possibly DCIS says the oncologist!!!

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Anonymous
Anonymous Member Posts: 1,376
edited June 2014 in DCIS (Ductal Carcinoma In Situ)
possibly DCIS says the oncologist!!!
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  • Anonymous
    Anonymous Member Posts: 1,376
    edited September 2007

    Im trying to do some research on this....I had my first bilateral mammogram a couple of weeks ago after finishing treatment for IDC in March.....lo and behold they find calcifications in the good breast now Cry...had a spot compression and ultra sound done then

    I met with my onco yesterday and he said he feels it is DCIS and ordered a biopsy.....said its approx 3 mm in size. He actually gave me a choice....He highly recommended biopsy (which I had already decided to request no matter what) or to wait 6 months and see "NOT!!!!!!!!"

    I guess my question is what kind of biopsy do you ladies think they will do? will it potentially remove a 3mm spot entirely or will I be looking at another lumpectomy???? How do you make the decision to have rads for this or not???? are rads always recommended with DCIS?????

    Thank you

    Jule

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  • roseg
    roseg Member Posts: 3,133
    edited September 2007

    I'm sorry you 've had this turn up.

    I think 5mm is the start point for rads on DCIS. 

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  • Fireweed
    Fireweed Member Posts: 189
    edited September 2007

    I would be upset! If the biopsy shows DCIS you are may be facing another lumpectomy. There is no "5 cm" cut-off for rads. The decision will be based on the margins, the grade, and the presence or absence of comedonecrosis as well as the size. You did it before and can do it again - but let's hope for a benign biopsy!

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  • lvtwoqlt
    lvtwoqlt Member Posts: 6,162
    edited September 2007

    I had DCIS and to find it they did a sterotactic biopsy. I don't know the size of mine because I opted for bilat mast because of previous ADH dx. After the surgery, the final report did not show any more DCIS but did show additional ADH in both breasts. If I had the lumpectomy, I would have had radiation.

    Sheila

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited September 2007

    I just got a call from the surgeons office.....I see him on Monday and they will see what kind of biopsy they will do and go from there I guess.

    Thank you ladies for the info.....Im just hoping that this will show up b-9 and all this worry is for nothing, but it seems that if something is going to happen, it will happen to me Cry

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  • roseg
    roseg Member Posts: 3,133
    edited September 2007

     http://www.breastcancer.org/symptoms/dcis/treatment.jsp

    Fireweed! 5mm is much smaller than 5cm!

    IF DCIS is 5mm or smaller rads aren't aways necessary. 

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  • ginger2345
    ginger2345 Member Posts: 517
    edited September 2007

    In my neck of the woods anything that looked like it might be DCIS would be biopsied(BIRAD 4 or 5); the usually practice is stereotactic biopsy. This could get all of the suspicious cells or not.

    Also around here, the size of the DCIS area is not a factor when deciding on rads; they're always recommended. Some other places don't always recommend and base the decision of a variety of factors.

    I hope your biopsy results are benign. hang in there.

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  • Beesie
    Beesie Member Posts: 12,240
    edited September 2007

    Jule,

    As the others have said, you probably are in for a stereotactic biopsy, which is a core needle biopsy done using a mammogram as a guide.  Here is information on it:

    http://www.radiologyinfo.org/en/info.cfm?pg=breastbixr&bhsh=768&bhsw=1024&bhqs=1

    The other option would be an excisional biopsy, which is the same as a lumpectomy but is done prior to a diagnosis (it's called a lumpectomy after a diagnosis has been made).  Your doctor might suggest this if the calcifications are in an area that is difficult to reach with the needle or if he feels it's best, with your BC history, to remove all of the calcifications regardless of whether they turn out to be DCIS or not. 

    Whichever biopsy you get done, here's hoping that these do turn out to be harmless calcifications, not DCIS!

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  • SharonCorrea
    SharonCorrea Member Posts: 40
    edited September 2007

    From what I was told at 2 major cancer centers, Rose is correct.  Rads are usually optional if the area of DCIS is less than 5 mm.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited September 2007

    Im just concerned that if I use rads on such a small case of dcis now and it comes back later I wont be able to use it again as in my research I have found reference that says you cant re-radiate an area...but I dont want to leave this untreated either....I spoke with the surgeons office today and I am scheduled to meet with him on Monday to see what kind of biopsy and the when and wheres of it so hopefully will know a little more then...

    Thank you ladies for all the info.

    Jule

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  • mbordo
    mbordo Member Posts: 253
    edited September 2007

    Jule-

    I'm so sorry you are going through this!  You were one of the first people to respond when I first was diagnosed - I remember your kind words, and sincerely hope you are not dealing with this again... 

