DCIS with MicroInvasion treatment?

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Skeptic
Skeptic Member Posts: 20
edited October 2015 in DCIS (Ductal Carcinoma In Situ)
Has anyone been diagnosed with DCIS-MI? (DCIS with microinvasion). If you were, what treatment did you have?

I recently had a lumpectomy for what was believed to be pure DCIS. After the excision however, the pathology report showed a microinvasion, which apparently is slightly different from an invasion because it is only 1mm or under in size. There is only one focus of microinvasion. The margins are clear. Because only pure DCIS was expected at the time of surgery, a sentinal node biopsy was not done at the time of the lumpectomy. (it is not standard practice to do an SNB for pure DCIS.)

The surgeon states that the likelihood of the sentinal node being affected from a DCIS microinvasion is 3%. She went on to say that the standard regimen for ER positive invasive cancer, i.e. radiation and ER supressing drug therapy, would eliminate any node invasion if it exists. So she was okay with foregoing doing another surgery to take the sentinal node biopsy if I planned on getting the radiation and hormone surpressing therapies. I could not get her to specify which of the two treatments, the radiation or the estrogen supressor, would eradicate any node invasion, but perhaps that question will be better answered by the radiation and medical oncologists I will be meeting with next month.

The potential side effects of all 3 proceedures (sentinal node biopsy, radiation, and ER inhibitors) sound almost as bad as the cancer itself. I am questioning if I should be doing anything for an invasion that is so tiny as to be called micro.

Has anyone been treated for DCIS with one focal point of microinvasion? What was the treatment, and what side effects from the treatment did you have? Would you consent to the same course of treatment again?
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  • Annette47
    Annette47 Member Posts: 957
    edited October 2015

    Yes, I was. The micro-invasion was identified at the initial biopsy so I had a SNB along with the lumpectomy, then radiation and now Tamoxifen. Yes, I would definitely do it again - the sidee effects have been quite manageable.

    From the radiation, I had some fatigue at the time, and some breast swelling that took a long time to resolve. No skin burning other than a light reddening during the boosts. And now, 3 years later, the skin on my areola has faded quite a bit.

    From the tamoxifen, some hot flashes, but not too bad. Some hair thinning, again, not bad - I mostly only notice it when I put my hair in a ponytail as the ponytail feels smaller than it did. I have had some problems with leg cramps occasionally, but I can’t be sure that’s from the Tamoxifen. Prior to being diagnosed, I was having LOTS of perimenopausal symptoms including breast tenderness and heavy, frequent periods and the Tamoxifen has alleviated those entirely so all in all, I’d say it’s a win.

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  • LisaAlissa
    LisaAlissa Member Posts: 1,092
    edited October 2015

    If you haven't read posts from Beesie's discussion of DCIS, please take a look at this, which is a wonderful description of DCIS. Note that Beesie's diagnosis was similar to yours, and as you read through the post you'll find a discussion of DCIS with a microinvasion is included. I'd also search for more posts from her here that include the words "microinvasion." I think I recall a post discussing how to make decisions...

    HTH,

    LisaAlissa


    etc: "here" to "her"...search other posts by Beesie!


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  • percy4
    percy4 Member Posts: 477
    edited October 2015

    I had a micro that was found upon lumpectomy for low and intermediate-grade DCIS. I was never offered a node biopsy by either my BS or my MO, even then. I had to read about it here (this pissed me off). I was also told, when I then asked, that the chance for nodal involvement was very low, and my RO told me that the rads would pass over the node area anyway. So much time had gone by since the lumpectomy, I had to get back to work, the node chances were low, so I did not do the node biopsy. I'm fine with that. They did check, in my original pathology, about vascular-vessel and lymph-vessel involvement, and there had been none (I found this out later; it was put in terms I could not understand by reading the path report). You might want to see if this was checked in your pathology. The fact that I had none of that made me feel better. I refused the anti-hormonals as my personal recurrence chance is thought to be quite low, and my microinvasion markers were non-aggressive.

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