1. < Breast Cancer

Estrogen/Progestrone medication & DCIS Stage 0 Grade 3 diagnosis

Posted by badkitty @badkitty, 6 days ago

Hello,

The following is my breast biopsy results:
Right upper outer breast, biopsy: Ductal carcinoma in situ, nuclear grade 3 with comedonecrosis and microcalcifications. "right breast calcification, upper-outer, bar clip" are five white-tan fibrofatty core(s) ranging from 1.2 to 1.8 cm in length. Four of the cores are in chambers that indicate calcifications.

In reading this it sounds like my DCIS stage is very good being 0 but my grade being 3 is not. The cells are very active and are growing? What does all this mean above? I have an appt with the oncologist surgeon on June 26th.

I will have another mammogram done but this will be with contrast. Is this better than a MRI?

My main question is. I was on Dotti patch(estrogen) and Prometrium(progestrone) did this medicine kick start my DCIS? I have stopped taking the medication.

They are already talking lumpectomy/radiation or mastectomy. I’m trying to wrap my head around this.
Thank you,
Christine

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Mentor
Laurie, Volunteer Mentor | @roch | 6 days ago

@badkitty

Welcome to Mayo Connect
You're in same situation many of us have been, you are getting information and trying to digest all of it.

There is lot of imaging options, and the provider orders the one that is appropriate in your situation. Same with surgery, different options. In my case, a MRI with contrast was done once biobsy confirmed cancer. I never had a mammogram with contrast. You can definitely can ask your provider why he recommend mammogram vs MRI.

On your question about Dotti patch and Prometrium , I am not sure you will ever know if that had any impact on you having cancer.

Do not be pressured or rush into a decision about surgery type. It is best to go into appointment with list of questions, listen to the options, ask your questions and then take time to think about.

There has been previous discussion about questions to ask .
The American Cancer Society has very long list of possible questions, all do not apply to you but you might want to pick out the ones your most concern about.
https://www.cancer.org/cancer/types/breast-cancer/understanding-a-breast-cancer-diagnosis/questions-to-ask-your-doctor-about-breast-cancer.html

I would definitely ask about genetic testing and lymph node involvement because they may affect your decision on type of surgery and follow on treatment.

If not sure after talking to surgeon, you can always can get an 2nd opinion.

Do you have someone to go to appointment with you? Another set of ears helps.

REPLY
2 replies
windyshores | @windyshores | 6 days ago
In reply to @roch "@badkitty Welcome to Mayo Connect You're in same situation many of us have been, you are..." + (show)
@roch

@badkitty

Welcome to Mayo Connect
You're in same situation many of us have been, you are getting information and trying to digest all of it.

There is lot of imaging options, and the provider orders the one that is appropriate in your situation. Same with surgery, different options. In my case, a MRI with contrast was done once biobsy confirmed cancer. I never had a mammogram with contrast. You can definitely can ask your provider why he recommend mammogram vs MRI.

On your question about Dotti patch and Prometrium , I am not sure you will ever know if that had any impact on you having cancer.

Do not be pressured or rush into a decision about surgery type. It is best to go into appointment with list of questions, listen to the options, ask your questions and then take time to think about.

There has been previous discussion about questions to ask .
The American Cancer Society has very long list of possible questions, all do not apply to you but you might want to pick out the ones your most concern about.
https://www.cancer.org/cancer/types/breast-cancer/understanding-a-breast-cancer-diagnosis/questions-to-ask-your-doctor-about-breast-cancer.html

I would definitely ask about genetic testing and lymph node involvement because they may affect your decision on type of surgery and follow on treatment.

If not sure after talking to surgeon, you can always can get an 2nd opinion.

Do you have someone to go to appointment with you? Another set of ears helps.

Jump to this post

If your testing shows your cancer is hormone positive, you can have an Oncotype DCIS done which will help guide treatment. People who take hormones get cancer, and people who don't take hormones get cancer. No way to know and I hope you are not feeling regret.

You will probably do well once you have answers and a plan. I am 9 years out from a grade 3 invasive cancer that invaded my lymph vessels. Keep coming back with questions that can hlep you with your doctor!

REPLY
christylv | @christylv | 5 days ago

I had DCIs stage 0 grade 3 as well. I choose to have a lumpectomy plus radiation. Soon I will be starting tamoxifen. The area was very small and caught early. The surgeon was not bad at All. I did not take the pain meds, just some Advil and Tylenol. Finished radiation two weeks ago. Went ok. Just some mild pains in breast and some redness. Which is now healing. Good luck with your decision. Listen to your doctors. They will help you make the right choices.

REPLY
1 reply
badkitty | @badkitty | 5 days ago
In reply to @roch "@badkitty Welcome to Mayo Connect You're in same situation many of us have been, you are..." + (show)
@roch

@badkitty

Welcome to Mayo Connect
You're in same situation many of us have been, you are getting information and trying to digest all of it.

There is lot of imaging options, and the provider orders the one that is appropriate in your situation. Same with surgery, different options. In my case, a MRI with contrast was done once biobsy confirmed cancer. I never had a mammogram with contrast. You can definitely can ask your provider why he recommend mammogram vs MRI.

On your question about Dotti patch and Prometrium , I am not sure you will ever know if that had any impact on you having cancer.