    Let's not put the cart before the horse, okay?  Let's not worry about rads, since you haven't been diagnosed yet...I'm guessing a stereotactic biopsy will be ordered. IF you *are* dealing with DCIS, lots of factors will come into play (total size of involved area, margins and grade) to determine rads/not.  But remember, 80% of biopsies for calcifications are normal - just because you've been down the cancer road before, you are assuming that will be the case.  I think that is normal for any of us, given our history...

    I sincerely pray that it is not, and you will come back and report B9 results to us, and won't need to give rads another thought...

    Take care,

    Mary

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  • ginger2345
    ginger2345 Member Posts: 517
    edited September 2007

    Hopefully, you won't have to worry about rads, but if you do you might ask about mammosite. Mammosite uses a small balloon and cathetar to deliver radiation internally. It takes  5 days after insertion. You do have to meet certain criteria and I and many others can fill you in if that's in your future.

    But one advantage of mammosite is the possibility, but not the certainty -- depending on location, of re-radiating the breast if a cancer would turn up again. (Some insurers still do not cover mammosite so you'd have to check that out too.)

    Anyway, hold the benign thought!

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  • louishenry
    louishenry Member Posts: 417
    edited September 2007

    Hi. I had 4mm dcis, low grade. The stereotactic biopsy took it all out, but we didn't know that until I had the lumpectomy. It wasn't too bad. Obviously, I had large margins, so I did not need rads. They are leaving tamox up to me. I'm still thinking about it.

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  • Fireweed
    Fireweed Member Posts: 189
    edited September 2007

    Sorry - bad typing! My 2mm DCIS showed comedonecrosis, so I did have rads.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited October 2007

    thank you ladies for all the info and advice...I have my appt with the surgeon tomarrow so will know what kind of biopsy will be done...Im sure it wont be done tomarrow like I was hoping but we will see...the last time I was in that office I was in surgury the very next morning having my lumpectomy...

    Im actually considering asking them if that might be the best route to go instead of biopsy...I really want this out no matter what it is...

    Jule

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  • ginger2345
    ginger2345 Member Posts: 517
    edited October 2007

    I have read the NCCN guideline that states no radiation is required for low grade DCIS if the size is 5mm or less. Of course, often we see low grade DCIS spread throughout the breast so mastectomy is recommended.

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  • jade56068
    jade56068 Member Posts: 584
    edited October 2007

    Ipann39

    I had almost the same thing and I had a needle plasement open breast biop.  that way he knew he got what he needed.  It didnt hurt and I was at Disney 2 days latter.  Hope that helped

    jodi

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  • sealady
    sealady Member Posts: 7
    edited October 2007

    I'm in the same boat, RoseG... first mammo after DCIS showed calcifications on good side. Am scheduled for a stereotactic biopsy on Thursday. Oncologist said that chance of DCIS is 50/50, and that if it is, then obviously the Tamoxifen isn't working. She said some decide to have preventive surgery instead of going through the worry and drama in the future. I'm not ready for that, but also not looking forward going through all this again! I hope it goes well for you!

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  • jade56068
    jade56068 Member Posts: 584
    edited October 2007

    Sealady

    I am sorry that you have to face this again....I know that its not a fun thing to deal with.  I am thinking of you and I hope for only the BEST.

    J

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  • geebung
    geebung Member Posts: 1,851
    edited October 2007

    Sealady, I am keeping all my fingers and toes crossed for a benign result.

    Hugs,

    gb 

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  • lvtwoqlt
    lvtwoqlt Member Posts: 6,162
    edited October 2007

    SeaLady, I went through the calcifications once on the left and twice on the right in 2.5 years. the first two times it was ADH the last time it was low grade DCIS. After the second time my doctor also recommended preventive surgery and put me on tamox. After the last time (April this year) I opted for the bilat surgery to get me off the emotional rollercoaster. At first I was not sure if I was doing the right thing but looking back on the past 5 months, I am know I made the right decision.

    Sheila

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  • Member_of_the_Club
    Member_of_the_Club Member Posts: 3,646
    edited October 2007

    Wait a minute, if you have DCIS and are on tamoxifen does it necessarily mean the tamox isn't working? Aren't there er/pr- DCIS?

    I am having a stereotactic in both breasts on Tuesday and there is a concern that I have DCIS in my already treated breast (stage IIb IDC). The calcifications are in a different quadrant of the breast from my original lumpectomy, so would not be considered a recurrence. I know if I have IDC I will have to have a mastectomy, because I've been radiated. I just ahd never heard it would mean my current treatment had failed.

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