Lumpectomy for small, low grade DCIS calcification? Why?

Options
breastquest
breastquest Member Posts: 52
edited February 2020 in DCIS (Ductal Carcinoma In Situ)

New and confused, surgeon told me the calcification on pathology is small 2mm and I would not need radiation or any treatment, but excisional biopsy. MRI is ok. But, now the surgeon is calling surgery a "lumpectomy". I've read everything on google.... but, if pathology is saying things are as good as they can be with dcis--- why do I need any followup surgery after a biopsy? (I know it's the standard of care...…) Doctor said I don't need any radiation. Again, is this true?

Also, lumpectomy they said is done with local sedation. How long does it take in the surgery, and is there a scar? Is the breast deformed after surgery for something under 2mm that is allegedly mostly in the petri dish?

Sorry to bother everybody about things that have been discussed a million times beforehand.....

And, finally with DCIS, am I a person with breast cancer. Or a person with pre-cancer?

thx

· Share on FacebookShare on Twitter

Comments

  • mammalou
    mammalou Member Posts: 823
    edited February 2020

    The follow up surgery is to make sure that got it all out with clear margins. A biopsy doesn’t always get it all. You probably won’t have a big scar and your breast should retain its shape with something that small.

    · Share on FacebookShare on Twitter
  • Beesie
    Beesie Member Posts: 12,240
    edited February 2020

    An excisional biopsy and a lumpectomy (without the nodes being checked) are the same surgery. It's generally called an excisional biopsy if the purpose is to excise the suspicious tissue for biopsy purposes, i.e. prior to a diagnosis or if a needle biopsy was inconclusive or discordant. And it's generally called a lumpectomy if a diagnosis has already been made and the remainder of the mass needs to be removed with adequate margins.

    As for whether DCIS is a cancer or a pre-cancer, the experts are divided on this so you can call it what you prefer. Particularly with such a tiny low grade lesion, I doubt that anyone would argue with you calling it a pre-cancer, if you choose.

    · Share on FacebookShare on Twitter
  • MountainMia
    MountainMia Member Posts: 1,307
    edited February 2020

    bq, my lumpectomy removed 15 mm (1.5cm) IDC and 29mm (2.9cm) DCIS, with sufficient margins. My scar is a little less than 2" long and completely smooth, just a bit pink still but it will continue to fade. (Surgery last April.) The remaining breast tissue was "rearranged" slightly so there is no divot or noticeable change in shape.

    I don't know how long your scar will be, but the tissue excised should be minimal. I would expect you'll have a very satisfactory aesthetic result.

    Good luck.

    · Share on FacebookShare on Twitter
  • breastquest
    breastquest Member Posts: 52
    edited February 2020

    Thank you very much for responding. It means a lot to me.

    · Share on FacebookShare on Twitter
  • Ingerp
    Ingerp Member Posts: 2,624
    edited February 2020

    One reason for cutting the area out is there’s about a 20% probability they’ll find something more evil nearby. And my physical therapist had an area that small with the same recommended treatmentjust surgery, no rads.

    · Share on FacebookShare on Twitter
  • blah333
    blah333 Member Posts: 270
    edited February 2020

    I think they call any time they remove a small area from the breast (that is not a biopsy) "lumpectomy." Yours sounds like it will be very tiny. It is definitely worth removing, and could save you a larger lump removal down the road - or allow you to wait many many years before it returns or grows. I doubt something that small will deform your breast. You will probably have a tiny scar, but there are things you can do to make it fade.

    Personally, I consider DCIS to be a cancer. It's in the ducts, but mine was multifocal and about 6cm. Based on reading my pathology report, I feel like it would have become invasive (left the ducts) within the next 6-12 months had I not gotten surgery. I removed both my breasts due to my age and family history. Since my surgery I have had two scares of recurrence. If it's not cancer, what would I have to worry about? Some DCIS is very slow growing, but most invasive ductal carcinoma (IDC) starts as DCIS. They don't have many studies on what happens if you leave DCIS alone (and for how long, maybe it doesn't spread afterall) because people usually do something about it, because they know it could be come invasive.

    However, due to how small yours is, I would just consider this a pre-cancer warning sign and know your breasts are predisposed to abnormal cellular activity

    · Share on FacebookShare on Twitter
  • Khakitag
    Khakitag Member Posts: 46
    edited February 2020

    I had a lumpectomy for a 9mm small DCIS 3 weeks ago and the 1.5”scar is healing nicely with no obvious deformity to the breast. I still am waiting to meet with med oncology and discuss my very long list of questions. Don’t be afraid to ask, and read. I’ve been pouring over papers and studies of DCIS and becoming quite educated. It’ll help you communicate with your Dr better.

    · Share on FacebookShare on Twitter

Categories