Just diagnosed; chance of DCIS upgrading to Stage 1 IDC?

Options
Charlene2012
Charlene2012 Member Posts: 3
edited December 2014 in DCIS (Ductal Carcinoma In Situ)

Hello dear all! I've been reading articles in this forum for several days. It has been very helpful. Thank you! 

I am 38 years old with 3 children. I started having nipple discharge on my right breast one month ago. The doctor found a very fine 1.5cm calcification area on the mammogram, the subsequent MRI revealed a 6cm lesion instead. So the current diagnosis is 6cm DCIS (right), grade 1/2, ER+. The treatment is skin-sparing mastectomy (right side) + SNB + immediate breast reconstruction (expander now + implant 3-4 months later). The surgery will be 3 weeks later.

This is definitely overwhelming to me. I've always been healthy and physically active, and it was dreadful turmoil trying to think what may have caused this. Gladly that phase has passed and now I just want to focus on the present and future, and stay positive. 

The breast surgeon told me there is a chance that my diagnosis might upgrade to Stage 1 IDC after the surgery, and this has been haunting me. I wonder if anyone have had similar experience, and how likely it might be. 
Is it due to the large size of my lesion and/or my young age?
What are the chances that invasive cancer might be found, with no lump or visible/palpable symptoms? Even if invasive cancer is found, how aggressive it can be?  is there a possibility it might even upgrade to an even higher stage of IDC?

Also, is there a possibility that the MRI might have overestimated the size of my lesion? 

Sorry about all these questions. I wish I had asked the doctor all these questions during our meeting. Any suggestions or sharing of information is greatly appreciated. Thanks again! :) 


· Share on FacebookShare on Twitter

Comments

  • Annette47
    Annette47 Member Posts: 957
    edited December 2014

    Approximately 20% of the time a diagnosis of DCIS is upgraded to IDC, but it is usually only a micro-invasion, which doesn't really affect your treatment and barely affects your prognosis (100% survival down to 98-99%). That's what happened to me, and the only difference was that I needed a SNB with my lumpectomy (since the IDC was found on the initial biopsy). The chances of it happening are greater with a large area of high-grade DCIS with comedo necrosis. Your area, if it is 6cm (and MRI's can be wrong in either direction) would be large, but your grade is low, and most likely you don't have comedo necrosis (a types of DCIS cell) if your grade is only a 1/2. Mine was tiny, and overall a grade 2, but I did have comedo necrosis (which means it was probably closer to a 2/3 than a 1/2). It is believed that most IDC originates as DCIS, so that is why there is always a chance when DCIS is found that some of it has started mutating to IDC, but most of the time (80%) that hasn't happened by the time it is found.

    I'd think your chances are pretty good at this point of not having any IDC, but if you do, as I said, it mostly likely won't make a big difference in your treatment.

    · Share on FacebookShare on Twitter
  • Lisamarie6864
    Lisamarie6864 Member Posts: 24
    edited December 2014

    Hi Charlene ;)

    Sorry about your diagnosis but glad you are here ;) the whole not knowing is so scary ..right? I am 50 years old. I found a 5cm DCIS lump back in August and had a masectomy in October. I, like you , were told of possible invasive being found in final pathology. It ended up all pure DCIS, can't tell you how relieved I was. No chemo or radiation...just Tamoxifen because of ER status. Hang in there. One day at a time ;)

    · Share on FacebookShare on Twitter
  • exbrnxgrl
    exbrnxgrl Member Posts: 12,424
    edited December 2014

    HiCharlene,

    I'm not sure that anyone can tell you with certainty whether an invasive component might be found at the time of surgery and if so how agressive it might be or what treatment might be. That being said, your chances of pure DCIS are probably quite good. Not easy to do, but try not to look too far ahead or worry about things that haven't happened yet. Always keep in mind that the greatest risk factor you had for getting bc, was being a woman, so never think about what you did or didn't do!

    · Share on FacebookShare on Twitter
  • Moderators
    Moderators Member Posts: 25,912
    edited December 2014

    Welcome to Breastcancer.org. We're sorry you have to be here, but glad you found us!

    Different scan types 'see' different tissues, at differing resolutions, as do different operators, and this can be why there was a size difference between scans. It is not uncommon at all.

    In full biopsies after mastectomies, of the breast tissue taken away, they sometimes find the DCIS has micro-invasions through the duct wall, but it is not common and the treatment is often a Mx (which you plan to have anyway). Try not to worry about IDC unless it comes back from post-surgery biopsy.

    Read reliable information on DCIS — Ductal Carcinoma In Situ, Diagnosis of DCIS OR IDC — Invasive Ductal Carcinoma where you'll learn about symptoms, diagnosis, treatment, etc.

    We hope this helps! It is a shock but everyone here has been through it too.

    The Mods

    · Share on FacebookShare on Twitter
  • Charlene2012
    Charlene2012 Member Posts: 3
    edited December 2014

    Thank you SO much for the welcome and all the information! It's encouraging and reassuring. I'm grateful. :)

    Merry Christmas and Happy New Year, everyone! 


    · Share on FacebookShare on Twitter

Categories