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All TopicsForum: DCIS (Ductal Carcinoma In Situ) → Topic: DCIS on biopsy but not in any of the lumpectomy

Topic: DCIS on biopsy but not in any of the lumpectomy

Forum: DCIS (Ductal Carcinoma In Situ) — Just diagnosed, in treatment, or finished treatment for DCIS.

Posted on: Jul 23, 2007 06:11AM

lisanash wrote:

Have any of you had DCIS diagnosed in the needle biopsy but them have the lumpectomy tissue be completey non-cancerous?
I was diagnosed with DCIS low - intermediate grade on the biopsy, 1 cm of microcalcifications on the mammogram but all 5.5 cm of the lumpectomy tissue was ductal hyperplasia - not even precancerous.
I dont' understand how the biopsy took out very little of the 1cm of microcalcifications - what happened to the rest of the the 1cm of tissue - is it possible that the biopsy removed all of the cancerous area?

Has this happened to anyone else? Was the biopsy a false positive? Log in to post a reply

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Feb 20, 2008 05:04PM soonergirl wrote:

Donna and Sheila, thanks for your comments and encouragement. I really did not realize until I started reading articles about a month ago how much uncertaintly there was in all of this. A couple articles I read said that when their is DCIS in the biopsy then the pathology on the surgery should consider the ADH to be part of the DCIS for margins. I think I will be fine and feel fortunate to have found it early. 

Dx 12/29/2007, DCIS, Grade 3, 0/2 nodes, ER-
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Feb 22, 2008 12:23PM Catherine wrote:

I had a stereotactic biopsy and that's the whole point of this type of biopsy, to remove the DCIS.  The lumpetomy is just additional insurance that all the cancer is removed.

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Feb 22, 2008 12:50PM wishiwere wrote:

bumping

wishiwere~ Path read stage 1C- 1st Primary was IDC w/DCIS 1.4 cm, ER/PR+ & HER2- Dx 9/21/2007, ILC, 1cm, Stage IB, Grade 2, 0/4 nodes, ER+/PR+, HER2-
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Feb 22, 2008 01:45PM Blinx wrote:

Good thread. Reminds me of when my surgeon called me after my lumpectomy to report margins -- he said the pathologist said "Is there supposed to be cancer in this specimen?" I told him to look harder -- I was a little deflated, thinking, did I go through surgery uncessarily?? I think upon further in spection they found what they were looking for. Or maybe they were just placating me.

Anyways, good to know that I wasn't the only one!!

Dx July 2007 DCIS Grade 3 (at age 46); Lumpectomy Sept 2007. ER+/PR-; Finished 33 rad tx Jan 2008. 3.5 years of Tamoxifen then quit..
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Feb 22, 2008 02:26PM wishiwere wrote:

I had one tumor that 'supposedly' was all removed with an MRI guided bx.  When the whole breast was removed they didn't find any of it in their where the little marker was left the week before. I'm still not 'trusting' about it.  For the most part, it was this second ILC 1cm lump in another quadrant that made the decision for a lumpectomy a no-go :(  I just asked for that report to be sent to me (the original bx on it) to see what was actually said, b/c it's the only one I didn't get from doc.

wishiwere~ Path read stage 1C- 1st Primary was IDC w/DCIS 1.4 cm, ER/PR+ & HER2- Dx 9/21/2007, ILC, 1cm, Stage IB, Grade 2, 0/4 nodes, ER+/PR+, HER2-
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Feb 24, 2008 06:14PM soonergirl wrote:

Wishiwere, on mine they could not find the marker that was put in at  the biopsy in the tissue at all. I am not sure what to make of that as I saw it on the mammogram after the biopsy.

Dx 12/29/2007, DCIS, Grade 3, 0/2 nodes, ER-
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Feb 24, 2008 06:19PM wishiwere wrote:

That's really interesting! I would wonder too!  DId you ask?  I was surprised, that they ran that MRI after they placed it (the clip), b/c I though they were metal, apparently not?

wishiwere~ Path read stage 1C- 1st Primary was IDC w/DCIS 1.4 cm, ER/PR+ & HER2- Dx 9/21/2007, ILC, 1cm, Stage IB, Grade 2, 0/4 nodes, ER+/PR+, HER2-
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Feb 24, 2008 09:37PM soonergirl wrote:

They said my clip was siliconewhen I had the biopsy. I asked about that in case it affected airport security. I too had read about metal chips but maybe they have changed them or some are different. They are quite small. Also they can migrate after they are implanted. I read that somewhere. My surgeon said it might have disappeared while the pathologists were looking at the tissue--they do a lot of slicing/dicing I guess. On a different matter, my doctor called tonight and after a second pathology look they agreed with the original that there was DCIS in the the biopsy cores that they took but it was all removed in the biopsy so all left in the breast tissue was atypical hyperplasia and some other abnormal features.

