DCIS Discovery during IDC Lumpectomy...Clean Margins?

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VLH
VLH Member Posts: 1,258
edited July 2016 in HER2+ (Positive) Breast Cancer

I wasn't sure where to post this since it straddles multiple topics. I ended up having a lumpectomy last week. The BS called yesterday to tell me that DCIS was discovered when the tissue was reviewed so I go back next week to have more tissue removed. My tumor was about 2 cm as expected and she said she removed a 4 cm x 5 cm area. If there is a different cancer detected (DCIS vs. IDC), does that mean I don't have clean margins, but the next surgery will hopefully achieve that objective? Clear nodes so I was pleased about that! Thank you.

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  • barbe1958
    barbe1958 Member Posts: 19,757
    edited July 2016

    DCIS can turn in to IDC so what she saw was a precursor to more cancer. It could have been there because of the IDC, or from another area. Getting clean margins means they have caught all cells that could turn cancerous in that area. Sounds like that's what she is trying to do. Congrats on the clear nodes!!

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

    I would think that your doctor is calling you back in for more surgery because your margins had DCIS cells and were therefore not clear. As barbe1958 said, congratulations on the clear nodes, but I think congratulations too, that while your margins were not clear, they had dcis stage 0 cells - which are not invasive like IDC cells. Hope all goes well next week and clear margins are achieved.

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  • VLH
    VLH Member Posts: 1,258
    edited July 2016

    Thanks for the responses.

    On a related note, in the TNM format, how does one measure tumor size? I'd fallen asleep on the sofa so was groggy when she called, but I think she said she expects to remove an additional 2 cm. Since she found the DCIS within the 4x5 excision area, would the DCIS tumor be 2 or 3 cm plus whatever additional cancerous tissue is discovered in next week's surgery? Perhaps the pathology reports will clarify the size issue.

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  • barbe1958
    barbe1958 Member Posts: 19,757
    edited July 2016

    DCIS isn't a tumour, but a chain of bad cells. She wants to scoop out as much around the area to make sure she got it all.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited July 2016

    VLH - your pathology report should include the size of the invasive component and it should include the TNM info for that portion separately from any accompanying DCIS. You can then do the math in trying to determine how much of what you had was IDC vs DCIS. Also, the pathology report for your re-excision should include the margin sizes so that you can determine how much re-excised tissue was DCIS and how much was non-cancerous breast tissue. Ask your surgeon if they will ink the removed tissue 360 degrees, that should give you a complete picture. Good luck

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  • VLH
    VLH Member Posts: 1,258
    edited July 2016

    Thanks, SpecialK. I'll have to revisit your note when I have the pathology report. I've checked the patient portals for both my surgeon and the hospital and no path report a week out from the initial lumpectomy. I sent a secure message to the surgeon so I could get my questions / thoughts reduced to writing, particularly because the surgeon speaks rapidly, but no response. The hospital nurse called today about next week's surgery so I'm kicking myself that I didn't think to ask her if they even get the report or if it only goes to the surgeon.

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