Diagnosed with DCIS: How do I decide on treatment?

Posted by tctredwell1 @tctredwell1, Aug 23, 2022

I was diagnosed with DCIS. I have to go in for a breast MRI with contrast tomorrow to see how active the cancer is. If it’s contained and not very active, do I have to have a lumpectomy?

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1 am 61 yrs old lady lumpactamy done 2 months before waiting for accurate decision pls advice I am afraid for chemo and radiation

Overall Grade: Grade 2 (scores of 6 or 7

Tumor Size: Greatest dimension of largest invasive focus (Millimeters): 10 mm
Additional Dimension (Millimeters): 5 mm
Additional Dimension (Millimeters): 5 mm
Tumor Focality: Single focus of invasive carcinoma
Ductal Carcinoma In Situ (DCIS): Present

Lobular Carcinoma In Situ (LCIS): Not identified
Lymphatic and / or Vascular Invasion: Not identified
Dermal Lymphovascular Invasion: Not identified
Microcalcifications: Present in DCIS

Margin Status for Invasive Carcinoma: see #B -
#E & #G
Margin Status for DCIS: All margins negative for DCIS
Distance from DCIS to Closest Margin: 4 mm
Closest Margin(s) to DCIS: Inferior
REGIONAL LYMPH NODES
Regional Lymph Node Status:
: All regional lymph nodes negative for tumor
Total Number of Lymph Nodes Examined sentinel 1 negative

Estrogen Receptor (ER) Status: Positive (greater than 10% of cells demonstrate nuclear positivity)
Percentage of Cells with Nuclear Positivity: 91-100%

Progesterone Receptor (PR) Status: Positive
Percentage of Cells with Nuclear Positivity: 81-
90%

HER2 by Immunohistochemistry: Equivocal
(Score 2+)
Oncotype score 28
Genetic test positive for braca1

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I was hopeful today that I would go for my mastectomy consult and I would decide to proceed for my DCIS stage 0 high grade - however again as everything things has been in trying to decide what to do it was not clear cut- whoa was not expecting to be scared about the process of making that decision it was scarier then I expected. Again I am not sure what to do - nothing-tamoxifen-radiation…. I just wish god would tell me what the right answer is . For now I am taking some time - going to seek 2nd opinion- anyone know of specialists in Upstate N Y - possibly will travel to ohio to Cleveland clinic

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@pinkybabar1962

1 am 61 yrs old lady lumpactamy done 2 months before waiting for accurate decision pls advice I am afraid for chemo and radiation

Overall Grade: Grade 2 (scores of 6 or 7

Tumor Size: Greatest dimension of largest invasive focus (Millimeters): 10 mm
Additional Dimension (Millimeters): 5 mm
Additional Dimension (Millimeters): 5 mm
Tumor Focality: Single focus of invasive carcinoma
Ductal Carcinoma In Situ (DCIS): Present

Lobular Carcinoma In Situ (LCIS): Not identified
Lymphatic and / or Vascular Invasion: Not identified
Dermal Lymphovascular Invasion: Not identified
Microcalcifications: Present in DCIS

Margin Status for Invasive Carcinoma: see #B -
#E & #G
Margin Status for DCIS: All margins negative for DCIS
Distance from DCIS to Closest Margin: 4 mm
Closest Margin(s) to DCIS: Inferior
REGIONAL LYMPH NODES
Regional Lymph Node Status:
: All regional lymph nodes negative for tumor
Total Number of Lymph Nodes Examined sentinel 1 negative

Estrogen Receptor (ER) Status: Positive (greater than 10% of cells demonstrate nuclear positivity)
Percentage of Cells with Nuclear Positivity: 91-100%

Progesterone Receptor (PR) Status: Positive
Percentage of Cells with Nuclear Positivity: 81-
90%

HER2 by Immunohistochemistry: Equivocal
(Score 2+)
Oncotype score 28
Genetic test positive for braca1

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@pinkybabar1962 is your HER2 being retested with FISH?

I am wondering why your Oncotype is so high with your other info being relatively good.

I would make sure to get a second (or more) opinion if you want more help with decision making.

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@windyshores

@pinkybabar1962 is your HER2 being retested with FISH?

I am wondering why your Oncotype is so high with your other info being relatively good.

I would make sure to get a second (or more) opinion if you want more help with decision making.

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Yes my her2 retested with fish came negative

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@asa13

Hello
Go for the mastectomy. 2012 had DCIS stage 0. Received radiation and a lumpectomy. 2021 DCIS again, had to have mastectomy. I wanted it in 2012 and they did not let me.

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I thought that was it - I was going to do it but the consult was scary for something that may or may not come back… can I ask if you had any reconstructive surgery following your mastectomy-if so what kind ? Also what was your grade of DCIS mine is a lll high of course 😞

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Has anyone experienced large size slightly painful veins under their post lumpectomy breast that are visible under the skin and palpable- running from under breast to abdomen

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@windyshores

@pinkybabar1962 is your HER2 being retested with FISH?

I am wondering why your Oncotype is so high with your other info being relatively good.

I would make sure to get a second (or more) opinion if you want more help with decision making.

Jump to this post

@pinkybabar1962 do you have a high ki67%? Exact Science, the company making the Oncotype, might be able to explain your Oncotype, or perhaps your doctor.
What does your Oncotype report suggest as treatment?

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@ckins105

I thought that was it - I was going to do it but the consult was scary for something that may or may not come back… can I ask if you had any reconstructive surgery following your mastectomy-if so what kind ? Also what was your grade of DCIS mine is a lll high of course 😞

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In 2012 was grade III. And yes, I had reconstructive surgery with implants. It has been a year and two months and I feel fine. Cancer is a lottery, Stay positive and strong.

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@windyshores

@pinkybabar1962 do you have a high ki67%? Exact Science, the company making the Oncotype, might be able to explain your Oncotype, or perhaps your doctor.
What does your Oncotype report suggest as treatment?

Jump to this post

Ki-67 Percentage of Positive Nuclei: 15 %

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@pinkybabar1962

Ki-67 Percentage of Positive Nuclei: 15 %

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That's not high. Hmmm. I wonder what increased your Oncotype. Though I believe for post-menopausal your score still doesn't mean chemo, is that right?

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