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Can DCIS be felt?

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jons_girl
jons_girl Member Posts: 444

Hi Friends:

I know this may be a very stupid question. But I haven’t had any dcis only idc. Is it possible to catch DCIS earlyby feeling it or seeing it (breast disfigured)?? I haven’t studied about it. I know it can be seen on mammo and mri. But not seen on ultrasound. Or that’s what I’ve heard.

Just thought I’d ask those of you in the dcis forum.

Thank you in advance for any info you want to share.

Comments

  • jelson
    jelson Member Posts: 622
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    DCIS can present in different ways - diffuse through the ducts - and I assume that can't be felt. Mine plugged a duct forming a palpable lump which I couldn't feel but my primary could. Eventually my enlarged, plugged duct could be seen on ultrasound.

  • beesie.is.out-of-office
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    In a relatively small percent of cases, I think about 10%, DCIS does form a lump, as happened in Jelson's case.

    But usually DCIS cannot be felt. My mammogram imaging looked like salt has been sprinkled around, heavier in some spots, lighter in others. I had a breast full of high grade DCIS and it was definitely not palpable.

    Here is a mammogram image of DCIS, pulled from The Radiology Assistant website:

    image

  • barbara4
    barbara4 Member Posts: 10
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    Can DCIS sometimes be invisible too ? I had extensive DCIS but it was invisible. I had 2 ultrasounds, a mammogram a ductogram and an MRI and they did not see the DCIS. The DCIS, (grade 1)was found during a lumpectomy as I had nipple discharge.

  • beesie.is.out-of-office
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    Yes, with DCIS, particularly grade 1, the calcifications can sometimes be so fine that they aren't seen at all. Eventually, maybe the next year's mammogram, they might show up, but often the DCIS is found incidentally before it is prominent enough to show up on imaging. This is why often when IDC and DCIS are found together, the diagnosis is made based on the IDC appearing on imaging, and the DCIS is discovered by the pathologist, examining the breast tissue under the microscope.


  • barbara4
    barbara4 Member Posts: 10
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    Thank you Beesie

  • jons_girl
    jons_girl Member Posts: 444
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    Beesie thank you for sharing this info with us here! What I have wondered is DCIS seems to almost always be associated with IDC. So I had surgery in 2017. Prior to my surgery all I had was a diagnostic mammogram and a ultrasound. The mammogram which would be able to see DCIS....didn't even see my tumor. Then I had a ultrasound which saw my tumor. I believe ultrasounds can't see DCIS at all. So I am wondering....can a person like myself have DCIS that isn't seen on mammo, ultrasound or missed during surgery? They got my IDC tumor out. I am having my first MRI in November. And I am glad because I am wondering if I should have had a MRI before I had my surgery now looking back. DCIS is interesting stuff. Thank you for sharing that photo. That definately looks like scattered density though. Mine was all white as I recall. I can't imagine they would have been able to see any DCIS if I had any.

    Tami

  • beesie.is.out-of-office
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    "The mammogram which would be able to see DCIS....didn't even see my tumor." No, not all DCIS is visible on a mammogram, and it certainly won't be visible if it's extremely tiny, which is often the case when DCIS is associated with IDC. Lots of people have tiny amounts of DCIS, never seen on imaging, that is found in their pathology.

    "I believe ultrasounds can't see DCIS at all." Generally that is true but in the rare cases where DCIS does form into a mass, it may be visible on a ultrasound. As always, there are exceptions to every rule.

    "can a person like myself have DCIS that isn't seen on mammo, ultrasound or missed during surgery?" As I said in my previous post, if the IDC developed from DCIS, then the DCIS would be in the same area as the IDC and therefore would be removed during surgery and found when the tissue is examined in the pathology lab. This happens all the time. So the fact that no DCIS was found with your IDC means that there was none, or at least that any DCIS that initially developed had evolved to become IDC so that no DCIS remained.

    "Thank you for sharing that photo. That definately looks like scattered density though. Mine was all white as I recall." I have extremely dense breast tissue and my calcifications were visible, although not as large an area was visible on the mammogram as on the MRI. Here are a couple of images of calcifications in dense breast tissue:

    imageimage

    I don't understand why you are concerned about this. Approx. 15% of patients do not have any DCIS found with IDC - so while this isn't the norm, it's not unusual either. And your imaging and surgery found the IDC, which is the more serious condition. DCIS is harmless - the concern with DCIS is that it might develop to become IDC. If your diagnosis did start as DCIS and it did develop to become IDC (a lot of DCIS never progresses any further), well, the IDC was found. So what's the concern?

    The simple truth is that it's always possible that a few cancer cells might be left in the breast after surgery. This is why radiation is always recommended after a lumpectomy. And of course nothing is impossible so yes, it could be that somehow you had some DCIS associated with your IDC that was never seen on imaging and was so tiny and away from the IDC (which frankly would make no sense) and was therefore left in your breast. But your greater risk of recurrence comes from the fact that you had invasive cancer, and a few rogue invasive cancer cells might have been left after surgery. DCIS cells need to undergo a biological change process before they become invasive cancer; that progress can take years and often never happens at all. Invasive cancer cells are already invasive. So when you consider the risks associated with your diagnosis, you are worrying about a much lesser concern. I'm not saying any of this to scare you - hopefully every cancer cell was removed from your breast during surgery and you never have a recurrence - but after having IDC, worrying about some rogue DCIS cells seems to be missing the bigger picture.



