DCIS - Stage 2? Stage 3? Isn't that impossible?

april485
april485 Member Posts: 3,257

I am getting very confused by some posters on this area. Some people are listing DCIS as their diagnosis and then saying Stage II or Stage III? Please correct me if I am wrong, but isn't DCIS ALWAYS stage 0? I know that it can be grade 2 or 3, but stage is always 0. Right? Am I missing something?Undecided

Thanks for anyone who responds to this with information. I am hoping that I am not missing something. I read Beesie's post throughly and it never said that DCIS can be staged higher than stage 0!

EDIT: With the exception of microinvasion which can be stage 1..meant to add that in there.

Comments

  • pupmom
    pupmom Member Posts: 5,068
    edited March 2013

    Yes, that is impossible! I think many people are confused about their dxs. Maybe they mean Grade instead of Stage. Or they have some IDC and just don't list it.???

  • Letlet
    Letlet Member Posts: 1,053
    edited March 2013

    Maybe they have DCIS and IDC as well?

  • april485
    april485 Member Posts: 3,257
    edited March 2013

    Letlet, that was my thought, but they list diagnosis as ONLY DCIS...just checking to make sure I did not miss something cause I am DCIS and was told and read that it is stage 0. I am grade 2 and I know the difference between stage and grade so I am so confused. I have seen this diagnosis - DCIS stage 2 or 3 at least a half dozen times on different people's signatures so I really freaked and decided to come here and ask if I have indeed missed something. I can see if I saw it on one or two, but there have been more than a few with that in their siggy!

    Thanks for responding. I hate second guessing things without making SURE I did not miss something.

  • april485
    april485 Member Posts: 3,257
    edited March 2013

    Also, thanks Yorkie mom for responding as well. How can so many people be that confused?

  • Janet456
    Janet456 Member Posts: 507
    edited March 2013

    Pure DCIS is always Stage 0.

    I think it's easy for people to be confused in the beginning, they might have been told it was DCIS, then had a lumpectomy and IDC was found too. x

  • pupmom
    pupmom Member Posts: 5,068
    edited March 2013

    April, sometimes people ask the poster about this and it is usually a mistake. I think it is fine to inquire. Misstatements are confusing and, well, just a little irritating. Sealed

  • april485
    april485 Member Posts: 3,257
    edited March 2013

    I have inquired Yorkiemom and they ignored the inquiry..lol

    In some instances, they are pretty new, but there are two of them where the person has been here for years and have more than 1k posts and were diagnosed in like 09/10!

    That is when I decided to come here and ask the question cause when someone is new, I understand that. But, the people who have over 1k posts and joined in 2009? That is what threw me for a loop!

  • pupmom
    pupmom Member Posts: 5,068
    edited March 2013

    That's weird April. Maybe they think they are correct. But they're not! Laughing

    Edited to add that I probaby haven't seen a lot of those posts because I tend to ignore the DCIS forum.

  • Beesie
    Beesie Member Posts: 12,240
    edited March 2013

    April, this is one of my big frustrations, because it leads to so much confusion among women who really do have pure DCIS, which is, of course, always Stage 0. There are a lot of women on this board who state their diagnosis to be DCIS when in fact their diagnosis includes a combination of DCIS + IDC. And yes, this includes some women who have been here for years. 

    I can't count the number of times I've seen "DCIS Stage I" written as someone's diagnosis, or even Stage II or Stage III.  Or someone might write that they have "invasive DCIS".  Or they say that they have DCIS and have positive nodes (having positive nodes automatically changes your diagnosis from Stage 0 and even if no invasive cancer is found in the breast, it is assumed that some was there). None of those diagnoses actually exist.  Pure DCIS is always Stage 0 and it is never invasive and it never includes positive nodes. That's not a judgement or opinion; that's the actual definition of DCIS. So this means that anyone who is Stage I or higher does not have pure DCIS.  They might have some DCIS along with their IDC, but their stage and diagnosis is based on the IDC.

