DCIS and duct size - question

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muska
muska Member Posts: 1,195
edited February 2016 in DCIS (Ductal Carcinoma In Situ)

I have a very basic question. DCIS is a tumor that originates and is contained in milk ducts. I am sure you were shown pictures at your first appointment: breast duct with bad cells lining it on the inside.

The duct diameter is tiny - I think it varies but is no more than 1mm. When it comes to large size DCIS tumors what does it actually mean? Does a duct with DCIS look like a boa constrictor from the The Little Prince? Just curious...

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  • Annette47
    Annette47 Member Posts: 957
    edited February 2016

    I could be wrong, but I was always under the impression that DCIS spreads along the duct and out through the branches of it, so it’s not like there is a solid lump of it usually - if that’s true, then a large size DCIS would be one that has spread in several directions along the duct lines (which branch like tree limbs) for quite some distance, but I don’t know for sure ... interesting question to be sure!

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  • Jelson
    Jelson Member Posts: 1,535
    edited February 2016

    I think you are right Annette - that is the norm, however in my case it was in fact more like a boa constrictor - my first indication was something palpable, an enlarged duct was then seen on ultrasound and on second ultrasound, the enlarged duct had become "plugged" by dcis cells and at that point a needle biopsy revealed the dcis.

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  • muska
    muska Member Posts: 1,195
    edited February 2016

    Annette, Jelson, I think you are both correct. Thank you for clarifying!

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  • Mommyathome
    Mommyathome Member Posts: 1,111
    edited February 2016

    another hmmm question.... If the DCIS is in the milk ducts if you had DCIS that was not identified and were breastfeeding, would it be passed through the milk? This is something I worry about as I was diagnosed with DCIS in left and Lcis is right in 2013 and I nursed my children in 2002, 2004, 2006 and 2010....

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  • Annette47
    Annette47 Member Posts: 957
    edited February 2016

    DCIS is NOT contagious. Even if by some chance, some of the DCIS cells were shed into the milk, they would have no way of setting up shop in your child’s nascent breast tissue. Most likely the stomach acids would dissolve them along with the other non-nutritive molecules in the milk.

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  • muska
    muska Member Posts: 1,195
    edited February 2016

    Ladies, one more question that stems from the first one. Let's assume one has a large DCIS that is described on path report as being 5cm by 3cm. This is a chunk within the breast that is filled with ducts that have DCIS. I suppose pathologist checks the 'outside' of the removed tissue for staining, i.e. cancer. But how can pathologist be sure there was no invasion inside the removed chunk of tissue?

    Editing to add that size doesn't matter much in this question, same question applies to smaller DCIS.

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  • McClure77
    McClure77 Member Posts: 55
    edited February 2016

    I'm no expert, but I can tell you that in my situation, the DCIS was nearly my whole breast, and then the IDC was within that. The IDC shows up differently on the scans than the DCIS does, so I assume that because the scans did not show anything inside the 5cm x 3cm area you are talking about, the pathologist would not be concerned with it containing cancer.

    Mommyathome: Did you have any duct issues while breastfeeding?


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  • Annette47
    Annette47 Member Posts: 957
    edited February 2016

    They take the removed tissue, freeze it and slice it very thinly, then check each slice for invasive cancer. This is why you can't be sure until after the final pathology. Even so, if it is a large area they are looking at, with a teeny-tiny area of invasion, they might still miss it depending on how the specimen is sectioned.

    To the previous poster, while it is sometimes possible to pick up IDC on scans as looking different than DCIS, if it is a true micro-invasion, it usually won’t show up on scans.

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  • muska
    muska Member Posts: 1,195
    edited February 2016

    Thanks, Annette. The process you desribed does not look 100% bulletproof to me and might be prone to errors.

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