Chemo for DCIS without microinvasion.....???

This is what I thought as well....no chemo for "pure" DCIS. I can't find the original source but it had to be in one of the DCIS groups I am in. I will keep trying to find it. I did email "Ask an Expert" from John Hopkins and the reply was as follows....

"If DCIS is indeed triple negative, we would treat it as such and give chemotherapy."

I have asked for clarification on that response and am waiting to hear.

My original question was "Is triple negative DCIS (no microinvasion) treated with chemo? I thought DCIS was contained in the ducts."

I had some additional questions regarding DCIS and HER2 which were also answered and I got answers but it made me think that maybe it was referring to DCIS WITH invasion....Not sure but will see what the follow up response is.

My follow up question...."Is this a new protocol? I was under the impression that pure DCIS didn't require chemo. And that HER2 was not routinely tested for DCIS. This is freaking me out quite a bit...."

Here is the reply to my follow up question....

"Very sorry this is freaking you out, understandable. DCIS is breast cancer, it is just confined within the milk ducts rather than having begun growing into the tissue outside of the milk duct. Chemotherapy is very individual to each patient, and yes, there are some patients who may not need it, even if it's triple negative (for very tiny breast cancers and possibly an older patient). Our best advice is for you to discuss your specific situation with your medical oncologist. It is true that HER2 is not routinely tested with DCIS. Again, every breast cancer is different and we cannot give a blanket statement for all patients."

Not sure what to make of this answer....

Ok so the answer finally got clarified....NO CHEMO for pure DCIS! The "Ask the Expert" corrected the info they had given out originally and apologized. In any case I am glad to finally have an answer that makes sense!!!!

Not sure who asked for a clarification after I did but it worked and finally straightened out the answer.

Here's the actually reply-

First, our apologies for the confusion about chemotherapy and DCIS. We've consulted with a few of our medical oncologists and their answers are:

"As long as it is DCIS alone and no invasion, we don't give chemo. DCIS actually has a high rate, about 60% of HER2 positivity, however our breast pathologists usually only check ER on DCIS."

"We do not treat DCIS with chemotherapy regardless of hormone receptors or HER2 status."

"Triple negative DCIS is certainly unusual, and we've not been testing for HER2 on DCIS as of late, mostly because it does not affect treatment considerations. For DCIS irrespective of receptor status we would not give chemo or Herceptin (for HER2 positive), the only options are endocrine therapy for prevention if ER+."