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Topic: DCIS with >10 areas of microinvasion

Forum: DCIS plus HER2-positive Microinvasion —

Meet others with this diagnosis.

Posted on: Mar 17, 2019 12:25PM

AMLMom wrote:

Hi Ladies, I’m getting ready to meet my MO for the first time next week. Has anyone else had a large area of DCIS with multiple areas of microinvasion? In addition to a small IDC grade 3 tumour (.6cm), I had “>10” areas of microinvasion. Has anyone had a similar diagnosis? If so, what was the treatment? How does it impact prognosis?

Also, would the Oncotype contemplate a 9cm DCIS tumour, or just count the IDC portion of the tumour?

Thank you

Dx 11/2018, DCIS/IDC, Left, 6cm+, Stage IA, Grade 3, 0/2 nodes, ER+/PR+, HER2- (IHC) Surgery 2/13/2019 Lumpectomy: Left; Lymph node removal: Sentinel; Reconstruction (left) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy Whole-breast: Breast, Lymph nodes
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Mar 17, 2019 12:57PM - edited Mar 17, 2019 01:01PM by Beesie

10+ microinvasions is certainly unusual. But a microinvasion is at most 1mm in size. The 6mm IDC tumor trumps the microinvasions and trumps the DCIS. Your diagnosis and treatment plan will be based on that 6mm invasive tumor; the microinvasions and DCIS will be satisfactorily treated by whatever is done to address this larger tumor. Your staging will be based on only the size of the largest IDC tumor, which in your case is 6mm. The micro invasions are not added into the size, and the size of the DCIS is ignored completely.

Although there are separate Oncotype tests for DCIS and for IDC, only patients who have pure DCIS are eligible for the DCIS Oncotype, which assesses the need for and benefit of radiation. The invasive cancer Oncotype, which assesses the need for and benefit of chemo, would be used in your case, and does not look at the DCIS component. The invasive cancer Oncotype test analyzes 21 genes within the tumor. It does not incorporate the size of the tumor into the scoring. Your test will be done on the tissue from the 6mm tumor.

The only way that the DCIS would come into play when a tumor includes both DCIS and IDC is in consideration of the surgery, if the DCIS is near the margins or is widespread and as a result necessitiates either a re-excision or a MX.


“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Mar 17, 2019 01:05PM AMLMom wrote:

Hi Beesie, thank you as always. Very helpful.


Dx 11/2018, DCIS/IDC, Left, 6cm+, Stage IA, Grade 3, 0/2 nodes, ER+/PR+, HER2- (IHC) Surgery 2/13/2019 Lumpectomy: Left; Lymph node removal: Sentinel; Reconstruction (left) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy Whole-breast: Breast, Lymph nodes

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