How long from DCIS to invasive?

njmae

Sorry I don't think anyone knows the answer to that.   I have been searching the research diligently and can't find anything, and I think it would be extremely varied between people.  I too have high grade with extensive comedo necrosis and am somewhat worried about wait times as well.  But for our DCIS to become invasive it has to have a molecular change.  They dont yet know what causes it to change or when.  I am telling myself that even if it did become invasive while we wait they would get it during surgery and it likely wouldn't have had time to travel to our nodes.   Hope that gives you a little peace while you wait.

As far as how long my wait is, I knew I had BIRADS 5 on Dec 4.  15 core biopsies taken on Dec 13.  DCIS diagnosed Dec 30. Another 4 biopsy cores taken Jan 21 (to rule out microinvasion that was discounted in the last sample?) I am seeing a PS for consult Jan 29 and they say it is about a 6 week wait after that because I want immediate DIEP recon.  And OR time is hard to find. I will let you know when I get an official date.  Good luck and hope you get in soon!

njmae, my biopsy was October 4, 2012 and the BMX was November 7, 2012.  I had invasive ductal carcinoma along with some DCIS.  I also had a .5 micromet in one sentinel node and yes, I've alway wondered if that was the result of having the biopsy and then waiting a little over a month for the surgery.  I would have liked to have had the surgery (BMX) earlier but my BS seemed to be in no particular hurry and didn't want to operate on Halloween for some reason. 

njmae,  I'm confused.  Did you have a needle biopsy or an excisional (surgical) biopsy?  

Margins wouldn't be a factor with a needle biopsy because it's generally assumed that the needle would not have picked up all of the cancer so more surgery will be necessary.  Even if it's believed that all the cancer was pulled up by the needle, surgery is still required to deliver adequate margins.

On an excisional (surgical) biopsy pathology report, margins should be noted.  But if you had an excisional biopsy and have clear margins, then you don't need to be worrying about how quickly you go into surgery. Clear margins mean that it's believed that all the cancer has been removed from the breast.  So if all the DCIS has been removed from your breast (and the pathology shows that it's all DCIS), then you don't have to worry about the DCIS evolving into invasive cancer and possibly moving into your nodes.  If you've had surgery that's resulted in clear margins, your planned mastectomy is in effect prophylactic and you have all the time in the world.

I had low-grade DCIS, no necrosis, with 1-2 microinvasions (was told that 2 separate micros are not more "invasive" than one).  The micros had wide margins; the DCIS around them had clean margins, but narrow.  I have also wondered whether if I had had my mammo sooner, or my surgery closer to biopsy, the micros may not yet have appeared.  Was told there is no way to know; could have been there a year, could have been there hours.  I investigated sentinal node biopsy thoroughly.  Just want to to reassure you about the very tiny chance of nodal involvement with microinvasions.  It is standard procedure to do an SNB on any invasion, even micro.  I've read here there is about a 10% chance of nodal involvemnt with microinvasion, my HMO put MY chance at 5%, Dr. Lagios put my chance at one third of a percent.  Though my current MO recommends SNB, as it is standard, she has to admit that in her 10 or so years practicing, she has never seen anyone with only micro(s) have nodal involvement.  And, of course, the micros she's seen obviously probably had been there awhile before being found, at least lots of them had.  So, if you have a micro, please don't worry too much that a micro would have gone to your nodes in any amount of time.