insitu and invasive are they the same thing?

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shaz101
shaz101 Member Posts: 718

Hi, my core sample came back saying the cancer was both insitu and evasive? Does that mean the insitu cancer has just spread or are they different? I'm getting so stressed. My next appointment is on the 7th of January, I'm struggling with the lack of information I have. Can they normally stage the cancer from a core biopsy or do I need to wait until after surgery?

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

    Shaz101,

    You don't say if your biopsy results are for ductsl or lobular bc. Either way, both an in situ and invasive cancer can be found during biopsy. What that means is that your bc has moved beyond the ducts (or lobes) and has the potential to spread further (in situ bc cannot spread). Staging based on biopsy is preliminary. Final staging is a result of your post surgical pathology report. The results of that report will drive treatment decisions. Your lack of information is in reality, incomplete info, as the scope of your bc will be clearer after surgery. Take it one step at a time and take care


  • shaz101
    shaz101 Member Posts: 718
    edited December 2014

    Thank you for your reply. This waiting is horrific

    the pathology report says...

    CLINICAL SUMMARY

    Core bx.

    (L) breast core bx (5A stellate)

    MICROSCOPIC

    Microscopy shows cores of breast tissue in which there is in situ and invasive carcinoma. The tumour has a ductal morphology and is provisionally of low grade.

    OPINION

    Core biopsy, left breast: Invasive carcinoma.



  • shaz101
    shaz101 Member Posts: 718
    edited December 2014

    I just packed away my Xmas tree and started crying. Wondering if I will put it up again. I know my chances are good. But all the way through the diagnosis I've been told my chances are good! But I have cancer. Just feeling a bit sad. I need to kick myself in my sorry butt.

  • Morwenna
    Morwenna Member Posts: 1,063
    edited December 2014

    Well, so you have breast cancer. I'd say you are totally entitled to feel sad, shocked, frightened and all the rest of it, but then what you will do is, you will get a plan of action ..... Surgery plus or minus chemo, rads, hormone therapy, herceptin .... depending on your pathology .... and then you will pull on your big girl panties and cope!

    That's what we do. Get a bit of anger and determination into the mix if that's what it takes, and get set to beat cancer's A$$!!!

    Hugs to you. This is one of the hardest times ... xxx

  • shaz101
    shaz101 Member Posts: 718
    edited December 2014

    Thanks Morwenna, just the words I needed to hear! I will cope and I will win! I've never backed down from a challenge, it's just that I orally pick them. This time it chose me.

    I'm going to get busy and enjoy seeing the new year in. I hope you do the same.

  • Morwenna
    Morwenna Member Posts: 1,063
    edited December 2014

    You're welcome! Personally, I am girding my own loins in preparation for a prophylactic mastectomy and bilateral TRAM flap reconstruction, next Tuesday!

    Gulp! :o

  • shaz101
    shaz101 Member Posts: 718
    edited December 2014

    I wish I had some wise and uplifting words that would help you. I am thinking of you morweena and I hope that this surgery is the beginning of you returning to a healthy body. 

  • Morwenna
    Morwenna Member Posts: 1,063
    edited December 2014

    That's my slant whenever I get the "WTF am I DOING!???" heebie-jeebies.

    This is a restorative surgery, and a way to start to put the last 2 year's behind me!

    Still finding it hard to sleep, or even to breathe at times though!

  • shaz101
    shaz101 Member Posts: 718
    edited January 2015

    Happy new year! I'm sure this will be a much better year for you.

  • Chloesmom
    Chloesmom Member Posts: 1,053
    edited January 2015

    So sorry you have had to join us Shaz. The last 6 weeks since my diagnosis have been a roller coaster. I have to say that the very hardest part was the first 3. Everyone told me that, but I was so frazzled it was hard to believe. It gets better once you have a plan in place. How do you eat an elephant? One bite at a time. I felt like an elephant stepped on me. Now I'm taking him down! Wish you the best! We are here for you.

  • Nomatterwhat
    Nomatterwhat Member Posts: 587
    edited January 2015

    Welcome Shaz, I also had DCIS in situ and ILC in the same breast.  It is definitely a shock and the hardest part is waiting for results.  It starts to get easier once you have a plan in place.  Take a deep breath, a step back and start your list of questions.  The best thing I ever did was to take my husband with me to every appointment, because I knew that I wasn't going to be able to comprehend what the doctor was saying to me after "you have cancer and we are going to.....".  He took all the notes, held my hand and carried the Kleenex.  You can do this!!!  We are here for you. Keep us informed.

