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Topic: IDC and DCIS in the same tumor?

Forum: Mixed Type Breast Cancer — Meet others who have mixed type breast cancer.

Posted on: Feb 4, 2015 08:57PM

rleepac wrote:

on my path report it says there was both IDC and DCIS in the same 2.1 cm mass. Not really sure what that means? Does that mean some of it was still at the 'in situ' stage and some of it progressed to IDC? Wouldn't that make it all IDC? I'm confused!

Bekah 1/6/15: Excisional biopsy 2.1 cm IDC in axillary tail, Age 42 at diagnosis. Dx 1/6/2015, IDC, Right, 2cm, Stage IIB, Grade 2, 1/2 nodes, ER+/PR+, HER2+ (IHC) Surgery 1/6/2015 Lumpectomy; Lymph node removal Chemotherapy 3/5/2015 AC + T (Taxol) Targeted Therapy 4/30/2015 Herceptin (trastuzumab) Targeted Therapy 4/30/2015 Perjeta (pertuzumab) Surgery 8/18/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 11/13/2015 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Hormonal Therapy 11/18/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 3/28/2016 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 9/8/2016 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Feb 4, 2015 09:04PM exbrnxgrl wrote:

Both can exist. At this point, it doesn't really matter as you will be treated for the IDC, not DCIS. best of luck to you

Bilateral mx 9/7/11 with one step ns reconstruction. As of 11/21/11, 2cm met to upper left femur Dx 7/8/2011, IDC, Left, 4cm, Grade 1, 1/15 nodes, mets, ER+/PR+, HER2- Surgery 9/7/2011 Lymph node removal: Left; Mastectomy: Left, Right; Reconstruction (left); Reconstruction (right) Dx 11/2011, IDC, Left, 4cm, Stage IV, Grade 1, 1/15 nodes, mets, ER+/PR+, HER2- Hormonal Therapy 11/21/2011 Arimidex (anastrozole) Radiation Therapy 11/21/2011 Bone Hormonal Therapy 6/19/2014 Femara (letrozole) Hormonal Therapy Aromasin (exemestane)
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Feb 4, 2015 09:08PM rleepac wrote:

Ok. That makes sense. Thanks.

Bekah 1/6/15: Excisional biopsy 2.1 cm IDC in axillary tail, Age 42 at diagnosis. Dx 1/6/2015, IDC, Right, 2cm, Stage IIB, Grade 2, 1/2 nodes, ER+/PR+, HER2+ (IHC) Surgery 1/6/2015 Lumpectomy; Lymph node removal Chemotherapy 3/5/2015 AC + T (Taxol) Targeted Therapy 4/30/2015 Herceptin (trastuzumab) Targeted Therapy 4/30/2015 Perjeta (pertuzumab) Surgery 8/18/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 11/13/2015 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Hormonal Therapy 11/18/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 3/28/2016 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 9/8/2016 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Aug 2, 2015 11:54PM ananda8 wrote:

My tumor, 2.4 cm, held DCIS and IDC. I had radiation and 5 years of Arimdex, no chemo. I'm almost 7 years out.

“Before enlightenment, chop wood, carry water. After enlightenment, chop wood, carry water.”
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Aug 4, 2015 03:41PM Blownaway wrote:

I had both side by side

Dx 3/31/2014, DCIS/IDC, Left, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2+ (FISH) Surgery 5/12/2014 Lumpectomy: Left; Lymph node removal: Left, Sentinel Surgery 6/2/2014 Lumpectomy: Left Targeted Therapy 7/2/2014 Herceptin (trastuzumab) Chemotherapy 7/2/2014 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 10/6/2014 3DCRT: Breast Hormonal Therapy 1/9/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy Breast
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Aug 5, 2015 07:55AM - edited Aug 5, 2015 07:57AM by cp418

I had a total 1.8 cm mixed mass of DCIS and IDC. It was described as the center being 0.5 cm DCIS surrounded by IDC. Wish it was found when it was still DCIS.....

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Aug 26, 2016 07:24AM Flautadulce wrote:

I have both DCIS and IDC. I've been told that there is disagreement among oncology specialists about whether IDC is a DCIS tumor gone bad or if they are 2 distinct cancers. My DCIS tumor was 10x larger than the IDC tumor. Personally, I think DCIS becomes IDC if left too long.

June 2016 DCIS and IDC 1.2mm, clean margins by 2mm, ER-neg PR-neg HER2neu-neg, 0 nodes, 0 lymph/vasc, mastectomy only, no chemo recommended
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Aug 26, 2016 07:57AM - edited Aug 26, 2016 07:58AM by Beesie

Flautadulce, my understanding is that it is believed that approx. 85% - 90% of IDC develops from DCIS. I wasn't aware that there was any disagreement about that. What isn't known, however, is what causes DCIS to evolve to become IDC. In my 11 years reading up on this, I've seen dozens of theories and research studies about this, none that have as yet come to a clear and definitive conclusion.

