Ductal Carcinoma and Mastectomy
Hi all
I’ve been diagnosed with Ductal Carcinoma. Met with the surgeon yesterday and he would like to do a mastectomy on one side with lymph node removal.
The CT scan has shown enlarged lymph nodes but he thinks that could be because there are obvious signs of inflammation on my breast.
I feel removing the lymph is a bit extreme in this case? Is it?
Comments
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Lymph node removal, specifically of the sentinel nodes, is very common and occurs during the majority of mastectomies. Imaging alone cannot confirm or negate that the presence of cancer cells. The only way to know if those lymph nodes are or aren’t affected is with node removal and biopsy. Breast cancer most commonly spreads beyond the breast via the lymphatic system so this is why it’s important to determine if any lymph nodes have already been infected. Again, imaging alone simply can’t determine if you have any affected lymph nodes. Take care
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Thanks for your reply. Would it not be best to do a sentinel node biopsy during surgery rather than removing all the lymph?
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I do not know exactly what your doctor told you. A sentinel node biopsy is most often done during the mx. They run the tests on that tissue while you are in surgery and if the results are positive, they will remove more nodes. If no sentinel nodes are positive, then no more are removed. I haven’t heard of an axillary node dissection done without first determining if any sentinel nodes are positive but I am not a doctor so it’s possible that your circumstances dictate a different approach.
To ease your mind, please give your doctor a call. Were they talking about an axillary node dissection without a sentinel node biopsy and if so, why? Ask specifically about your situation and why this might be the case. Please remember that there may be circumstances where this is necessary but no one here is your doctor. Yes, this sounds unusual but there may be a valid medical reason for it. Just ask! Take care
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Hi @foggydew and welcome to Breastcancer.org. We're so very sorry for the reasons that bring you here, but we're really glad you've found us. As you can already see, our amazing community is full of wonderful members always willing to try and help. You're sure to find great information, andvice, encouragement, and support here — we're all here for you!
There might be some confusion in your diagnosis — you've posted this thread in the Ductal Carcinoma In Situ (DCIS) thread, but the title of your post indicates Ductal Carcinoma (which, if not In Situ, means Invasive Ductal Carcinoma, or IDC). There is a stark difference between these diagnoses and the treatment for them, as one (DCIS) is limited to the ducts within the breasts and would NOT require a node removal as there has been no spread outside of the duct. Conversly, with IDC, this is cancer that HAS spread outside of the duct and into other parts of the breast, and runs the risk of potentially traveling to nearby lymph nodes, which would then require removal for testing. Have you confirmed with your doctor which type of diagnosis you're facing? Here is some more information you can read about each of these:
There's also some good information about when lymph node removal is used:
We hope this helps explain some things. Let us know what you find out and what other questions you have so we can help!
—The Mods
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I’ll send him an email Thank you. Yes he was talking about the auxiliary node removal without biopsy.
I have another question. He mentioned I have Ductal Carcinoma and I said “you mean DCIS?” He said no. It’s ducal carcinoma. Are they not the same thing?
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@foggydew See our post above to answer your question! Looks like we were posting at the same time!
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IDC is when it invades other tissues. It has not.
So wouldn’t it be DCIS?
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foggy dew,
As the moderators mentioned, ductal carcinoma in situ,DCIS, and invasive/infiltrating carcinoma (IDC) are two very different things. I didn’t notice that you posted this in the DCIS forum. So your first question should be to clarify whether it’s DCIS or IDC. It is possible and not uncommon to find both, but the treatment for IDC, an invasive cancer, will also treat the non-invasive DCIS. Take care
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Exbrncgrl, it hasn’t spread to any tissues.
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No, IDC is when it breaks out of the ducts but remains in the breast. It is invasive but considered local . You may be thinking of breast cancer that moves beyond the breast, metastatic, to other organs. IDC has the potential to move beyond the breast which is why treatment is important. DCIS is when the cancer remains fully in the duct. It is not invasive and cannot spread but, if not treated, it can undergo changes and become invasive. Please check out the links the mods provided.
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See my message above. You can have an invasive cancer confined to the breast, IDC. DCIS is confined to the ducts and cannot spread ( but needs to be treated as explained above). Rather than us guessing, wait for your doctor to respond or call.
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Right. I understand now. Strange he didn’t specify when I met with him. What test / scan would show this information?
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Your biopsy results should give you this info. Remember, it is not uncommon for both IDC and DCIS to be present. Treatment will be focused on IDC but will take care of any DCIS as well.
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Thank you for all your help.
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@foggydew This information should also be helpful about what the pieces of your pathology report mean:
In particular, this section:
Understanding Your Pathology Report (breastcancer.org)
Let us know how else we can help!
—The Mods
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