DCIS on biopsy but not in any of the lumpectomy

Donna and Sheila, thanks for your comments and encouragement. I really did not realize until I started reading articles about a month ago how much uncertaintly there was in all of this. A couple articles I read said that when their is DCIS in the biopsy then the pathology on the surgery should consider the ADH to be part of the DCIS for margins. I think I will be fine and feel fortunate to have found it early. 

bumping

I had one tumor that 'supposedly' was all removed with an MRI guided bx.  When the whole breast was removed they didn't find any of it in their where the little marker was left the week before. I'm still not 'trusting' about it.  For the most part, it was this second ILC 1cm lump in another quadrant that made the decision for a lumpectomy a no-go   I just asked for that report to be sent to me (the original bx on it) to see what was actually said, b/c it's the only one I didn't get from doc.

That's really interesting! I would wonder too!  DId you ask?  I was surprised, that they ran that MRI after they placed it (the clip), b/c I though they were metal, apparently not?

Wishiwere & soonergirl--

About that clip:  When I had a core biopsy done on my lump last month, they inserted a very small titanium clip right where the biopsy was taken.  The radiologist assured me that 1) it would not interfere with an MRI (it was safe even though it was metal) and 2) it would not set off any security alarms at the airport.  He volunteered that info as if it had been asked before. 

I had a quick, 1-view mammogram a few minutes later, to be sure the clip was where they thought they had put it.  (It was I guess.)  A week later, I had a breast MRI.  When I checked in for the procedure, I mentioned the titanium clip.  The MRI people said it would not cause any problem at all.  I said I just wanted to be sure, 'cause I didn't want that thing to come shooting out of my breast and across the room or anything.  They laughed and assured me it would not move.

BTW, the radiologist said the titanium clip was in the shape of the symbolic BC "loop". Kind of neat, if that's true. 

you know?  Now that you said that, I do remember her saying titanium!  And I asked the same thing?  Won't the MRI magnet just rip it out my breast?  I envision something like you, seeing my breast tissue plastered all over the inside the unit I was in!  Still strange they couldn't find in the breast tissue after the mast. I mean, after all, as small I am, they didn't have to dig for it at all? 

the exact same thing happened to me!!- in fact i kept posting and asking if anyone had experienced this and when no one replied i thought i must be crazy so i am pleased to finally have company (not in being crazy :-)  )  in august of 05 they "found" DCIS in my right breast - not such great news since i had already had a lumpectomy and radiation for ILC in my left breast in october of 04- but i had another lumpectomy and the surgeon said it was "the cleanest breast tissue he had ever removed" - when sent to pathology there was no DCIS- anywhere!! so that was my question- where did it go? no one ever had a clear cut answer- my radiologist said it did indeed sometime all come out during the steriotactic biopsy and since is was so small that is what she "suspected" had happened- i feel better knowing i had the lumpectomy and more radiation- it can only improve my chances of survival - i hope!! thank you for this thread

I have read that the clips can migrate--sometimes fairly soon after insertion. So even if they are there right after they put it in it might be somewhere else a couple of weeks later. I too find it reassuring to know that it is not so uncommon to remove the entire DCIS with the biopsy.  I have concluded though that before deciding on the surgical course of action after a biopsy a second opinon from a pathogist may be worthwhile- as there is definitely some interpretation in reading the slides.

I think it happens quite a bit. My stereotactic biopsy removed all of the 4mm of Dcis. The lumpectomy showed no residual disease of any type. Rads were not recommended. I was very relieved.

clr23~ I noticed that another lady who posted in this thread back in Jan. 2008 stated that in 2006 she had DCIS on biopsy but non found on lumpectomy. She opted to NOT have radiation at that time. But if you look at her Dx bio it appears that she had a dx of DCIS/IDC 6 years later and had a MX. I wonder if not having radiation played a part in her new DX. I wish she was here to give her opinion and to let us know how she is doing. See below:

"All of my DCIS was removed at biopsy. None was found in the lumpectomy tissue either. Because my area of involvement was very small, I opted out of radiation (with my docs' blessings) and began Tamoxifen. I consider myself VERY lucky.        

Allergan Natrelle Style 45-700 ccs Dx 10/2005, DCIS, <1cm, Stage 0, Grade 2 Surgery 12/2/2005 Lumpectomy: Left Hormonal Therapy 1/1/2006 Dx 10/2012, DCIS, 6cm+, Stage 0, Grade 3, ER-/PR- Dx 11/7/2012, IDC, 1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2- Surgery 11/7/2012 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 5/16/2013 Reconstruction (left); Reconstruction (right)."

I had a 4mm tumor and when my lumpectomy path report came back there was only 2mm of the nodule left in the specimen. I think that sometimes when the biopsy is done the area is small enough that the tissue samples remove a fair amount.

my breast surgeon told me that this happens sometimes when you are lucky (?) enough to have gotten all of the cells with the biopsy

I had a core biopsy that dx dcis 4mm high grade. Had a lumpectomy and no dcis found. Doctor said biopsy had gotten it all. So radiation was questionable, but I asked for the Oncotype DX for DCIS, which was ordered. Oncotype score came back with high probabability of reoccurance, so I opted for hypofractionated course of radiation. Biopsy also had said it was ER positive, but weakly, at 10 percent. Oncotype test said it was ER and PR negative! Tumor board agreed that the Oncotype test took precedence over the original biopsy result ref ER/PR negativity. So that changed the protocol from having to take hormone blocker, to not taking one, as it is not effective for ER and PR negative dcis.