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DCIS with microinvasion

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flowergirl1975
flowergirl1975 Member Posts: 57

Hello Everyone. I am 48 and just diagnosed with BC on April 19th. I have been having diagnostic mammograms for about 5 years (twice a year). Ladies at the breast center say I have "busy breasts" cysts, calcifications, etc… Mammogram in March came back as a BI-RADS 4b for a lobulated hypoechoic lesion with internal blood flow. A few days later I had a biopsy which came back as a papillary lesion with atypia. I was referred to a surgeon, had a savy scout procedure with an excisional biopsy a few days later. Up until this point I was doing pretty good. Until my biopsy results came back….. DCIS, grade 2, crib form, solid, papillary and flat type, with lobular extension, focal necrosis, microcalcifications, and focal microinvasion. DCIS measures 2.1 cm and involves a papillary lesion. I am ER/PR + (not sure about HER2-not enough tissue), Ki-67 is 15%. I remember a feeling of overwhelming sadness for some time after learning the news. I have spent so much of my time googling (I know bad) my diagnosis, prognosis, biopsy results you name it. I know this is early stage which I am thankful for, still very scary. When reading about others experiences it has helped me not feel so alone in this crappy journey I am now on. Tomorrow I have an MRI since the biopsy did not have clear margins, Friday I am scheduled for a lumpectomy along with sentinel node biopsy. Friday's plan may change based on MRI results (hopefully not). On one hand I can't wait for the MRI because I want to know what I'm dealing with, on the other hand I am scared because what if it's worse? What if it's in my lymph nodes, lots of "what if's" run through my mind and of course it's always bad. Thanks for listening/reading :-)

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  • suncris
    suncris Member Posts: 5
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    I can relate to what you are experiencing. I am 46 and was diagnosed with BC on 4/24. High grade DCIS of the right breast with microinvasive carcinoma. I had an MRI last week and it came back with indeterminate areas. I am now waiting on a MRI guided biopsy next week. I too have been researching and looking up everything. It’s been an exhausting couple of weeks. It’s hard to think about anything else. Sending good thoughts and prayers to you for a clear MRI and successful surgery.

  • obsolete
    obsolete Member Posts: 333
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    Hi, good luck with your upcoming MRI and lumpectomy. Please bear in mind <4mm papillary lesions can sometimes be covert on MRI. Also be aware that papillary lesions can sometimes present in multiples along chest wall area. Best wishes!

    PAPILLARY NEOPLASMS OF THE BREAST - REVIEWING THE SPECTRUM

    https://www.nature.com/articles/s41379-020-00732-3

    PAPILLARY CARCINOMA OF THE BREAST

    Although concerning, papillary carcinoma of the breast is less likely to spread to the lymph nodes, is more responsive to treatment, and may offer a better prognosis than other types of invasive ductal cancers.

    Papillary carcinoma is sometimes misdiagnosed as intraductal papilloma or papillomatosis.

    https://www.verywellhealth.com/papillary-carcinoma-of-the-breast-430629

    CLINICOPATHOLOGICAL AND IMAGING FEATURES OF BREAST PAPILLARY LESIONS ...

    See "Clinical characteristics of papillary lesions according to pathological examination" in Tables listed for historical stats.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10000596/

  • obsolete
    obsolete Member Posts: 333
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    DIFFERENTIAL DIAGNOSIS OF BENIGN AND MALIGNANT BREAST PAPILLARY NEOPLASMS ON MRI WITH NON-MASS ENHANCEMENT

    https://www.sciencedirect.com/science/article/pii/S1076633223000673

  • baileyjumper
    baileyjumper Member Posts: 17
    edited May 2023
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    Hi flowegirl. I just had almost the same experience as you! I'm 32. Two weeks ago I had the savi scout excisional biopsy to remove a papilloma with atypia. Mine came back as DCIS with clear margins. I'm now choosing between mastectomy or radiation and tamoxifen.

    Best of luck to you.