  • shaz101
    shaz101 Member Posts: 718
    edited January 2015

    Thanks chloesmum. I'm up for a challenge, but normally I choose them! It's very good advice though. I think I'm starting to get my head around it. I've even started doing everyday chores again! If you don't mind me asking... why did you get a mastectomy? I'm assuming I am having a lumpectomy _the ultrasound of your mass is just under 2cms. Part of every wants one ask hem just to remove the bloody things!

  • shaz101
    shaz101 Member Posts: 718
    edited January 2015

    Thank you Nomatterwhat. I think my mum will come with me most of the time and I'm hoping to record the appointments so I can listen back. My mum is worse than me at listening, but she really wants to go. is your first diagnosis the same lump? I'm just wondering if the US got the size wrong or is it a different lump? How are you going now?

  • Nomatterwhat
    Nomatterwhat Member Posts: 587
    edited January 2015

    My mammogram caught the DCIS which was suppose to be a simple lumpectomy, but, the blue dye turned the entire right breast blue.  My surgeon stopped the surgery and when I woke up she told me that she couldn't get clear margins due to the 7 cm mass that was also in the breast and that a mastectomy was my only option.  After further testing, pre-cancer cells were found in the left breast.  My surgeon said I would probably have cancer in the left breast in 3 years so I decided to have a double mastectomy.  I had 4 rounds of chemo, next week I will finish radiation and soon will start Tamoxifin.  I wear my prosthesis at work and usually go flat at home and have started going flat while running errands.  My hair is starting to grow back and I feel absolutely FANTASTIC!!!!! 

  • Chloesmom
    Chloesmom Member Posts: 1,053
    edited January 2015

    The doctor initially suggested a lumpectomy and radiation. I had painful breasts as they were fibrocystic and could never do self exams that I felt were worthwhile. I did not want to go through radiation due to the pod dibble side effects. The choice was mastectomy and no rads if it wasn't near the chest wall and hadn't spreads vs lumpectomy and rads.

    Psychologically I didn't want to worry every time I had to have another Mammo. The US said it was 1.5 cm. the final biopsy said 1.76. This is considered a small tumor ans without positive nodes and being a low grade my doc chose no chemo.

    Mine is invasive lobular. ILC. They don't understand this type as well as 10% get this type. Researching it I donut there was a greater chance that it would show up in the other breast. I didn't feel good about leftie as was having pain in there so said take them both. The doc didn't feel it was necessary and said it would prolong my recovery but I chose to have one long recovery rather than possibly 2 recoveries. As it turns out like Nomatterehat my left one had precancerous lobular cells and I would have been back. As I said they think ductal and lobular are different cancers somewhat won't necessarily be your situation. Lots of women are walking around as unis. I prayed about it and felt confident going in that it was the best choice for me. It's quite individual. I visited the shop where they fit you with forms and talked to the fitter to see what was ahead before the surgery. Some would be overwhelmedd but for me it helped

    The surgery was not a big deal I expected. Tylenol for 2'days and just tired. More restless by advice to rest and not clean the house like I feel like doing. I was small chested to begin with and was not attached to my breasts. It was not traumatic for me to wake up and find them gone. Everyone is different.though and it can be hard for some I'm very active and found they were often in the way with exercise. My husband is fine with it and said he married me for my smile. It my boobs and I'm still the feminine me. Joined a face book page to network with others via. the website Flat and Fabulous.org.

    As my tumor was a hormonal, low grade (the cells weren't as malformed as some), small size (under 2 cm) and nodes weren't involved it is a grade 1 which my BS said means no chemo, but I see the MO next week and hope he agrees. The decision for more treatment is based on a combination of factors too. I was awake at night worrying about all the side effects etc. You can really spin you wheels before you even know what to worry about. There is so much info on this website I'd recommend checking all that out as it helped me so much.

    All the best,

    Sisan

  • shaz101
    shaz101 Member Posts: 718
    edited January 2015

    Thank you for sharing! It's so helpful to hear other women's stories. I'm pleased that they found it in your other breast early so you don't have to go through it all again. How do they miss a 7cm mass on a mammogram? Amazing. I'm glad you have just about finished radiation. 

