 close margin. Turned out to be the same low-int. grade DCIS. Had a 2nd opinion from Dr. Lagios on the pathology. There are more options than your surgeon/oncologist may tell you. I saught a 2nd surgical opinion from Dr. Mel Silverstein. He is an oncoplastic surgeon and offers lumpectomies with immed. reconstruction when other surgeons would recommend mastectomies only as an option. I am seeking another opinion in Feb from Dr. Esserman at UCSF (regarding close margin). She has made some very bold statements about the "overtreatment" of non high grade DCIS. I am also getting an Aurora RODEO MRI next week which is suppose to be better at picking up DCIS than mammogram (recommended by Dr. Lagios). I have done my homework. Everyone's case is unique and it is important to get 2nd opinions and all the info before rushing into major decisions. I created a blog to share my DCIS journey and all these great resources: www.dcis411.com  Stay calm and listen to your instincts. Donna   

Karen356 is one of those people who joined BCO, posted once, and never came back. Her last visit was Jan 22, the day after she joined and posted.

These people who don't stay around to hear the answers to their questions kinda tick me off. 

Good point, dsj, I didn't think of that.