    Then there are the women who say that they progressed directly from DCIS to Stage IV.  Technically this is possible only if there was a missed / occult invasion - in other words, the original diagnosis was a misdiagnosis.  It can happen, but it's extremely rare.  In all my years on this board, I've probably seen at least 30 situations where women have said that this happened; in all but one case, I know from further discussion that it was actually known from the start that there was some invasive cancer present along with the DCIS, or the individual experienced a local (in the breast) invasive recurrence after the initial DCIS diagnosis and it was that invasive cancer that led to the development of mets.

    I think what often happens is that someone might have a preliminary diagnosis of DCIS based on a biopsy.  Then some invasive cancer is found during surgery, however the surgeon or oncologist never explains that the diagnosis has changed. This is why we see so many women who state DCIS as being their diagnosis when it's really not.  Most appreciate getting a better understanding if you politely ask a question, but there are some who are completely convinced that they are right. It is hard to tell someone that they misunderstand their own diagnosis and in some cases have misunderstood for years.

  • april485
    april485 Member Posts: 3,257
    edited March 2013

    Thank you Beesie! As always, your explanation is very helpful. I knew in my gut I was right, but after seeing it for the 6th or 7th time in different siggy diagnosis lines, I was starting to second guess what I knew was right...always stage 0 unless IDC is present along with the DCIS. Thanks again for the clarification.

    Oh and one woman did change hers to IDC when I inquired about it today. It actually made me very happy. She just had not changed it after the IDC was found after her lumpectomy I guess. Anyway, I am thrilled to report that mine remained DCIS AFTER my lumpectomy. Hoping I never have to change my stage!Smile

  • Ariom
    Ariom Member Posts: 6,197
    edited March 2013

    I am with you April, I have been scratching my head, and wondering when I read those Dx too.

    So glad to have it clarified by Beesie.

    I am happy to say that mine remained Pure DCIS after my Mx too. Have to say that I had a SNB at the time too, as a "just in case" measure, and I don't regret that for a moment.

    I am so thrilled for you April, and I hope you never have to change your stage either!

  • april485
    april485 Member Posts: 3,257
    edited March 2013

    Thanks Ariom. I did not have a SNB and was told not necessary and I guess everyone is different. I am confident that I have no nodal involvement since my lesion was 5mm upon excision and pathology. But, just to be sure, when I get the final path report from my reexcison on Tues, having my slides sent to Dr. Lagios for a second opinion. Laughing

  • gemini4
    gemini4 Member Posts: 532
    edited March 2013

    Isn't Stage 0 a fairly new classification? My neighbor was dx'd with DCIS around nine years ago, and it was called Stage I.



    I seem to recall reading that Stage I used to include DCIS. But to your point I don't think it was ever classified beyond that stage.

  • Ariom
    Ariom Member Posts: 6,197
    edited March 2013

    Hi April, I only had the SNB because I had the Mx. My surgeon stated that "It would be very remiss of me to not do a SNB, when I will be so close to the Nodes during surgery!" He told me that if I had decided to have the Lumpectomy and Rads he wouldn't have done the Biopsy unless it was indicated after the final Pathology.

    I chose to have the Mx because I was afraid there would be more, than was seen. I was also afraid of a recurrence, and I just plain didn't want to have the Rads, if there was any way to avoid them.

    My situation is a little different, in that my Husband is in a wheelchair, a C5/6 Quad from a Hang Gliding accident. I would have had to leave him to go to another town for that treatment, so it just wasn't something that I wanted to do.

    I a very happy with my decision and have healed really well. I have gotten rid of the cording that was a bit of an issue early on. I have settled well into wearing a prosthesis. I never intended to reconstruct, and couldn't be happier with my decision.

    I consider myself incredibly lucky, and I feel great.