  • shaz101
    shaz101 Member Posts: 718
    edited January 2015

    Sisan, Thank you for sharing ☺ it is very helpful to hear everyone's stories and how they made the decision that is best for them. I can understand your decision. I never want to go through this again. 

    Even though I'm worried about the surgery its been good to hear that is quite simple and not as painful as I expect. The fear of the unknown is what is terrifying. Have you needed to have much time off work? I'm concerned about how much time I'll need to have off. 

  • ktab96
    ktab96 Member Posts: 126
    edited January 2015

    Shaz, when I was diagnosed with IDC, it was the most frightening time of my life. There were so many decisions to be made in a relatively short amount of time. I found it very important for me to educate myself on the subject in order make the best possible decisions in what was best for me. It also made me feel more empowered and took some of the fear away. I met all of my doctors prior to surgery (Internist, Oncologist, Radiologist and Surgeon). I went into surgery know the entire plan of attack. The great news is I am now 3.5 years post surgery and life is good.

    As for my treatment, I decided to go with a lumpectomy with targeted radiation (SAVI) I am on an Aromatase Inhibitor for 5 years and will switch to Tamoxifin for another 5 years..

    When I had my surgery, I was surprised at the lack of pain I had. The incision where they removed the lymph nodes was bit uncomfortable as there are many nerves in that area.

    Shaz, I wish you well, May your surgery go smooth, may your recovery be speedy and may your fears be calmed.

  • Chloesmom
    Chloesmom Member Posts: 1,053
    edited January 2015

    I have a very physical job. Lots of lifting caring for active toddlers. Have told them 6-8 weeks but taking one day at a time deciding

  • Nomatterwhat
    Nomatterwhat Member Posts: 587
    edited January 2015

    Shaz,  As with Chloesmom, I had fibrocystic breasts as well.  Unfortunately, ILC is not always caught.  I always had to have an U/S with my mammogram and they always saw something but always thought it was fat (and I have a lot of it).  I never worried about it until the pathology report stated "large and bizarre formations" found.  That scared me to death.  The BMX wasn't to bad, but those drains are a pain in the a**.  Even with a large mass like that, I had no lymph node involvement.  I was off two weeks and then went back part-time for two weeks and then back to full time.  I don't work with active toddlers, but I do work with attorneys, and sometimes they are the worst kind of toddlers!!!!  They have been great to me and I haven't had to worry about missing any appointments or treatments as they tell me that getting well is my number one job at this time. 

  • shaz101
    shaz101 Member Posts: 718
    edited January 2015

    Thank you  ktab, its comforting to hear that your surgery wasn't too painful. I'm so grateful to you and everyone on this site for helping me to get through this Xmas and new year period while I wait. 10 years on drugs wow. I thought it was a max of 5. Not that that worries me as I'd rather they keep an eye on me for years than not! The more I hear from people the better the decisions I make will be the right ones for me. I wish you good health xxx

  • shaz101
    shaz101 Member Posts: 718
    edited January 2015

    Cloesmum, It's funny how much I worry about my job and how much time I will be away. I really enjoy my job and because its desk based I should be OK to return quite early. I worry about money. I have a big mortgage which I pay alone. Should I speak to the bank or just wait and see? I couldn't imagine having to pick up littlies after surgery! But I can imagine they would make you smile. Thank you

  • shaz101
    shaz101 Member Posts: 718
    edited January 2015

    I'm glad they found yours NoMatterWhat. Should I take my mammogram to my next appointment and get them to recheck my other breast? I'm just concerned because my Dr sent me for it due to the indent on my left, so I'm worried they didn't really look at the right. I've cut my leave break short. I'm going back to work on Monday. My surgery apparently is 'penciled' in for the 20th of January so I will need more leave then. I'm so pleased your workplace is being supportive. I've only told my general manager and the hr manager and they are great. I'm really nervous and unsure how and when to tell the rest of my department. How are you feeling now? Not just physically but mentally? Has it changed your priorities? 

  • Nomatterwhat
    Nomatterwhat Member Posts: 587
    edited January 2015

    I am assuming they did both breasts at the mammogram.  I would let the doctor know you are concerned about the other breast and ask him about the results for that breast.  As far as telling your co-workers is when you feel comfortable in telling them.  I waited until all my bosses were in the same room and told them, then gathered the rest of the staff and told them.  It was a very emotional day. 