  • jons_girl
    jons_girl Member Posts: 444
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    I’m sorry I am sounding concerned. I probably just am concerned about nothing. Thank you for pointing this info out to me again. I apologize.

    Just thought maybe since I never had a mri that something could have been missed even in my other breast. But again I’m probably concerned for no reason. I didn’t have dcis so I am not as familiar with that diagnosis

    Your saying then because I didn’t have radiation I could have a recurrence from rogue cells and I should be more concerned about that I understand that’s a possibility too

    Thank you for taking the time to respond. I probably shouldn’t have said anything.

  • beesie.is.out-of-office
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    jons_girl, no need to apologize. But you do seem very concerned about the possibility of missed DCIS, and after you appear to be reassured, another post comes out re-stating your concern.

    What I was trying to do was offer perspective. The question as to whether there was DCIS associated with your IDC diagnosis really is a non-issue. Even if some DCIS was missed - which is extremely unlikely - you still face a greater recurrence risk from the IDC itself (although that risk might be small, depending on your diagnosis).

    Whether there might be some DCIS somewhere else in your breast or in your other breast is a completely different issue. Everyone diagnosed one time with breast cancer is higher risk (than the average woman) to be diagnosed again. This could be DCIS or it could be invasive cancer. So yes, it's possible that something could be developing somewhere else in either of your breasts. Since many breast cancers are present for 3-5 years before they become large enough to be detected, the beginnings of that new diagnosis might even have been present when you were diagnosed last time, but might have been too small to see (even MRIs don't see small tumors or newly developing DCIS). You are a woman, you have breasts and breast cancer can develop. Hopefully you aren't diagnosed a second time - and the odds are in your favor that you won't be - but this is why it's important that anyone who's had breast cancer get regular screenings, and ideally, two modalities of screening. Here again, this risk of a new primary cancer, whether DCIS or IDC, is greater than the risk that some DCIS might have been missed with your last diagnosis.

    Again, that's not to scare you but to put your concern about whether some DCIS might have been missed with your last diagnosis into perspective. After an invasive BC diagnosis, we all face 3 risks - risk of a local recurrence, risk of a metastatic recurrence, risk of a new primary breast cancer. That's just something we have to live with - nothing can change that, not any screening and not even a BMX. There's no need to add a 4th worry about something that is less likely and presents less risk.

    Listing off the 3 risks we all face probably didn't make you feel any better! Scared



  • jons_girl
    jons_girl Member Posts: 444
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    thank you Beesie. Yes I'm aware of the risks and my personal risks too. No it doesn't scare me as I already knew that. I shouldn't have brought my concern up on this board. If I could delete the thread I would do so. Thank you for your posting this info. If anyone else has concerns like I had then they'd be able to read what you posted. I appreciate that info and reminders since you already posted that's before

    I will be having another check up in November this timemy first breast mri. I’m sure all will be fine.

  • minustwo
    minustwo Member Posts: 13,077
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    jon's girl - of course you can always ask questions on this board. I've read the posts on both of the sites about this issue and all of the answers you've received. We understand you are nervous. I'm sorry you deleted your posts since as you recognized, others in the future can learn from past questions.

    My immediate response was - who cares about the DCIS since you've been diagnosed with IDC. That may not sound very caring, but I don't mean it to be rude. I had DCIS when it was still considered cancer - and now it is no longer considered cancer. As Beesie says, worrying about that is a non-starter since you've had IDC.

    I can't remember & your data doesn't say - did you have radiation? I know that's the gold standard after lumpectomy. Hope you're able to put this concern away.

  • jons_girl
    jons_girl Member Posts: 444
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    hi minus two: No worries I am always nervous before my next scan it’s just me

    I’m sorry I deleted my posts. I just felt silly about leaving my posts on the thread after all the talk today so I deleted them. It’s ok. Beesie gave all the info people would need if they had the same questions. I appreciated the info she shared with the group. I just had silly concerns and questions. So I deleted my posts. It’s ok. I wasn’t really contributing I didn’t think.

    No I didn’t have radiation. My medical oncologist supported my decision. If my cancer came back I didn’t want no option for radiation and my only choice to be mastectomy. My tumor was very small like 4mm. Like a bb. Stage 1 grade 1

    Because I had not had dcis, only IDC, I didn’t know a lot about dcis but i had wondered sone things about it. That’s why I asked the questions. I’m still learning stuff about breast cancers. No worries tho. The concerns and questions about dcis have been put away.

  • ammie
    ammie Member, Moderator Posts: 7
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    Hi Jon’s Girl,

    I have recently been diagnosed with DCIS, but my area of DCIS involves 3 palpable masses. (I first felt 2 tiny, distinct lumps a few months ago, now I am aware of 3 lumps.) These findings are based on needle biopsy, mammograms, ultrasounds, and MRI. I’ll be going in for UMX

    I actually have the opposite concern: that my final pathology report will show IDC as well as DCIS.

  • lastar
    lastar Member Posts: 551
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    Several women, as did I, reported feeling a tingling like "milk letdown" felt when breastfeeding. There's a thread here somewhere.

  • jons_girl
    jons_girl Member Posts: 444
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    Ammie: I’m sorry for my late response. 😕Thank you for sharing your experience regarding your Dcis. I hope your recovery goes well. We are here for support. I hope no IDC is found. 💐 you’ve had a lot of diagnostics!

    Lastar: thanks for sharing that info about Dcis symptoms. That’s interesting. I’m not sure I have ever heard of that symptom. So that’s good to know.