Invasive AND in situ - how is that possible?

pam43525
pam43525 Member Posts: 6
edited August 2014 in Just Diagnosed

I had stereotactic biopsies of both breasts 8/1/14.  The final report stated that the final diagnosis of the left breast is "Invasive well-differentiated ductal carcinoma.  High-grade ductal carcinoma in situ".  Can anyone explain what this means?

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited August 2014

    I think they are talking about separate core samples. You can have a whole alphabet soup of different conditions/diagnoses from one small area in the breast.

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  • placid44
    placid44 Member Posts: 497
    edited August 2014

    It sounds like a mix of two kinds of cells:

    1) Invasive, interductal carcinoma (IDC) that is not very aggressive. "Invasive" meaning that those types of cells have the ability to spread beyond the breast. That doesn't mean that they have...you will find out when they biopsy your lymph nodes. "Well-differentiated" means that under a microscope, the tumor looks somewhat like ordinary breast tissue...If the report had said "poorly differentiated," that would mean it does NOT look like breast tissue. Those types of tumors are more aggressive. ; and

    3) Non-invasive, but fast-growing cells. "In situ" means those cells do not have the ability to spread beyond the breast.

    Some of the other things you will want to find out next are: a) size of tumor (how much of it is IDC and how much is ductal carcinoma "in situ" (DCIS); b) receptor status -- does the IDC have receptors for estrogen, progesterone, and her2? c) Has the IDC spread to any lymph nodes, and if so, how many? The answers to those questions will help determine the recommended treatments.

    Will your doctor(s) be reviewing the report with you?

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  • Belle13
    Belle13 Member Posts: 3
    edited August 2014

    I also had the same thing.  The entire tumor was 2.3 cm.  They did a lumpectomy with clear margins and disected 4 sentinal nodes which were negative.  I began my A/C on June 30 and completed it 2 weeks ago.  I will begin my Taxol next Wednesday, followed by 5-6 weeks of radiation.  My doctor says that the lumpectomy and radiation basically equals mastectomy.  I am happy with that... unless absolutely necessary, 

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  • keepthefaith
    keepthefaith Member Posts: 2,156
    edited August 2014

    I don't think it's that uncommon to have IDC and DCIS at the same time. I don't have it on my profile, but my tumor had another one close by that was DCIS. Both removed by LX. I believe you will be treated based on the most aggressive tumor, if you have more than one. I think they use the largest tumor for staging purposes. Good questions for your MO or BS. Good luck!!

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  • exbrnxgrl
    exbrnxgrl Member Posts: 12,424
    edited August 2014

    not uncommon at all to have IDC and DCIS. When it comes time for treatment decisions, your IDC will trump DCIS. Good luck.

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  • Blessings2011
    Blessings2011 Member Posts: 4,276
    edited August 2014

    Same here. 

    I had multi-focal IDC, and multi-focal DCIS in the left breast. Radiologist told me that where IDC was present, it was very common to also see DCIS.

    Like exbrnxgrl said, my treatment was based on my IDC.

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  • bevin
    bevin Member Posts: 1,902
    edited August 2014

    HI there, as I understand, most people are generally found to have a mix of DCIS (non invasive) and IDC (invasive).

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  • carryingiton
    carryingiton Member Posts: 1
    edited August 2014

    Same here too...they told me "in situ" and according to the oncologist it seems not to be the aggressive type. However, because is large thatn 5cm and my breast is smaill I am receiving chemo first, then surgery. I am about to have my second FEC and then 3 rounds of D. Still in shock..I have always been healthy, never taken any medication, do yoga, cancer does not run in my family...but my last mammogram was signed as a "normal" and it was not. My surgeon urged me to get a lawyer, but I am focusing on healing now. I try not to distrust the health system in general because I am receiving a good care but they let me down but missing my cancer.

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