    I feel fantastic most days.  There are days when I am out running errands with my hat on and feel stares and hear people whispering, but for the most part, I don't care.  After what I have been through I am happy to be alive.  Eventually, I will have hair and nobody will even give me a second look.  Mentally, I don't look back, I always look forward. I don't sweat the small stuff anymore.  If my house doesn't get cleaned, so what.  If I don't feel like talking to people, I don't answer the door or the telephone.  I have lost friends that don't know how to talk to me anymore and don't care.  I still have my true friends and my husband, my soul mate, my best friend for 32 years has been my rock from day one. I do what makes me happy and don't care what others think. 

    Take a deep breath and know you will be fine.  Hugs. 

  • shaz101
    shaz101 Member Posts: 718
    edited January 2015

    Thanks NoMatterWhat. They did do the mammogram on both. I'll take the films in and ask them to recheck it, to give me some piece of mind.

    I think my work issue is complicated because I'm performance managing someone! And to make it tricky, 2 years ago she was one of my best friends. So I feel weird about her knowing, I don't want any fake pity from her! I may get my manager to tell people, its just when! Maybe when I'm off for surgery??? Or should I do it before? I know there is already talk. Someone before I went on leave for Xmas said... You seem to be away a bit lately... I just mumbled someyhing about having appointments and changed the subject.

    I'm really pleased you feel fantastic most days! I hope those days become permanent for you. It is a bit freeing when you don't dothings just 'because its eexpected' and do what you want! I haven't heard from any friends since Itold them! Its sad. I guess they ddon't know what to sat. 

  • SweetHope
    SweetHope Member Posts: 439
    edited January 2015

    Shaz, sorry your friends are absent. Why not contact them? If you did not have cancer, I bet you would reach out to them if you hadn't heard from them in a while. Let them know you are still you. Some of my kids (adults) are clueless as to what to say to me, so I just push myself on them! I talk away about myself and change the subject before they need to respond. That keeps them in the loop, but doesn't make them feel awkward.

    Just know that we are listening. We don't always respond, but we are here, and you can tell us anything.

  • shaz101
    shaz101 Member Posts: 718
    edited January 2015

    Thank you sweethope.

    You are spot on. I haven't reached out. I have been told by one friend that she didn't what in invade my personal space while I had so much to deal with. I've told her to invade away. Any interruption is better that what's going on in my head. I'm not very good at asking for help. But I need to try. I've gone back to work today, or at east I an try to do one thing productive. How is your treatment going?

  • Thamil805
    Thamil805 Member Posts: 4
    edited January 2015

    hi in june of 2013 i was diagnosed with both dcis and idc er+ and pr+

    i was devastated it is completely natural to be afraid and also sad your going to feel alot of different emotions and thats ok.

    just know you will get through this

  • newinab
    newinab Member Posts: 12
    edited January 2015

    Hi Shaz101

    I was diagnosed with Invasive Ductal Carcinoma Nov 10 2014. I was very scared, all day long my mind was consumed with the word cancer. I told my boss, co-workers and friends on the day I was diagnosed. I was very glad I told everyone because I got a lot of support. My co-workers even collected a large sum of money to help me with my finances while I was off work, it sure reduced some of my stress. I had my surgery on Dec 11 2014. I had a total mastectomy with no reconstruction on right breast and they removed three lymph nodes. Didn't have any real pain from it, just a little sore,I took ibuprofen for a while. The bit of pain I had came from my underarm incision. The drain tube was a bit of a nuisance for me but had it removed after two weeks. I do my stretches every day, each day I feel a little better. It will be four weeks since the surgery. I will be going back to work next week. This week I got my boss to send home some work that I can do from home. My report yesterday was a good one, no cancer in my lymph nodes or outside margins. Will know about treatments in 3 weeks time. My surgeon believes I may have to take a pill for so many years, he is not sure. Think positive and you can beat this.

  • shaz101
    shaz101 Member Posts: 718
    edited January 2015

    Thank you newinab,

    I've had a whirlwind week. I asked my manager to tell our department on Wednesday while I was sseeing my BS. So they could all talk about it without me being there. Thursday was hard, but made harder because my surgery date was moved forward to the 13th. So Thursday was also my last day at work for a while. I had pre op on Friday and I have the mapping done on Monday ready for a partial mastectomy on Tuesday. 

    I'm so pleased your lymph nodes are clear. 3 weeks seems like a long time to wait. I hope it goes well. My BS told me I will have 4-6 weeks of rads and the final pathology will decide any other treatment. How are you feeling about going back to work? 

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