Because most IDC develops from DCIS, it is very common to find IDC tumors that include a very small amount of DCIS. This probably happens more often than not.

Similarly, it is very common to find DCIS tumors that include a very small amount of IDC. I had over 7cm of DCIS along with 1mm of DCIS. DCIS-Mi, my diagnosis, is in fact separately identified as the very first level of Stage I invasive cancer. The "Mi" stands for an invasive tumor that is 1mm or small in size.

For those who have a combination of DCIS and IDC, the staging is based on the size of the IDC. The DCIS is not added in. This is why I am Stage IA, despite having so much DCIS. The only thing that counts in my staging is that 1mm of invasive cancer.

Here's what I think is the big question, and which I have never yet seen researched:

Why do some tumors that start as DCIS almost immediately evolve to become IDC and then continue to develop and grow as IDC? (i.e. those tumors that are found to be mostly IDC with just a small amount of DCIS),

whereas

Why do other tumors that start as DCIS continue to develop and spread as DCIS but at some point also have a tiny breakthrough of invasive cancer? (i.e. those tumors that are found to be mostly DCIS with just a small amount of IDC).

I suspect that although both these types of cancer include DCIS and IDC, they might be very different in genetic make up and in terms of what triggers the development of the IDC and the continuing growth of the cancer.

“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Dec 20, 2016 12:30PM Dafne wrote:

Beesie, I could not have said it better if I tried.

My thoughts exactly... Wish there was an answer to this. I just hope there will be an answer in the future. If not for us, at least for the women that follow...

Dear cancer, thank you for making me stop and listen and remember what's really important. You can go now. Surgery 10/25/2016 Lumpectomy: Left, Right Dx 11/1/2016, DCIS/IDC, Right, 2cm, Stage IA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Dx 11/1/2016, DCIS/IDC, Left, 1cm, Stage IA, Grade 1, ER+/PR+, HER2- Surgery 3/28/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Dx 5/2017, DCIS/IDC, Left, 1cm, Stage IA, Grade 1, 0/1 nodes, ER+/PR+, HER2- Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Sep 22, 2019 01:08PM 32B wrote:

I was diagnosed with DCIS and eventually was found to have "micro-invasions" of IDC. It seems common. Good to talk to people in a similar boat as it is a bit confusing.

Dx 1/12/2018, DCIS/IDC, Right, <1cm, Stage IA, Grade 2, 0/8 nodes, ER+/PR+, HER2- Surgery 2/8/2018 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Tissue expander placement Hormonal Therapy 11/15/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Sep 22, 2019 01:28PM letsgogolf wrote:

I don't think having DCIS and IDC makes it a mixed type tumor. My understanding is that a mixed type tumor is one tumor that has properties of two types of breast cancer such has Lobular along with Ductal. Mine was Ductal with Lobular features and was also referred to as "Mixed Type". I don't think LCIS with Lobular or DCiS with Ductal would qualify as mixed type. Somebody please correct me if I am wrong.

Oncotype DX = 3. IDC with Lobular Features. Sentinel Node had Micrometastases - Estrogen 100%, Progesterone 99.89%, Ki67= 3.3% Dx 2/14/2017, IDC, Left, 1cm, Stage IB, Grade 1, 0/8 nodes, ER+/PR+, HER2- Surgery 2/27/2017 Lumpectomy: Left Radiation Therapy 4/6/2017 Whole-breast: Lymph nodes Hormonal Therapy 6/1/2017 Arimidex (anastrozole) Targeted Therapy
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Sep 22, 2019 03:37PM Beesie wrote:

letsgogolf, that's my understanding as well.

If DCIS (ductal in-situ, i.e. non-invasive) and IDC (invasive ductal) together in the same tumor was to be classified as "Mixed Type" (or ILC and LCIS) then the vast majority of cancers would be"Mixed Type".

“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Sep 22, 2019 06:19PM letsgogolf wrote:

Beesie, Good point. I think you are exactly right.

Oncotype DX = 3. IDC with Lobular Features. Sentinel Node had Micrometastases - Estrogen 100%, Progesterone 99.89%, Ki67= 3.3% Dx 2/14/2017, IDC, Left, 1cm, Stage IB, Grade 1, 0/8 nodes, ER+/PR+, HER2- Surgery 2/27/2017 Lumpectomy: Left Radiation Therapy 4/6/2017 Whole-breast: Lymph nodes Hormonal Therapy 6/1/2017 Arimidex (anastrozole) Targeted Therapy

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