I was diagnosted with DCIS

Hi!

It sounds like they got good margins when they removed the DCIS, so I think there's a good chance this will be the end of it. Remember that DCIS is contained in the ducts and hasn't spread elsewhere in your body. If they got it with good clean margins, you're in good shape. Make sure you go to the DCIS section on this site and read up on it. That's what I did when I was diagnosed and it really helpedme understand what I was dealing with.

Wishing you well.

Linda

I'd just like to add that it looks like your doctor is very concerned with getting you all the info you need and I love that you got this website. I found this on my own after my DCIS/Paget's diagnosis, and it has been helpful beyond words. You'll get such fabulous help and support here!

Red, lumpectomy is the surgical removal of the lump, as when you had your fibroadenoma removed.  Another name is excisional biopsy, though I think by definition to some lumpectomy and excisional biopsy are 2 different things.  In the end it's all the same, you had something surgically removed.  To go with no rads the doctors like to have 1 cm (10 mm) of clean margins, meaning no DCIS.  2mm is cutting it kind of close.  A lot of women go on to have a second surgery in order to remove more tissue so that they can obtain that goal of 1 cm.  (I guess you could think of it like an egg, the yellow part being the DCIS and surrounding that is the white of the egg, they would want to have 1 cm of that white stuff.)

If you google Melvin Silverstein and Van Nuys Prognostic Index (VNPI) you can get a general idea of what your treatment options are.  There are two VNPI's out there, the newer one has age added in as a factor, along with the other 3 factors - size of DCIS, margin and tumor grade .  As Rockwellgirl said above they are a little more agressive with younger women, but if everything else if favorable, margins, size and grade, than no rads may be an option for you.  Most likely you will be talking to a radiation oncologist just to get his/her opinion.

I was recently diagnosed with DCIS. I have the pathology report but only understand parts of it.  In short, it reads that I have, Apocrine DCIS, intermediate nuclear grade with intraluminal necrosis,arising in a background of hylinized sclerosing nodule. also says that I have ductal hyperplasia & microcalcifications. In addition, I have had silicone breast implants for about 20 years.  I need to decide between lumpectomy followed by radiation or a mastecomy.  The surgeon said that having the breast implants makes it harder to see if other cancer has formed & the calcifications mean that I am at higher risk of it recurring. Any advice with any of this? Anybody with breast implants & DCIS?      

Hey Kim!!!

Troubled -I am here and yes I did have implants and DCIS and many fibroadenoma over the years.

As far as the cals making it higher risk for recurrence, don't think so!!!  DCIS intermediate which you have I believe, if they get clear margins you have a small chance of recurrence.  Read some great books on breast cancer in the library or Borders and research DCIS!  Ignore the part when some in my opinion ignorant dr's would like to call this PRE_CANCER, it is NOT precancer it is pre invasive cancer if they find you do not have any invasion or microinvasion.

Implants can hide or shadow cancer, but that is not likely if the implant is UNDER the muscle.?  Was yours placed above the muscle if so then your dr is right and you should take their advice on how to proceed from here with implants in place or not!  Mine is under the muscle and NO dr ever told me they would cause them to miss a cancer with the screening I was doing every 6mths, ultra,mammo and MRI.

Implants in do make surgery a little more nerve racking for the surgeon but I have had probably 8/9 since my implants had been placed in 1997/8 , Can't remember which!  It is doable with implants I had lumpectomies and wide excession with the implants in and no leaking or ruptures ever occurred!

I have had the same wordage on some of my many path reports through the years that you posted here.  I had the DCIS in two areas and it was high grade comedeo, (sp). 

Please pm with with any specific questions!  Glad to help you through this. 

Regarding radiation.....I believe that age is not a factor.  Most doctors surgeons and oncologists will advise you that if you are having a lumpectomy, follow up with radiation.  When I went through radiation, there were all age groups, 20, 30, 40, 50, and even late 60's and although not all had DCIS, the one who was 34, the one who was 51 (me) and the two who were 62 and 66 did have DCIS.  The radiation recommendation was based on clinical research findings that a lumpectomy followed by radiation as opposed to lumpectomy alone was the best outcome route to take.

Red, it is so frightening to hear that you have cancer, but dcis is not life threatening as you probably know. Like you I have no family history of BC. Total bad surprise. I had lumpectomy and 6 weeks of radiation. I am 2 weeks post treatment and feeling normal again, physically and almost back to normal mentally as well. Just have to be more vigilant with screening which, in the long run, may be for the better.

Red Bubbles, the question that comes to my mind is "what does your doctor recommend you do?"  With an area as small as yours opting for no radiation is a possibility, but you most likely will need to have larger margins.  Have you discussed this with your doctor?  A lot of the people here get second or third opinions, it's a good idea to talk to more than one doctor.  After I was diagnosed I feel into quite a severe depression.  The doctors couldn't understand why because my prognosis was good.  I know this is a very scary time for you and you have every right to feel sad and confused.  I hope your doctor is giving you some kind of guidance this.  Let us know what he/she suggests for you as the next step.

Red, I am in a similar boat. Diagnosed with DCIS, 20mm, comedo, grade 3; however,  I do  have it in my family, and I am age 50.

I had the excision biopsy 3 weeks ago. still hurts. I have a MRI on Friday for both breasts. I am deciding between lump and mast - after you read awhile it all starts to be less overwhelming, but at first I was feeling as you are. I understand that the rads arent a piece of cake, meaning they are exhausting, etc. I am also leaning toward more aggressive treatment than less. I decide by 6/19. w/Surgery in July.

Red Bubbles, Having a re-excision is a good next step.  This way you will know for sure how large an area of DCIS is there and you will be able to get larger margins.  Hopefully, there will be no more cancer cells and only nomal tissue will be found.  It is really hard to make a final decision until you know for sure what's cookin'.  Do you have a date scheduled for this yet?

I don't understand all the pathology behind the difference between LCIS and DCIS other than one starts in the lobules and the other in the ducts.  For some reason LCIS does NOT go on to become invasive but is more of a risk factor for breast cancer to occur in either breast.  DCIS, on the other hand can become invasive.

Hi Red. What ever happened? Did you have your surgery? Did you get bigger margins? You had pretty much my Dx. 4mm DCIS, micropappilary, cribriform. Mine was all removed in biopsy, so I achieved my margins the first go. I was 45 at the time. No rads recommended. I am on tamox. It's not too bad, some night sweats, irregular periods. I get a vaginal ultrasound every 6 months to moniter the lining as well as my pre-DCIS fibroids. Our pathology is really great. Chances are very high that it will be behind us. It's taken me about a year to stop thinking about it as much. There is a good book called "Assess your true risk of breast cancer". You can get it at Amazon. It's written by a geneticist named Patricia Kelly and she does a very nice job explaining DCIS. Good Luck!