  • april485
    april485 Member Posts: 3,257
    edited March 2013

    Ahh, that is true. I have read that they always pretty much do a SNB if you have a mastectomy. Given your circumstances, it would have been my choice as well. Glad you are feeling great! I hope that once I am through tx, I will too. Right now, this is so stressful!

  • Ariom
    Ariom Member Posts: 6,197
    edited March 2013

    I know how awful the waiting is April, I had to wait for what felt like an eternity, because my surgery was just before Christmas, I had to wait till everyone was back after the holidays for my final Pathology.

    Since getting all this overwith, I can't believe how the time has flown. The time just dragged while I was waiting, but now I am speeding toward my six monthly checkup and testing.

    Take care, and try not to stress too much. I know it is hard, but the one thing I have realised out of all this is, the stress can't change the outcome, but it can make you miss a great day!

  • gemini4
    gemini4 Member Posts: 532
    edited March 2013

    Ariom, we had our surgeries the same day! The wait over the Christmas holiday was indeed a challenge. I then had to have a re excision for bigger margins. But even with that hiccup, I will be finished with rads a week from today, and it does feel like the time has flown.

  • Ariom
    Ariom Member Posts: 6,197
    edited March 2013

    Hi gemini, Oh Wow! you are the first person I have found that was on the same day as me. I didn't fit in on the January 2013 thread, and I never found a December 2012 thread.

    So glad you found me!

    So sorry that you had to go back in for better margins, but WooHoo to you, for being almost throught he rads. I bet you're glad that's almost behind you.  How has it been? Are you doing ok?

    I can't believe it is March, it felt like everything was going in slow motion before the surgery, and now it is just flying by.

    Take care!

  • Annette47
    Annette47 Member Posts: 957
    edited March 2013

    Ariom - I was the day before you guys!  Went back in on the day after Christmas to see how my pathology turned out.   I agree with you that time is flying by now, especially now that I'm done with rads.

  • gemini4
    gemini4 Member Posts: 532
    edited March 2013

    Funny, Annette, what a difference a day makes.  I recall I went in for my post-op on Xmas eve so my surgeon could look at my incision.  She was leaving town the next day.  I think it was a few days after Christmas that she called me from vacation to discuss the pathology results, but Christmas delayed things a good bit.  And New Year's also delayed my Onco results (fortunately came back low, so no chemo).

    There's something oddly comforting that this has all taken place pretty much in a single season, and winter at that.  It feels nice to be concluding things as spring is starting. 

  • Ariom
    Ariom Member Posts: 6,197
    edited March 2013

    Hey Annette, you had to wait month for your surgery too. How hard was that, I went nuts!

    gemini, you were lucky to not have to wait too long for yours, but you had to go back, so that was awful for you.

    Let's face it, none of it is good, but it's doable, and isn't it great that we can all come here and look back on it now. I know I am different, from the experience, but not in a bad way.

    Spring for you two, and Autumn for me!

    Take care!

  • gemini4
    gemini4 Member Posts: 532
    edited March 2013

    You too, Ariom -- thanks!  Smile

    The re-excision surgery wasn't so bad.  I was mentally prepared for the possibility of it, and somehow it wasn't so scary since the margins were close but still clean.  All in all, it hasn't been too horrible, and here's hoping we are all "one and done."

  • Ariom
    Ariom Member Posts: 6,197
    edited March 2013

    OOOOOHH Yeah, Gemini!

  • april485
    april485 Member Posts: 3,257
    edited March 2013

    Amen to that Gemini! Thankfully my re-excision showed HUGE margins now (all over 1 cm..yahoo) and so I am ready to begin my treatment! I am soooo happy the surgery is over with. I had technically "clean" margins too...just one that was <1mm so back in she went. Now all margins are big and wide Smile

  • Ariom
    Ariom Member Posts: 6,197
    edited March 2013

    Thank goodnesss for that April!

    I could not be happier for you. Those are big margins, so you must be feeling so good!

    I wish you all the best for the treatment, hope it is fast and uneventful!

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