Just diagnosed with IDC

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Cylb0608
Cylb0608 Member Posts: 2
edited March 2021 in Just Diagnosed

After experiencing nipple discharge, I was sent for a diagnostic mammogram where calcifications were seen in two areas, stereotactic biopsy was performed and returned with both DCIS and IDC. (My mother had breast cancer at age 42, so I knew it was a matter of time) I am 48. Other than the nuclear grade being 2-3 not much info was given on the pathology. Here is the jist:


Scattered foci of invasive ductal carcinoma (see comment) in a background of ductal carcinoma in situ (DCIS), solid and cribriform

patterns, with luminal necrosis and calcifications (nuclear grade 2-3). Please note calcifications span 15 cm.

Can anyone help interpret this? Do I have a tumor or is the IDC just present within the calcifications? I feel that the 15 cm is a huge span, almost 6 inches. I do have an appointment on Monday with a BS, but would love some insight before I go so I have some clue what she is talking about!

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  • Moderators
    Moderators Member Posts: 25,912
    edited March 2021

    Hi Cylb0608, and welcome to Breastcancer.org.

    We're so very sorry to hear of your diagnosis, but we're really glad you've found us. We're sure you'll find our Community an amazing source of advice, information, encouragement, and support -- we're all here for you!

    It's a little quiet around here on the weekends, but you should receive some replies here soon from our incredible members to help you understand what your dealing with. In the meantime, these pages from the main Breastcancer.org site on Your Diagnosis will help explain what each piece of your pathology means, as well as offer some good Questions to Ask Your Doctor About Your Diagnosis.

    Please let us know how your appointment goes on Monday and if there's anything else we can help with!

    Welcome again,

    --The Mods

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  • Beesie
    Beesie Member Posts: 12,240
    edited March 2021

    Cylb,

    Welcome!

    None of us are radiologists or doctors, so take anything we say as speculation not fact.

    From what your report says, "Scattered foci of invasive ductal carcinoma (see comment) in a background of ductal carcinoma in situ (DCIS), solid and cribriform patterns, with luminal necrosis and calcifications (nuclear grade 2-3). Please note calcifications span 15 cm." it sounds to me as though you have a large area of DCIS, with a few areas within that where there small amounts of IDC have developed.

    DCIS forms within the milk ducts of the breast, and as DCIS, it stays in the ducts. The ducts are kind of like spaghetti (well, hollow spaghetti), winding around inside the breast. With DCIS, as these malignant cells multiply, rather than form a mass, they tend to spread out within the narrow milk ducts. This is why some people have very large areas of DCIS. I had over 7cm.

    Most IDC develops from DCIS. The DCIS cell undergoes a biological change and attains the ability to break through the wall of the duct. Once the cell gets through the duct wall, it is IDC. What sometimes happens when there is a large area of DCIS is that most of the cells remain DCIS, and therefore remain in the duct, but a few of the cells evolve through this biological process and become IDC. So the diagnosis is a mix of mostly DCIS with one or a few small spots of IDC. It sounds like this is what's happened in your case. This graphic from the BCO information pages shows how this happens - your diagnosis appears to be one of the two examples at the bottom.

    image

    15 cm is large, but the calcs might not all be DCIS. Have you had an MRI? That might be helpful. My mammogram didn't show as large an area of DCIS as I had, but my MRI did. Some surgeons automatically send newly diagnosed patients for an MRI, but others don't so you'll have to see what your surgeon says.

    When you are talking to the surgeon, get a copy of the pathology report. Critical information for the treatment plan is ER status and HER2 status.

    Good luck with the appointment on Monday. Let us know how it goes.

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  • Cylb0608
    Cylb0608 Member Posts: 2
    edited March 2021

    Thank you so much for the response and it makes more sense now that you explained it to me that way. I haven't had an MRI but I'm sure the surgeon will recommend that on Monday before anything. I will ask for the pathology report too, I was looking for the receptors and HER2 information on mine but that wasn't shown on what they sent me of course. Thanks again!


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  • LivinLife
    LivinLife Member Posts: 1,332
    edited March 2021

    Cylb I just want to send support and best wishes to you and for your upcoming appointment. That is a large area - At first I wondered if it was 15 mm though 15 cm is certainly possible.

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