Contralater DCIS

First, I don't necessarily buy that it is DCIS. That's what they told me last time after the needle biopsy and it turned out to be small but aggressive IDC. I was screaming and kicking and fighting every.inch.of.the.way, but I did everything they told me I needed to do.

Now it's back in the right breast. I will confess that I was so convinced this was OVER I skipped mammograms for a couple of years. After some soul searching, I figured out that it wasn't the mammogram that bothered me -- it was the waiting for the letter. I was unaware that most centers will your results read while you are there if you ask. So if you are like me and postponing because you can't bear the uncertainty, call today and ask for results while you wait.

So here is what the pathology report says:

DCIS, Size at least 2 mm, architectural patterns: solid, clinging (no idea what the means and neither does Dr. Google), nuclear grade--high, grade 3 (aggressive), necrosis present, ER+PR-, no HER2 analysis.

So my questions are:

1. Does size matter at this juncture?

2. What is the significance of the architectural pattern"

3. What is the significance of the ER+PR- hormone receptor status? (Dr. Google may know but I can't find it.)

4. I had TCx4 last time -- can one get the same chemo twice or am I looking at the Red Devil?

5. What factors will be material to whether radiation is recommended?

6. Why me? I have no family history and gene study was negative. Does anyone get gene studies redone?

I'm trying to come to terms not with treatment, but the near certain fact that this is going to kill me.

For the record, my oncologist told me if i would go through the drill, she "guaranteed" me it wouldn't come back. Actual statistics for the risk of contralateral BC are skewed by women who have a BMX (SMART), women who die before the contralateral BC can manifest, the fact that most studies are just five years, and women dying from other causes.

We aren't told the real risk which is something north of 20%. I'm old and deeply cynical but that feels patronizing.