Treatment - DCIS and IDC ER+/PR+/HER2-

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AMLMom
AMLMom Member Posts: 102
edited March 2019 in IDC (Invasive Ductal Carcinoma)

Hi All,

I just received my pathology after a lumpectomy with oncoplasty on Feb 13th. I had a very large area of DCIS (9 cm with positive margins) along with .6cm of IDC (plus I believe they removed a few mm on biopsy). There were also >10 areas of microinvasion in the dcis. All grade 3 with extensive comedo necrosis and bizarre pleomorphism. I was 45 at diagnosis.

Does anyone have a view on standard treatment for this type of diagnosis? I have seen some posts with signatures that indicate chemo and some that don’t (only radiation and tamoxifen). I’m just wondering what to expect.

Also, 2 1/2 weeks out from surgery and I’m still pretty sore in my armpit and breast. Is that normal?

I think my surgeon said that he wouldn’t go back if the margins were dirty and that he would have to do a mastectomy, but we will see on Tuesday.

Thank you!






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  • L-O-R-I
    L-O-R-I Member Posts: 114
    edited March 2019

    Hi AMLMom,  Welcome :))  What a stressful time you are going through!  Very sorry about that!!  I thought that I would write to encourage you to do a lot of research for yourself.  There are a lot of contradicting opinions/options out there, as you already mentioned.  Also, maybe get a second opinion. 

     https://www.cancerquest.org/patients/cancer-type/breast-cancer?gclid=Cj0KCQiAk-7jBRD9ARIsAEy8mh6A13rOJoeiDV0YcWSOrnHYXssoF5m_OYTsdy8zwDuJ-pawpR9nK0UaAkYNEALw_wcB

    I recommend that you take a look at this site.  When you talked about your DCIS, which is shocking for a woman to see in her diagnosis, it really isn't as bad as it looks when you read the facts about DCIS.  The IDC, which is a lot smaller, is the more worrisome detail, which this site addresses as well.

    Anyway, I just wanted to encourage you to make decisions  based also on what you have studied.  You can go to several Doctors and they will all have differences in their advised treatment, based on their experiences.  Your Doctor said that if the margins are dirty, he wouldn't go back in, but would do a full mastectomy?  There are Doctors that have done a second and a third attempt at getting clear margins.  Statistics say that far too many mastectomies are done prematurely.  It is you that has to weigh out the options and the risks vs rewards and then you have to live with those choices.  I'm just saying that when you are more informed, you are more in control.  Some of the choices that you will realize that you have, are a difference of a few percentage point in success rate.  There are too many women on this site that have said, "If I knew that, I would have made a different choice!"  

    Lori


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  • AMLMom
    AMLMom Member Posts: 102
    edited March 2019

    Thank you so much Lori. I appreciate the information and encouragement. Given the size and location of the area, my BS originally thought a mastectomy would be required. however, given that’s i have bigger breasts with sufficient tissue, he was able to save the breast with oncoplasty. However, he didn’t think he would have enough room to go back for more. I am meeting him on Tuesday

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  • AMLMom
    AMLMom Member Posts: 102
    edited March 2019

    Great news! Although my margins on the specimen were dirty, what I didn’t realize is that my BS actually took a small second piece of tissue during surgery in the area because he was worried it would be too close, and that tissue was clean. I am so so grateful!!

    The BS said that given my age and grade 3, the MO may suggest chemo, but he likely wouldn’t. He also said they may suggest Oncotype to determine whether it’s necessary.

    Thx!

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  • Ingerp
    Ingerp Member Posts: 2,624
    edited March 2019

    AML I was just going to say that for HER2- they often do an Oncotype test to see whether or not chemo is warranted. Best of luck!!

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  • AMLMom
    AMLMom Member Posts: 102
    edited March 2019

    Thank you Ingerp!

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