Do not be pressured or rush into a decision about surgery type. It is best to go into appointment with list of questions, listen to the options, ask your questions and then take time to think about.

There has been previous discussion about questions to ask .
The American Cancer Society has very long list of possible questions, all do not apply to you but you might want to pick out the ones your most concern about.
https://www.cancer.org/cancer/types/breast-cancer/understanding-a-breast-cancer-diagnosis/questions-to-ask-your-doctor-about-breast-cancer.html

I would definitely ask about genetic testing and lymph node involvement because they may affect your decision on type of surgery and follow on treatment.

If not sure after talking to surgeon, you can always can get an 2nd opinion.

Do you have someone to go to appointment with you? Another set of ears helps.

Jump to this post

My husband will be attending my appointments from here on out. I did find a comprehensive list of questions to ask and have printed it off, weeding out the questions that are not applicable to me. Before I go in for the mammo with contrast I was hoping to know why it was preferred over the MRI. The answer from my contact at Mayo was “this is what the doctor requested”. Not real helpful. But…. I will trust the process. Thank you for responding I do appreciate it!

REPLY
1 reply
Mentor
Laurie, Volunteer Mentor | @roch | 5 days ago
In reply to @badkitty "My husband will be attending my appointments from here on out. I did find a comprehensive..." + (show)
@badkitty

My husband will be attending my appointments from here on out. I did find a comprehensive list of questions to ask and have printed it off, weeding out the questions that are not applicable to me. Before I go in for the mammo with contrast I was hoping to know why it was preferred over the MRI. The answer from my contact at Mayo was “this is what the doctor requested”. Not real helpful. But…. I will trust the process. Thank you for responding I do appreciate it!

Jump to this post

@badkitty
If your test is at Mayo, you can send your provider a portal message asking why they ordered the mammogram with contrast vs the MRI. There is probably a reason and the provider should answer that question.

REPLY
doxielover1 | @doxielover1 | 5 days ago

I just finished my radiation from DCIS stage 0 grade 3. I did a little extra radiation because I’m not going to do the AI inhibitors. Just had a lumpectomy and got it all with clear margins. The radiation really got me down and I thought I was in pretty good shape! My friend had stage 0 grade 3 and had a double mastectomy! I did have the MRI though. Mine was very small like it sounds like yours is too.

REPLY
1 reply
doxielover1 | @doxielover1 | 5 days ago
In reply to @christylv "I had DCIs stage 0 grade 3 as well. I choose to have a lumpectomy plus..." + (show)
@christylv

I had DCIs stage 0 grade 3 as well. I choose to have a lumpectomy plus radiation. Soon I will be starting tamoxifen. The area was very small and caught early. The surgeon was not bad at All. I did not take the pain meds, just some Advil and Tylenol. Finished radiation two weeks ago. Went ok. Just some mild pains in breast and some redness. Which is now healing. Good luck with your decision. Listen to your doctors. They will help you make the right choices.

Jump to this post

How many radiation treatments did you have? I had 20….not bad burning but wow I am fatigued and anxious! Just passed 2 weeks out and can kinda tell it’s easing up!

REPLY
1 reply
Rubyslippers | @triciaot | 5 days ago

I had requested a mammogram with contrast instead of a 3D mammogram at my first follow up after surgery because I thought it would find new cancer better for me. I had very few calcifications with my DCIS. The contrasting agent can better highlight the vascular system - maybe finding a cancer because of the angiogenesis instead of calcifications. I was at a very large comprehensive cancer center and was told they were only using contrast with mammograms for research purposes. They had limited units to handle this method. This was in 2022.
If there were a reason they were intentionally looking for angiogenesis in your situation they may have chosen the mammogram with contrast.

I could not find info on whether MRI is better than a mammogram with contrast in finding angiogenesis. But MRI is better overall in finding lesions.
A dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is superior in finding angiogenesis from articles I found. Evidently a DCE-MRI may use the same contrasting agent (gadolinium is often used) but it’s the way the images are captured that is different.

Hope that helps. If they are suggesting too many mammograms, with or without contrast, in the same year you might want to be aware of your radiation exposure.

REPLY
christylv | @christylv | 4 days ago
In reply to @doxielover1 "How many radiation treatments did you have? I had 20….not bad burning but wow I am..." + (show)
@doxielover1

How many radiation treatments did you have? I had 20….not bad burning but wow I am fatigued and anxious! Just passed 2 weeks out and can kinda tell it’s easing up!

Jump to this post

I had 21. Yes I was tired a little too. Mainly hit me in the evening after 7pm. Are you taking any hormone blockers ?

REPLY
1 reply
christylv | @christylv | 4 days ago
In reply to @doxielover1 "I just finished my radiation from DCIS stage 0 grade 3. I did a little extra..." + (show)
@doxielover1

I just finished my radiation from DCIS stage 0 grade 3. I did a little extra radiation because I’m not going to do the AI inhibitors. Just had a lumpectomy and got it all with clear margins. The radiation really got me down and I thought I was in pretty good shape! My friend had stage 0 grade 3 and had a double mastectomy! I did have the MRI though. Mine was very small like it sounds like yours is too.

Jump to this post

Why did your friend choose mastectomy? Did she get reconstructive Also?How is she doing now?

REPLY
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