Biopsy results in shock

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Konakona
Konakona Member Posts: 173
edited November 2015 in Just Diagnosed

I don't enen know how to start?

Had my annual mammogram on October 7th, got a call back for cluster microcalcifications, after another Mano and 2 ultrasounds, no lump found only the microcalcifications, was sent to have a estereotatic biopsy. I had the results on Monday:

DCI with mutinous component, and strong component is CDIS grade III

I have an appointment with my radiologist on Monday

I feel so numb and scare, do I have two tumours? One? Where is the lump?

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  • keepthefaith
    keepthefaith Member Posts: 2,156
    edited November 2015

    Not sure about your questions, but, it sounds like you may have DCIS, which is non-invasive and has not left your ducts to surrounding tissue. I am telling you this based on how I understood your post, only. The best place to find out more is through your medical team. Try not to panic! Get your medical team together, take someone with you to your appts, if you can; if not, record the appt, so you can go back if you need to. Get copies of your medical records as you go. Ask questions of your medical team until you understand what you need to, in order to make the best decisions for you and your treatment plan. Get second opinions if you need to. Best wishes!

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  • Smurfette26
    Smurfette26 Member Posts: 730
    edited November 2015

    Sorry you have found yourself here Konakona. It is a very scary time. There's a lot to get your head around.

    Try to get some questions written down to ask your medical team. You will feel more empowered when you know more.

    Hugs Donna.

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  • Konakona
    Konakona Member Posts: 173
    edited November 2015

    tanks, I am trying to be strong, I have ups and downs through the day, but the incertity is killing me, especially because my biopsy report is so confusing

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  • Lemint
    Lemint Member Posts: 162
    edited November 2015

    Its very scary but your in the right place for support. Try not to let your mind take over with negative thoughts. I know its easier said than done. Will be thinking of you.

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  • Konakona
    Konakona Member Posts: 173
    edited November 2015

    thank you! I will post again after the appointment with my radiologist

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited November 2015

    based on what you posted, it appears that you have NON-invasive DCIS, Grade 3 AND some invasive mucinous type breast cancer. Once you have surgery, you will be staged according to the invasive cancer which mucinous is AND is usually a favorable type of cancer to have. It is also important to find out if the mucinous BC is "pure" or "mixed."


    As you can see from my signature below, I was diagnosed with mucinous as well. Us mucinous sister have a thread devoted to mucinous. Join us on the " mucinous carcinoma" thread.


    Also, register at the NCCN's website and read the section devoted to mucinous and tubular breast cancer. Follow the footnotes and also read the discussion section concerning endocrine therapy about 100 pages down....alot to digest...but knowledge is power!


    Hang in there! Once you have a treatment plan in place...the journey will get slightly easier....

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited November 2015

    community.breastcancer.org/forum/137/topics/733018

    Above is the mucinous link....

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited November 2015

    Hi KonaKona:

    There is some good advice above. Please be sure to write down all your questions and ask the doctor to explain it to you.

    There is some difference of opinion above as to whether it means (1) there is only DCIS (with two different components), OR (2) there is a mixture of IDC (mucinous) and DCIS (grade 3).

    You said the report indicates "DCI with mutinous component, and strong component is CDIS grade III"

    I am confused about "DCI". Did you mean to type "DCIS" or "IDC"?

    DCIS = ductal carcinoma in situ

    IDC = invasive ductal carcinoma

    As VoraciousReader said, one kind of IDC is "mucinous".

    But, according to this site, it is also possible to have mucinous DCIS ("mucinous ductal carcinoma in situ"):

    http://surgpathcriteria.stanford.edu/breast/dcis/m...

    So, please let us know whether the report says there is "DCIS with a mucinous component" or if it says there is "IDC with mucinous component."

    BarredOwl


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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited November 2015

    barrel....kona posted a new thread identifying HER 2 status and KI-67.... Those tests at done for invasive cancer.

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  • Konakona
    Konakona Member Posts: 173
    edited November 2015

    the report is very confusing, it says

    "Invasive ducal carcinoma with mucinous component and strong component of high grade ducal carcionoma in situ"

    By reading this, I think they are 2 tumors.

    Does the mucinous carcinoma not show on mammograms or us? I had a mamo followed by a spot magnification one and 2 ultrasounds and they found nothing,

    I am so scare, specially not knowing what all this means, thanks everybody for your responses

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited November 2015

    Hi Konakona:

    For now, it is very hard for you, because you are in the fact-gathering stage, and you are not sure exactly what you are dealing with. A biopsy only samples a very small area, so it is just a partial picture of what is there, to help decide what to do next.

    It is very common to have DCIS and IDC together, like you and me.

    Did you feel a lump or not?

    I did not have any "palpable" lump (no one could "feel" any lump). A mammogram can often detect cancer before a lump can be felt, which is good and can permit early detection at earlier stages.

    Different types of imaging (mammogram, ultrasound, and MRI) are based on different technologies and "see" different things. Sometimes, the cancer cells cannot seen by all of the imaging methods. (I never had an ultrasound.)