Dx 12/29/2007, DCIS, Grade 3, 0/2 nodes, ER-
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Feb 25, 2008 12:48PM otter wrote:

Wishiwere & soonergirl--

About that clip:  When I had a core biopsy done on my lump last month, they inserted a very small titanium clip right where the biopsy was taken.  The radiologist assured me that 1) it would not interfere with an MRI (it was safe even though it was metal) and 2) it would not set off any security alarms at the airport.  He volunteered that info as if it had been asked before.  :)

I had a quick, 1-view mammogram a few minutes later, to be sure the clip was where they thought they had put it.  (It was I guess.)  A week later, I had a breast MRI.  When I checked in for the procedure, I mentioned the titanium clip.  The MRI people said it would not cause any problem at all.  I said I just wanted to be sure, 'cause I didn't want that thing to come shooting out of my breast and across the room or anything.  They laughed and assured me it would not move.

BTW, the radiologist said the titanium clip was in the shape of the symbolic BC "loop". Kind of neat, if that's true. 


otter
Dx 2008, IDC, Stage IA, Grade 2, 0/3 nodes, ER+/PR-, HER2-
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Feb 25, 2008 02:19PM PSK07 wrote:

After my surgery, but before rads, the rad onc ordered a mammogram to be absolutely, totally certain that the clip was removed during the surgery &, by association, the DCIS.  The path report they'd received didn't mention that it was in the tissue, although I remember my surgeon saying that it had been removed. (the surgeon said that he never sees the clip - the whole idea is to get the tissue w/sufficient margin - if he does see it, then something's wrong & he has to regroup.)

Pam - adding LCIS & ALH to the mix, 8/25/08 Dx 8/3/2007, DCIS, <1cm, Stage 0, Grade 2, 0/0 nodes, ER+/PR+
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Feb 25, 2008 02:39PM wishiwere wrote:

you know?  Now that you said that, I do remember her saying titanium!  And I asked the same thing?  Won't the MRI magnet just rip it out my breast?  I envision something like you, seeing my breast tissue plastered all over the inside the unit I was in!  Still strange they couldn't find in the breast tissue after the mast. I mean, after all, as small I am, they didn't have to dig for it at all? 

wishiwere~ Path read stage 1C- 1st Primary was IDC w/DCIS 1.4 cm, ER/PR+ & HER2- Dx 9/21/2007, ILC, 1cm, Stage IB, Grade 2, 0/4 nodes, ER+/PR+, HER2-
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Feb 26, 2008 02:09PM Blinx wrote:

I've got more clips in me than I know what to do with! I had a mammogram about a month after my lumpectomy, prior to radiation -- the surgeon left a trail of clips outlining the area that was excised -- shows up loud and clear on the film. Don't know if they are titanium, silicone, or what.

Check out your post-op films and see if you have anything similar.

Dx July 2007 DCIS Grade 3 (at age 46); Lumpectomy Sept 2007. ER+/PR-; Finished 33 rad tx Jan 2008. 3.5 years of Tamoxifen then quit..
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Feb 26, 2008 06:05PM melmedic06 wrote:

the exact same thing happened to me!!- in fact i kept posting and asking if anyone had experienced this and when no one replied i thought i must be crazy so i am pleased to finally have company (not in being crazy :-)  )  in august of 05 they "found" DCIS in my right breast - not such great news since i had already had a lumpectomy and radiation for ILC in my left breast in october of 04- but i had another lumpectomy and the surgeon said it was "the cleanest breast tissue he had ever removed" - when sent to pathology there was no DCIS- anywhere!! so that was my question- where did it go? no one ever had a clear cut answer- my radiologist said it did indeed sometime all come out during the steriotactic biopsy and since is was so small that is what she "suspected" had happened- i feel better knowing i had the lumpectomy and more radiation- it can only improve my chances of survival - i hope!! thank you for this thread

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Feb 26, 2008 06:39PM soonergirl wrote:

I have read that the clips can migrate--sometimes fairly soon after insertion. So even if they are there right after they put it in it might be somewhere else a couple of weeks later. I too find it reassuring to know that it is not so uncommon to remove the entire DCIS with the biopsy.  I have concluded though that before deciding on the surgical course of action after a biopsy a second opinon from a pathogist may be worthwhile- as there is definitely some interpretation in reading the slides.

