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Questions regarding Pathology Report for Invasive Ductal Carcinoma

Posted by katrina123 @katrina123, Jan 6 12:03pm

A few days ago, I had lumpectomy surgery for Invasive Ductal Carcinoma, and I just received the pathology report on the patient portal.
Good news--Clear margins for the Invasive Ductal Carcinoma.

Questionable news--The report shows Ductal Carcinoma In Situ: Present.
Nuclear grade 2
report says at least 3 mm.
However, it shows distance from DCIS to Closest Margin: 2mm
So, I have no idea if I have DCIS or not.

This is a big surprise. I will have to wait until Monday to find out what this means for me. I wonder if I will need to have another lumpectomy before my radiation.
Have any of you had this happen to you?

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Rubyslippers | @triciaot | Jan 7 6:02pm

Here is what my pathology report stated after a lumpectomy for DCIS, and they do say “estimated size”. This is from MD Anderson cancer center:

TUMOR
Histologic Type: Ductal carcinoma in situ
Size (Extent) of DCIS: Estimated size (extent) of DCIS is at least (Millimeters): 7 mm
Nuclear Grade: Grade II (intermediate)
Necrosis: Not identified
MARGINS Margin Status: All margins negative for DCIS
Distance from DCIS to Closest Margin: 1 mm
Closest Margin(s) to DCIS: Anterior

The original size from the MRI scan was measured longer, 1.6 cm, and wider, .9 cm. I’m not sure if the change in size was due to the tissue removed during the core needle biopsy, 4 samples were taken, and a fine needle biopsy was also done.

REPLY
2 replies
katrina123 | @katrina123 | Jan 8 8:12am
In reply to @windyshores "@katrina123 I believe sometimes DCIS and IDC are part of the same tumor, and it is..." + (show)
@windyshores

@katrina123 I believe sometimes DCIS and IDC are part of the same tumor, and it is also possible to have a separate DCIS. I get that you are focused on the "estimated." I honestly forget if that language is used for DCIS that has been removed. Your doctor will explain!

Has a mastectomy been suggested? Do you need radiation again? Meds?

I hope you get clarifying info soon so anxiety can be addressed with answers!!

Jump to this post

I am perplexed. How can DCIS and IDC be part of the same tumor? DCIS is the presence of abnormal cells inside a milk duct and IDC is cancer that has moved into tissue outside of the milk ducts.

REPLY
1 reply
katrina123 | @katrina123 | Jan 8 8:20am
In reply to @triciaot "Here is what my pathology report stated after a lumpectomy for DCIS, and they do say..." + (show)
@triciaot

Here is what my pathology report stated after a lumpectomy for DCIS, and they do say “estimated size”. This is from MD Anderson cancer center:

TUMOR
Histologic Type: Ductal carcinoma in situ
Size (Extent) of DCIS: Estimated size (extent) of DCIS is at least (Millimeters): 7 mm
Nuclear Grade: Grade II (intermediate)
Necrosis: Not identified
MARGINS Margin Status: All margins negative for DCIS
Distance from DCIS to Closest Margin: 1 mm
Closest Margin(s) to DCIS: Anterior

The original size from the MRI scan was measured longer, 1.6 cm, and wider, .9 cm. I’m not sure if the change in size was due to the tissue removed during the core needle biopsy, 4 samples were taken, and a fine needle biopsy was also done.

Jump to this post

triciaot,

Thank you. Now I feel better, and I think there might be a good possibility that they took it all out.

REPLY
windyshores | @windyshores | Jan 8 8:50am
In reply to @katrina123 "I am perplexed. How can DCIS and IDC be part of the same tumor? DCIS is..." + (show)
@katrina123

I am perplexed. How can DCIS and IDC be part of the same tumor? DCIS is the presence of abnormal cells inside a milk duct and IDC is cancer that has moved into tissue outside of the milk ducts.

Jump to this post

@katrina123 my DCIS , IDC and ILC were all part of the same mass. That means part of the tumor had broken out of the duct. My cancer was "heterogeneous" or mixed, which made diagnosis tricky because parts of it were even HER2+ and parts HER2-.

REPLY
katrina123 | @katrina123 | Jan 8 3:16pm

Interesting. I don't know very much about DCIS. I am curious what my oncologist and surgeon are going to have to say about the pathology report.

Thanks for the information.

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katrina123 | @katrina123 | Jan 12 1:08pm

triciaot and windyshores,

Just as you both suspected the DCIS was along with the IDC. I had clear margins for both so that is a good thing. Now I will find out in a couple of weeks how much radiation I will need to have.

Thanks for the information.
Katrina

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Moderator
Colleen Young, Connect Director | @colleenyoung | Jan 14 9:39pm
In reply to @fenicks "I'm sorry that I do not have any information for you on the test results. I..." + (show)
@fenicks

I'm sorry that I do not have any information for you on the test results. I do, however, want to acknowledge the heaviness of waiting for an explanation. It is agonizing and I wanted you to know, I hear you. I hope any news you hear is everything good. Hugs

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@fenicks, welcome. Have you also been diagnosed with breast cancer?

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gemjaynes | @gemjaynes | Jan 15 6:17pm

Your course of treatment may depend on the results of an oncotype test of the tumor tissue. I didn't know about this outside lab test and thought all I needed was a lumpectomy and radiation. I was wrong.

REPLY
gemjaynes | @gemjaynes | Jan 15 6:38pm
In reply to @triciaot "Here is what my pathology report stated after a lumpectomy for DCIS, and they do say..." + (show)
@triciaot

Here is what my pathology report stated after a lumpectomy for DCIS, and they do say “estimated size”. This is from MD Anderson cancer center:

TUMOR
Histologic Type: Ductal carcinoma in situ
Size (Extent) of DCIS: Estimated size (extent) of DCIS is at least (Millimeters): 7 mm
Nuclear Grade: Grade II (intermediate)
Necrosis: Not identified
MARGINS Margin Status: All margins negative for DCIS
Distance from DCIS to Closest Margin: 1 mm
Closest Margin(s) to DCIS: Anterior

The original size from the MRI scan was measured longer, 1.6 cm, and wider, .9 cm. I’m not sure if the change in size was due to the tissue removed during the core needle biopsy, 4 samples were taken, and a fine needle biopsy was also done.

Jump to this post

After I had surgery, the report on the portal had quite a few errors. It referred to a "right breast" when the lumpectomy was performed on my left breast. And I still had the scars (plus a big L still written on my left shoulder) to prove it. So your confusing second diagnosis may be an error. I was in a position to write off the errors on my report as a "find and replace" problem, because they had already operated on the correct breast. Holiday weekends are the worst time to come across an alarming discrepancy like that.

REPLY
1 reply
windyshores | @windyshores | Jan 16 8:57am
In reply to @gemjaynes "After I had surgery, the report on the portal had quite a few errors. It referred..." + (show)
@gemjaynes

After I had surgery, the report on the portal had quite a few errors. It referred to a "right breast" when the lumpectomy was performed on my left breast. And I still had the scars (plus a big L still written on my left shoulder) to prove it. So your confusing second diagnosis may be an error. I was in a position to write off the errors on my report as a "find and replace" problem, because they had already operated on the correct breast. Holiday weekends are the worst time to come across an alarming discrepancy like that.

Jump to this post

@gemjaynes I think the "confusing second diagnosis" has been resolved: it is one tumor with both IDC and DCIS.

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