no lymph node removal for early DCIS??

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yogamom2
yogamom2 Member Posts: 82
edited December 2018 in Just Diagnosed

Hi all, I am 60 years old, just diagnosed, had my meeting with the surgeon on Monday and will have lumpectomy in early Jan. Mammo & Biopsy reports state: DCIS stage 0: small (5mm), well contained, intermediate nuclear grade, cribiform, associated w/ calcifications found on mammogram with no mass or symptoms. Of course that stage could change with the pathology following Jan.surgery.

My surgeon has ordered an ultrasound and said if that doesn't show anything new I won't need lymph nodes removed or radiation. I asked about the OncoType test but she said that's not usually used for stage 0 DCIS. She is considered a breast specialist in our area and spent the last week at a BC conference in TX. I will need to see a medical oncologist for hormone blocking medication because my biopsy showed 95% positive for both estrogen & progesterone receptors.

Has anyone else had similar advice, esp re: lymph nodes & Oncotype? Thanks for your thoughts

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  • AliceBastable
    AliceBastable Member Posts: 3,461
    edited December 2018

    That sounds pretty standard for your type of tumor.

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  • PurpleCat
    PurpleCat Member Posts: 358
    edited December 2018

    My original biopsy came back as DCIS. I had a lumpectomy to remove it, but no lymph nodes because there's no need to check nodes when it's DCIS. Then the final pathology came back showing invasive cells, so I had to have a second surgery for sentinel node biopsy. I was so upset at needing a second surgery, and asked why they didn't just take the nodes the first time. I was told they don't want to risk lymphedema unnecessarily, and after recovering from that surgery I definitely see the value of avoiding it if possible.I only lost three, and my chance of lymphedema is small, but not zero like it would have been with DCIS. They didn't say anything about oncotype until I got the second, invasive diagnosis.
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  • Ingerp
    Ingerp Member Posts: 2,624
    edited December 2018

    Two years ago I had DCIS and my BS said it was up to me whether or not to take the sentinel lymph node. I said I’d just as soon not have an unnecessary surgery so he skipped it. (This time around with IDC it was justified but keep in mind this is not a biopsy—they remove the lymph node(s).)

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  • MDRR
    MDRR Member Posts: 133
    edited December 2018

    I initially had a diagnosis very similar to yours. I had a lumpectomy and no lymph nodes taken; was expecting about 3 weeks of radiation. But when the surgical pathology showed it had become invasive and was stage 1, I opted for a bilateral mastectomy (instead of further surgery to try and get clean margins), and that included sentinel node biopsy. The SNB showed involvement in 2 nodes, but very initial involvement. My surgeon indicated the initial diagnosis (stage 0) and lumpectomy did not indicate the need for lymph node biopsy, but again, the pathology drove the need for further surgical involvement.

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  • Jelson
    Jelson Member Posts: 1,535
    edited December 2018

    No lymph node removal for DCIS with lumpectomy is the norm - when a mastectomy is performed for DCIS a sentinal node biopsy might be done because if warranted, it won't be possible to do after the mastectomy. Why not check out the DCIS specific thread while you are waiting for surgery!!

    jelson

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  • yogamom2
    yogamom2 Member Posts: 82
    edited December 2018

    Thanks for everyone's helpful replies. Glad to know this seems standard of care. The need for a second surgery after pathology was what concerned me, but I'll trust my surgeon and hope for the best.

    I had looked at the DCIS thread as well and didn't see anything noted there. Since I'm newly diagnosed, and new to this forum, I started here. If I post again I will make sure it's to that thread.

    Good luck to all.

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  • Jelson
    Jelson Member Posts: 1,535
    edited December 2018

    you should also check the main section of BCO, there is a lot on standards of care for all types of BC including DCiS. I didn't know about BCO until after surgery - I would have had a better idea of what was going on!!!

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