  • flowergirl1975
    flowergirl1975 Member Posts: 57
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    Good Morning everyone :-) Thank you to each and everyone of you for reaching out! MRI went fine, no issues. Now I just have to wait, hopefully no worse news. Looking forward to surgery Friday (sounds weird) but I just want to get things moving. The tests and biopsies and waiting has been awful on my anxiety.

    Sunchris- I know exactly what you mean. The situation consumes your thoughts. I want to not think about it and continue as I normally would but it's just impossible. I think I have looked at the same studies/websites multiple times. I am sorry for your diagnosis, please let me know how your MRI guided biopsy goes. I will be thinking of you next week and hoping everything goes well.

    Obsolete- thank you for the additional information. Something I hadn't thought about. I will have to read more into that.

    Baileyjumper- I am sorry you are going through this as well :-( Especially at 32!! Was this something you felt? or were you having mammograms already at this age? Its great your biospy came back with clear margins, can I ask why you are considering a mastectomy?

    Lotusconnie- Yes I have read that as well. The studies say its unlikely but my mind of course goes to "what if Im one of the few" :-(

  • baileyjumper
    baileyjumper Member Posts: 17
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    Yes, I started mammograms early because my mom was diagnosed with IDC in October and I found out I have a double Chek2 mutation. I am considering mastectomy as an option because of my higher recurrence risk and because of potential long term side effects with being on Tamoxifen. Plus the stress of having mammograms/mri every 6 months.

  • lotusconnie1999
    lotusconnie1999 Member Posts: 39
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    flowergirl, my heart goes out to you. I pray that you don't have lymph node involvement. Focus on the fact that you have a very early stage of breast cancer and it is caught very early!!

  • flowergirl1975
    flowergirl1975 Member Posts: 57
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    Baileyjumper- It sounds like you are being proactive with things which is good. So much information to process. The stress of waiting for test results is awful so I totally get it.

    Lotusconnie- thank you for your kindness.

    I spoke with my surgeon today about my MRI results. Thankfully DCIS is located to one area, not all over my breast so a bit of good news. Right breast appears to be fine as well. There is an axillary lymph node with mild thickening. Dr said he wasn't too concerned, felt it was a result of the biopsy, savy scout procedure, and recent surgery two weeks ago. The kicker of it is that my MRI showed two areas in my liver. Only showed up in one image, not in any of the other photos. DR spoke to radiologist and they felt it was a result of an mri "artifact" since it did not appear in multiple photos. An oncologist was also brought in and his feelings were that it was not cancer as well, seeing that I was diagnosed with DCIS. It would be very very rare for it to be cancer. Its either nothing, or could just be something benign in my liver. Has anyone else experienced a breast MRI with artifacts? I had never heard of it before until now. I guess it's fairly common. Im looking forward to surgery Friday …another step forward.

  • dsc
    dsc Member Posts: 50
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    I will be thinking of you on Friday. I’ll be about 10 days after you with lumpectomy and SNB, so will be looking for your post surgery report once you are up to it! Wishing you well for your surgery and a speedy recovery. ❤️

  • flowergirl1975
    flowergirl1975 Member Posts: 57
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    Hello! Happy Mothers day to all the moms out there!

    Lotusconnie- Thank you…. Surgeon, Oncologist, and radiologist all feel that its probably an artifact. But until I hear that its nothing its unfortunately in the back of my mind.

    DSC-Im sorry you are going through this too :-( Thank you for your well wishes. Please let me know how your surgery goes as well. Hoping for a best case scenario for you!

    My surgery went well. Not really a whole lot of pain, although I am keeping up with taking my ibuprofen. I feel pretty good other than the drain (which is more annoying than anything) I have it in until Wednesday. My doctor said he took out at least another 2 CM, I think that means I probably have had roughly 4 cm in total of tissue removed. He said there will be a noticeable defect but I don't really care as long as its all out. They did remove a lymph node which will be tested. DR felt confident that he got it all out, we will see in a few days. More waiting for results………ugh.

