Comedo/Cribriform DCIS - does that automatically mean HER2+?

I had comedo type along with some solid and cribiform, and did in fact also have a micro-invasion, but as is common with DCIS and tiny areas of IDC, they did not even test for HER2 as it doesn't change the treatment plan.    Herceptin is only given with chemo, which is never used with pure DCIS as it addresses the possibility of rogue cells which may have escaped the breast, which is by definition impossible as long a the diagnosis is pure DCIS, regardless of the form.     It is not usually given with areas of IDC <5mm, although there have been exceptions, but in general it is considered that in such cases the risks that it may have spread is much less than the risks of severe, life-altering side effects from the chemo.

HER2+ is actually much more common in DCIS than in IDC, so it's prognostic implications in DCIS are as of yet unknown - you would think if having HER2+ made DCIS more likely to become invasive, the proportions would be more similar, but they aren't.

As for the mastectomy vs. lumpectomy decision, it is of course up to you, but you should know that survival rates are about the same, and may be even better for lumpectomy plus radiation than mastectomy, regardless of HER2.    Cancer within the breast cannot kill you - it is only when it spreads outside of the breast that it becomes a problem, and once that has happened, mastectomy doesn't change anything.   Beesie has a good post that you might find helpful:

Not sure why it won't let me put it in, but if you search under her name and Mastectomy vs. Lumpectomy you should be able to find it.

I had exactly your Dcis,grade 3,comedown necrosis, at the biopsy. I was her2 negative so no I don't think there's a link. If I was her2 positive I think I would have had Herceptin treatment. I just had lumpectomy and radiations. Usually comedown necrosis grade 3 are the most aggressive Dcis. Believe it or not I'm not sure about my final diagnosis after lumpectomy. That's why I am consulting with dr.lagios. An expert professor in Dcis for over 30 years. It's worth the money you pay. I am eager to hear from him he's in Europe now. I worry sometimes bcos I was told grade 3,I wish I was lower grade..however I'm hoping that dr.lagios will give me my final diagnosis and answer all my questions. Best of luck...

just to add from my own experience..I'm not trying to lead you to do any decisions but it's just my personal opinion since I have anxiety..looking back to what i went thru since my diagnosis in August 2013 and lumpectomy/radiations,etc....I would probably opt for mastectomy. My own experience with radiations was really bad..beside since I had grade 3 but no micro invasion as they told me(but who knows really,that's why I'm consulting dr.lagios) I just wish I was given the option again and I would have removed my breast instead..because to the day I still suffer from breast pain every single day. It got worse after the radiations...I ask sometimes myself am I going to live in pain every day of my life..and what if I had mastectomy instead !! I don't need to take over your thread but I really wanted to open a discussion however I don't know how to do it here on this board:// forgive my ignorance ,I need to know if there's any ladies who went thru lumpectomy and radiations after Dcis.and they suffer from pain??? Swollen breast,extreme sensitivity,not even my kids can come close to my breast when I hug them,it's affecting my life. And making me wonder of mastectomy was less painful than living with an extreme sore breast. ?? Beside I hope that radiation really destroyed any other cancerous cells that des might have seen in my breast.what made me wish I did mastectomy is that if there's other areas where there was any other cancer,removing the breast would guaranteed that all is gone?  Please ladies who had similar experience share with me your experience please. I guess scared42 would be helped as well to be well informed..I'm exactly 42 years old like you scared42....after almost 8 months of this whole nightmare ,I still find myself unable to find peace of mind and answer torturing questions.....I appreciate any opinion that might be helpful please.

Yes, Hope, DCIS grade 1,  .9mm.  But they were driving me toward 6 weeks of rads.  I would have gone for it, but I had a long time to study up while healing from the lumpectomy.

You haven't filled out your diagnosis but if you are certain there is no invasive factor, it is still DCIS.  All I can say is if I had a recurrence, i would go for either another lumpectomy (to get a clear diagnosis) and then maybe a MX.  I am much older than you and I know this decision is harder for a younger woman.  I do urge you to go for the 2nd opinion.  Your situation is more complicated than me and you are on the cusp.   Whatever you decide, I know you have a long life ahead of you.  Don't let DCIS freak you out.

and sorry you re right my diagnosis was set to private..didn't pay attention...after lumpectomy they found 4+ cm Dcis. That's why they sent me for radiations...not sure what grade as I said that's why I'm waiting to hear from dr.lagios. But my oncologist was always positive about my case by the way..never said anything bad..he was a nice oncologist....he never said I had micro invasions they never found any micro invasions in the area of Dcis. But if I was "lucky" to catch it this early shouldn't i do something about it ? My fear that I will get invasive bc next time.that's why probably I should remove my breast before this happen? If it's a wake up call. Shouldn't I take all measures to protect myself from a potential risk? 

info babe- you are such a sweet lady. You made me go "awwwh" when I read your message and supportive words,thank you so much ..I will send you a pm soon...thanks for teaching me how to open my own thread,I'm sorry  I  didn't mean to take over scared42 thread,but I know that when we have the same diagnosis we love to learn about other people experiences and treatment plans. I wish you the best scared42. I know that her2 negative is better than positive..this is what my oncologist told me ..it means it's less aggressive..please keep us posted.