Extensive DCIS with scattered multifocal IDC

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Axolotl
Axolotl Member Posts: 56
edited May 2021 in Mixed Type Breast Cancer

Hi, I'm new here and trying to make sense of my pathology reports.

I had a unilateral mastectomy with clear nodes. Er+/pr+/her2- (FISH). The pathology report says: "The lesion is formed of extensive multifocal high-grade DCIS. Within this there are multiple infiltrative foci of a grade 3 IDC (grade scores T3, P3, M2). These infiltrate between the DCIS, and this carcinoma is not forming a single mass lesion." The DCIS is appx. 7cm and the report says, "the maximum overall dimension of the invasive carcinoma has to be assumed to be between 5 - 7 cm." Later in the path report it says the diagnosis is extensive high-grade DCIS with scattered foci of IDC. TNM stage: pT3, N0.

The earlier biopsy, which was done on the main tumor, reported 6mm of DCIS with 2mm of IDC. Predominately DCIS, with IDC grade 1. I realize the biopsy is only a small sample of the whole, but I was surprised at the variation between the reports.

My question is, considering the clear nodes and earlier biopsy report, why did the pathologist report 5-7cm of IDC? My understanding is that true T3N0M0 cancers are very rare and typically low-grade. It seems that 5-7cm might be an overstatement, no? I wonder why the pathologist did not give the measurement for the main tumor, or state the percentage of IDC within the DCIS? 5-7cm of IDC is 70-100% of the 7cm DCIS, so why give a diagnosis of extensive DCIS with scattered foci of IDC at all if it going to be counted as mostly IDC?

The bs is sending for the oncotype dx, hopefully that will give more information regarding treatment. I'd like to avoid chemo.

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  • beauz
    beauz Member Posts: 207
    edited January 2018

    Hi Axolotl, my understanding from reading is that your IDCs were scattered in an area of dimension 5-7cm. Best wishes for your following treatment.

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  • beach2beach
    beach2beach Member Posts: 996
    edited January 2018

    Hi,

    They never truly know until they actually go in and take out a larger area to see the extent. I was initially diagnosed on biopsy as IDC. After mastectomy my pathology was changed to ILC with LCIS and DCIS. Do you have a copy of your final pathology? Mine only goes as far as to say as the size of the largest invasive carcinoma is 0.7cm and when it lists DCIS it says several ducts and LCIS as present. Margins uninvolved by carcinoma is nearest margin 0.7cm and unviloved by DCIS 0.7cm. Lumps it all together in the same tumor without distinction of how much made up how much of it.

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  • Palesa2018
    Palesa2018 Member Posts: 140
    edited August 2018

    Axolotl, your diagnosis is incredibly similar to mine and I also had an Oncotype of 12. I hope you since got the answers you were looking for. My DCIS was over 6cm and I had two nodes of IDC measuring 5.5mm and 3mm. The true picture only comes out after surgery.

    Besides the mastectomy what other treatments have you had and how are you coping? I had direct to implant mastectomy. While the cancer was on the right I decided to go bilateral to prevent on the left because of family history. I am scheduled for radiation because of the DCIS. I have an overly cautious medical team. I will also start tamoxifen and Zoladex.

    All the best with your journey!!

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  • Axolotl
    Axolotl Member Posts: 56
    edited August 2018

    Hi Palesa2018,

    I didn't have radiation or chemo. Currently I'm on Lupron and Aromasin. I'm experiencing some side effects from them, including hot flashes and night sweats, but aside from that am doing well. We decided to go with Lupron and Aromasin because of the SOFT and TEXT studies which showed that this combination is stronger than Tamoxifen alone in younger women (I'm 37). I think Lupron serves the same function as Zoladex. I'm trying to stay fit and eat well. 4 months post surgery I did a Spartan Sprint, and also participated in a 42km cycling event. I don't have a family history, so I kept my good boob although I'm no longer as symmetrical as I'd like.

    After going through everything, I feel that at this point I can only wait for the treatment to end (I'll be on the medications for 5 years) and hope I never have a recurrence. I'll have my next follow-up with my breast surgeon in October.

    All the best to you as well!!! This journey is not easy.

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  • My-Lan28
    My-Lan28 Member Posts: 12
    edited May 2021

    Hi Ladies

    I am new in this forum. I was diagnosed Breast Cancer on August, 2020 , I had cancer with 2 stages on both of my breast. My left breast had stage0 DCIS 5cm (grade 3) and beside it there were stage 1B IDC with multi focal tumors ( grade 2) of 1.7cm , 0.8cm, 0.3cm, 0.2cm, 0.2cm. My right breast again I had stage0 DCIS 0.8cm ( grade 2) and stage1A IDC 0.9cm (grade 2). No lymph nodes involved.

    I done all my treatments included of Bilateral Mastectomy, 4 chemos, 15 radiation and taking Tamoxifen. Right after my surgery my oncologist send my breast cancer sample to USA to get mamma print to see i am benefit from chemo. When the result come back with 19% risk of recurrence but I took chemos, radiation and Tamoxifen, it will bring down to 7% of risk of recurrence. I am very scare, I had 2 young kids 7 and 13. I am 46 this year. Anyone long term BC survivors whom had the same condition like my case , please contact me, give me some hope, support for this journey.

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