  • lotusconnie1999
    lotusconnie1999 Member Posts: 39
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    flowergirl, happy Mother’s Day. Glad to know that the lumpectomy went well. I hope the pathology result is good!!

  • dsc
    dsc Member Posts: 50
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    so happy to hear your lumpectomy went well - now the waiting….


    I wish I could say something that would make the waiting easier, but just take this time to rest and heal. Before you know it your results will be available and you’ll be one step closer to this being behind you!

    Thinking of you.

  • flowergirl1975
    flowergirl1975 Member Posts: 57
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    Good Morning! Thank you Lotusconnie, should be any day now. The waiting and not knowing is awful, it consumes my day. I feel as if I have this black cloud hanging over me. I just want to be through this part and on to my treatment stage…ugh! I know the only way to get there is to go through it. My liver MRI is scheduled for next Thursday so I should have answers soon on that. Thanks for you support-Hugs!

    DSC-feeling pretty good since my surgery. Not on pain meds anymore. Going in today to have my drain removed so Im happy about that. I would love to have a real shower…LOL. When do you go in for your lumpectomy ?

    Feeling sad this morning, not sure why. Roller coaster of emotions and I want to get off the ride. Hope everyone has a good day!

  • dsc
    dsc Member Posts: 50
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    Hi flowergirl. Yay for getting your drain removed. I didn’t know I’d have a drain for a lumpectomy. Another thing to look forward to. 😞


    My surgery is Tuesday. Somehow I have to make it through this long weekend. It won’t be anything like previous years. No wine. No get togethers. No excess food. Although I know maybe I should enjoy, I’m just not in the mood.

    I hope you have more answers soon and this crappy waiting game is done, and you can move to the next step.

    Thinking of you. 💕

  • flowergirl1975
    flowergirl1975 Member Posts: 57
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    lotusconnie- I am so sorry to hear about your dad :-( You have some good suggestions thank you for sharing them with me. I did have my drain removed today which was interesting. Didn't hurt, slight pinching once removed. The NP showed me how much of the tube was in my body and I couldnt believe it! I'm happy to have that thing gone. No results yet so I will continue to wait….and wait…… Postive thoughts! Postive thoughts!

  • flowergirl1975
    flowergirl1975 Member Posts: 57
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    DCS- I will be thinking of you as you have your surgery and wishing you all the best. I dont think drains are common for lumpectomy's but I had quite a large amount removed which is why I had one.

    Unfortunately, results were not good. Im quite an emotional mess right now. Margins were not clear. I had another bigger microinvasion, and a positive lymph node. The extent of the cancer was not seen on mammogram or MRI which is the scary part. I will be having a double mastectomy, not sure what my treatment plan will be. Will probably know more next week. The news just keeps getting worse.

  • yippeekiyaymf
    yippeekiyaymf Member Posts: 25
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    Just sending you a huge hug—- I hear you- this all is scary and well Sh&%! - you are not alone

  • moderators
    moderators Posts: 8,290
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    @flowergirl1975 - We're so sorry to hear that! We know this is a difficult time for you, but hopefully the situation will improve once you get a clear treatment plan in place.

    Please come back to let us know how you're doing and what you learn from next appointments. We are all here for you!

    Warmly,

    The Mods

  • dsc
    dsc Member Posts: 50
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    Hi flower girl. This is crap, but now you know and you can start your treatment plan. I completely understand your feelings. I’m a little behind you (surgery on Tuesday) but it seems many of us are feeling the same way (they tell me the beginning is worse but the whole thing has been crap so far). All I can say is that I’ve done a lot of reading and reaching out for support and everything / everyone seems to say the same thing: one step at a time, there are plenty of treatments out there, this will be tough but you can do it, and soon enough this will be behind you. Sending all my positive love your way. 💕

  • flowergirl1975
    flowergirl1975 Member Posts: 57
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    DSC- your surgery will be fine, you will do great!! I really had no issues with my lumpectomy (x2) and you wont either. It will be good to have it over and done with and move on to the next step. Please let me know how everything goes. I will be sending you love and positive vibes as well. Hugs!!!