    "Ductal Carcinoma in Situ" (DCIS) is a non-invasive form of breast cancer that is confined to the ducts (has not escaped the duct). It is by definition a "Stage 0" cancer, the lowest stage with the best prognosis. Over time, some cells might change and break through the wall of the duct, becoming "invasive". Once cells invade the tissue around the duct, the rogue cells are "invasive ductal carcinoma" or "IDC".

    If the IDC is still relatively small, and has stayed in place in the breast, it could still be early stage (e.g., Stage I), with quite a favorable prognosis. You can ask the radiologist for his thoughts about what is known so far, although things could change (or not) as more information becomes available (e.g., from another biopsy, surgery and lymph node biopsy).

    Here is a short introduction to DCIS on this site:

    http://www.breastcancer.org/symptoms/types/dcis

    Here is a short summary with information about grade, and pictures about DCIS and how it can progress to invasive cancer (breaking through the wall of the duct), also from this site:

    http://www.breastcancer.org/symptoms/types/dcis/di...

    IDC and DCIS are usually removed by surgery. When there is a mix of DCIS and IDC present, the stage will be based on the stage of the invasive disease. Actual stage will only be known after surgery and lymph node biopsy ("sentinel node biopsy").

    I see you are meeting with a radiologist on Monday. Since the ultrasound didn't see anything, please ask the radiologist about whether Magnetic Resonance Imaging (MRI) would be helpful for diagnosis and/or surgical planning for you. MRI is the most sensitive imaging method and might provide more information about the possible size of the area of DCIS and IDC, etc.

    BarredOwl

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited November 2015

    kona..DCIS often accompanies mucinous BC. If you read the mucinous carcinoma of the breast thread, you will discover that many of mucinous sisters had both. The researchers at the rare breast cancer lab at Sloan Kettering are trying to understand the connection.


    With respect to seeing mucinous breast cancer on imaging, because mucinous breast cancer often looks like a cyst on mammography, it is often missed. My doctor felt it and sent me for imaging and a sonogram identified it. It had been missed on previous mammograms and sonograms. The MRI discovered the drop of DCIS that was next to the mucinous tumor.


    Now....with respect to being frightened. A cancer diagnosis is frightening. BUT....for many,many, many of us, breast cancer is a very treatable disease. Please read the mucinous breast cancer thread. It is filled with very valuable information specific to mucinous BC.

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  • Konakona
    Konakona Member Posts: 173
    edited November 2015

    thanks, I am having a really bad day today, the incertity is killing me.

    Do you know what a ki:67 means? Mine says 8

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited November 2015

    kona..take a deep breath and try to relax.....music.....a glass of wine.....an old film...friends..family...

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited November 2015

    Hi Konakona:

    The uncertainty is very hard. It seems hard to believe, but you will actually feel better as you get more information and have more discussions with your doctors.

    Ki-67 is a marker of cell proliferation (growth). Yours is on the lower end. People tend to worry about Ki-67 more if it is much higher (although it is just one factor), so please do not lose any sleep over your Ki-67 number. Add it to your list of questions for discussion to confirm.

    Meanwhile, here is some info from this web site about it:

    http://www.breastcancer.org/symptoms/diagnosis/rat...

    BarredOwl

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  • Konakona
    Konakona Member Posts: 173
    edited November 2015

    Well, saw my radiologist this morning, she was very surprised with the results from the biopsy because she could not see anything on mamo and ultrasound and always told me "don't loose any sleep over this, it's going to be all right, I have seen hundreds pf mammograms..."

    I did ask her about her opinion on this beeing one tumor or two, she thinks is one the DCIS that broke through and become DCI.

    If that's the case, should the biopsy only say DCI? my untestanding is that the moment is out of the duct is invasive, why put in situ in the biopsy report?

    Anyhow, I walked out of there, still confused, scare but with an appointment with a surgeon for Wenesday and a good stash of anxiety pill

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited November 2015

    Hi Konakona:

    Thanks for the update.

    Some DCIS cells probably changed and became invasive. But not all of the DCIS cells became invasive, and they are still stuck in the ducts. Thus, you have some DCIS and some IDC. Two types of cancer cells (DCIS and IDC) are present. They included the DCIS in the biopsy report, because the DCIS is malignant (cancerous) and also needs to be removed by surgery.

    Glad you got something for anxiety, and have an appointment with a surgeon soon.

    You may wish to ask the surgeon:

    Does your practice focus on treating breast cancer patients? How many breast surgeries a year do you perform?

    Would Magnetic Resonance Imaging (MRI) be helpful for diagnosis and/or surgical planning and provide more information about the possible size of the area of DCIS and IDC, etc.

    If you are interested in reading a little more to prepare for your appointment, here is some information:

    For DCIS and IDC, read about estrogen receptor ("ER") and progesterone receptor ("PR") status:

    http://www.breastcancer.org/symptoms/diagnosis/hor...

    For IDC, read about HER2 status:

    http://www.breastcancer.org/symptoms/diagnosis/her...

    Lumpectomy information:

    http://www.breastcancer.org/treatment/surgery/lump...

    BarredOwl

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