Scared DCIS will show up invasive

I was grade 3, had a SNB and no invasion was found.  

lisa, on average about 20% of women who are initially diagnosed with DCIS via a needle biopsy are later found, after all the surgery is done and the pathology results are in, to have invasive cancer and/or nodal involvement.  Of course all DCIS is not alike and women with small amounts of low grade DCIS face the lowest risk, while women with large amounts of high grade DCIS with comedonecrosis face the highest risks. 

I was in the second group - I had a lot of high grade DCIS with comedonecrosis. My needle biopsy only showed ADH but my excisional (surgical) biopsy showed more ADH, plus DCIS and a microinvasion of IDC. And I had no clear margins. When I had my mastectomy (2 1/2 months after the excisional biopsy), even though there was a lot more high grade DCIS found, there were no more microinvasions. It was all DCIS. 

As scary as it is to think that you might have some invasive cancer, the important thing to remember is that in about 15% of the 20% of cases where some invasive cancer is found after an initial diagnosis of DCIS, the amount of IDC is very small - just a microinvasion or two, or a t1a tumor. So usually we are talking about an amount of invasive cancer that is no larger than 0.5mm. With a microinvasion, as I had, the treatment plan doesn't change at all and the prognosis barely changes.  Even with 5mm of invasive cancer, the treatment plan is unlikely to change, unless the cancer is triple negative or HER2+. 

So try not to worry. The odds are in your favor that your final diagnosis will be DCIS.  But even if some invasive cancer is found, it's likely to be just a small amount, which will hopefully have little impact on your treatment plan.  Yes, there is about a 5% chance that it could be something more but there's no point in worrying about it - the odds are low and there is nothing that worrying will do to change what's going to happen. If you fall into that 5% group, you and your doctors will deal with it.  

Good luck next week.  Hoping that the final diagnosis is pure DCIS! 

Hi all

I'm like Beesie in my 50mm tumour I had 3mm invasive, luckily no lymph node involvement. I don't need chemo or rads just tamofixen which I start next week. You just don't know until you get your final pathology,  then if like me you find that you have some invasive you're very, very lucky that you found the lump and got something done about it.

I know what you're going through.  I died a million deaths before I got my bmx and my path reports.  I am NOT a courageous person, anyway, and also had high grade and lots of DCIS, a horrible family history of bc, etc.  As with Beesie, it turned out that I had an invasive component, but nothing in lymph nodes, and my margin was close, etc., so it wasn't all what I wanted to hear BUT I'm two and a half years out, my treatment was just the bmx (hah "just"--but, really, it's all behind me now, a distant memory already, and I love my new breasts...).  Your chances of anything in the nodes is miniscule, and even your very worst case isn't a death sentence, as this has obviously,no matter what, been caught early.  Odds are overwhelming that you will be done with bc forever after this, but even if there's some 'catch' it's unlikely to be anything that bad.  Try to focus on that?  (I didn't focus on the positive, but....So, I guess I'm hear to tell you that even if you worry a lot between now and then, things are very very very likely to be very fine!)  I will be thinking of you.