microinvasion suspected
got the path back from my biopsy: microinvasion suspected. any thoughts? should this move me more towards mastectomy vs lumpectomy? anything else i should think about?
Comments
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Momstrong: From my mammogram they suspected a spot of invasion, but there was none. Do you know why they suspect micro-invasion? I have seen this before and the final pathology was pure DCIS. Perhaps they can give you an idea of how certain they are, but suspect it is difficult to guess at this point. Also, you could always start with a lx and have a mx later based on findings. Good luck with these difficult decisions.
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Hi Dear - I had the unfortunate experience of being given the "all-clear" from my initial pathology report. Meaning only low and intermediate DCIS; no invasion. Very unhappily, a few days later that was amended to include a microinvasion. Apparently the surgeon had asked the pathologist for a fast report, though I had not asked for one, and one slide was still outstanding. Still; the point is this. My information (and I checked) told me that a micro within DCIS, especially if the borders away from the micro are good, is no reason to have an Mx as opposed to a Lx, just because of the micro. Lumpectomy with radiation is as good as mastectomy in many/most cases, if the DCIS is confined to a relatively small area. You do not get rid of the possible nasty implications from a micro by taking your whole breast off. You just don't. And, really, depending on the specific markers, a micro does not put you in very much more danger than just DCIS. As they thought I only had DCIS and nothing more, I was not given a sentinel node biopsy upon lumpectomy. With a micro of invasive cancer, nodal involvement is remotely possible (I was told one in 20, though neither my MO nor my BS suggested I do the SNB when a micro was discovered)). Very rare. I did not have the node biopsy, though, if you do have a micro, it is still the usual standard of care to have it done. I was comfortable not.
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As others have said, a micro-invasion, if present, doesn’t really change your treatment or long term prognosis much at all. In my case, since they knew about the micro-invasion from the initial biopsy, I did have a SNB along with the lumpectomy. A mastectomy is not necessary simply because of the presence of invasive cancer - the danger of invasive cancer is that it has the ability to leave the breast (although with a true micro-invasion the odds of that are very, very low). Removing the breast would be like closing the barn door after the horse had already escaped - wouldn’t do anything about the true problem.
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