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Topic: Deciding on treatment this week

Forum: DCIS plus HER2-positive Microinvasion —

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Posted on: Sep 22, 2018 12:34AM

Justkeepmoving wrote:

The origional diagnosis was DCIS high grade ER/PR negative. DCIS tumor was large, pushing up against my nipple and painful. MRI showed other areas of probably DCIS. I decided to get a mastectomy - pathology showed microinvasion.

I really believed that with such a small involvment of invasive cancer it would be determined that removing the whole breast and having no lymph node involvement would mean I'm "cured" (I know - that word isn't used much here) but my oncologist is looking into my recurrence risk factors and is suggesting chemo. More details to follow but this is strange for me as I keep having an understanding that I only had DCIS.

The microinvasion is ER + 51%, PgR + 19% and HER2 +

Also mentioned is luminal B

I'll learn more later this week and get my Drs recommendations but my head is swimming with questions. Could the biopsy have caused this microinvasion? What are the long term effects of the chemo?

Dx 5/22/2018, DCIS, Left, 5cm, Stage 0, Grade 3, 0/1 nodes, ER-/PR- Dx 6/29/2018, IDC, Left, <1cm, Stage IA, ER+/PR+, HER2+ Surgery 6/29/2018 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Sep 22, 2018 02:05AM - edited Sep 22, 2018 02:07AM by WC3

It can. However the biopsies are necessary in most instances to determine the course of action and if cancer is confirmed, treatment is usually commenced.

It's impossible to say if that is what caused the microinvasion though. DCIS cells often escape the duct only to be pulled back in by cells lining the duct. It becomes IDC when cells manage to escape being pulled back in.

Pathologic complete response (pCR) to chemotherapy. Dx 2018, IDC, Left, 3cm, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 5/31/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 11/14/2018 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy Arimidex (anastrozole), Zoladex (goserelin) Targeted Therapy Perjeta (pertuzumab) Targeted Therapy Herceptin (trastuzumab) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Sep 22, 2018 06:44AM Justkeepmoving wrote:

thank you. That's very interesting

On the pathology report the line just next to the description of the microinvasion describes an area of necrosis associated with a biopsy. It doesn't say how close these areas are together or if it's related - but I was trying to rationalize that I don't have invasive carcinoma or microinvasion at all - that it was all caused by the biopsy.

But I guess just having those cells outside of the duct is bad to have... I'll let the experts do their thing and inform me of what they found.

I don't want to worry or care but here I am worried about something I don't even have all of the facts about. And I'm upset both about getting chemo and upset thinking they might decide that I don't require chemo possibly leaving cells in me someplace in my body.

I realize this is all babbling. Again I feel like I don't have all of the information and it's frustrating.

Dx 5/22/2018, DCIS, Left, 5cm, Stage 0, Grade 3, 0/1 nodes, ER-/PR- Dx 6/29/2018, IDC, Left, <1cm, Stage IA, ER+/PR+, HER2+ Surgery 6/29/2018 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap

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