Dx 12/29/2007, DCIS, Grade 3, 0/2 nodes, ER-
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Feb 26, 2008 06:39PM - edited Feb 26, 2008 11:48PM by soonergirl

This Post was deleted by soonergirl.
Dx 12/29/2007, DCIS, Grade 3, 0/2 nodes, ER-
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Feb 26, 2008 06:39PM - edited Feb 26, 2008 11:47PM by soonergirl

This Post was deleted by soonergirl.
Dx 12/29/2007, DCIS, Grade 3, 0/2 nodes, ER-
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Feb 26, 2008 08:56PM louishenry wrote:

I think it happens quite a bit. My stereotactic biopsy removed all of the 4mm of Dcis. The lumpectomy showed no residual disease of any type. Rads were not recommended. I was very relieved.

Dcis May 2007, 4 mm, grade 1-2, no rads recommended. Tamoxifen September 2007 .BRCA 1/2 Negative. Sis with LCIS
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Jan 13, 2018 12:13AM clr23 wrote:

Hello ladies!

Just wondering how you are all doing now since this thread is an old one. I was diagnosed with DCIS in November. Genetic testing was negative and MRI showed calcification only in that one area. Was given 2 options: either a lumpectomy with 6 weeks radiation & 5-10 yrs on tamoxifen or a bilateral mastectomy. I was ready to go have a bilateral mastectomy but wanted nipple sparing. I had to opt for an additional surgery to do nipple delay and my surgeon did a lumpectomy at the same time. When I went for my post op checkup I was told there was no DCIS in the lumpectomy and that they must’ve gotten all the DCIS when the biopsy was done. So now I have to wait til 1/22 to see a medical radiologist & a medical oncologist to find out what other options I have. I am hoping they say no radiation and maybe tamoxifen or other hormone blocker. Has anyone gone Thoens route and the DCIS come back? Thank you all for sharing your stories! It hasn’t been most helpful to navigate through this chapter of my life

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Jan 14, 2018 06:17PM Silbar wrote:

clr23~ I noticed that another lady who posted in this thread back in Jan. 2008 stated that in 2006 she had DCIS on biopsy but non found on lumpectomy. She opted to NOT have radiation at that time. But if you look at her Dx bio it appears that she had a dx of DCIS/IDC 6 years later and had a MX. I wonder if not having radiation played a part in her new DX. I wish she was here to give her opinion and to let us know how she is doing. See below:

"All of my DCIS was removed at biopsy. None was found in the lumpectomy tissue either. Because my area of involvement was very small, I opted out of radiation (with my docs' blessings) and began Tamoxifen. I consider myself VERY lucky.        

Allergan Natrelle Style 45-700 ccs Dx 10/2005, DCIS, <1cm, Stage 0, Grade 2 Surgery 12/2/2005 Lumpectomy: Left Hormonal Therapy 1/1/2006 Dx 10/2012, DCIS, 6cm+, Stage 0, Grade 3, ER-/PR- Dx 11/7/2012, IDC, 1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2- Surgery 11/7/2012 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 5/16/2013 Reconstruction (left); Reconstruction (right)."


Real courage is moving forward when the outcome is uncertain~~from my fortune cookie
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Jan 20, 2018 07:53PM clr23 wrote:

Thank you Silbar!

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Apr 7, 2018 08:14PM - edited Apr 11, 2018 03:27PM by GKL

This Post was deleted by GKL.
Dx 2/14/2017, DCIS, Left, <1cm, Stage 0, Grade 2, ER+ Surgery 3/13/2017 Lumpectomy Radiation Therapy 4/18/2017 Whole-breast: Breast Hormonal Therapy 6/30/2017 Arimidex (anastrozole)
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Apr 7, 2018 09:42PM Rrobin0200 wrote:

yep, happened here. DCIS in biopsybut yet when the final path was written after the BMX, nothing found.

Dx 3/6/2017, DCIS, Left, 1cm, Stage 0, Grade 3, 0/4 nodes, ER-/PR- Surgery 3/31/2017 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Jun 2, 2018 10:13PM Justkeepmoving wrote:

my breast surgeon told me that this happens sometimes when you are lucky (?) enough to have gotten all of the cells with the biopsy :)

Dx 5/22/2018, DCIS, Left, 5cm, Stage 0, Grade 3, ER-/PR- Surgery 6/29/2018 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Jun 21, 2018 05:00PM 1toughmomma wrote:

Yeah after my first biopsy the radiologist looked at the post bx mammo and felt confident enough to say he thought he got it all, then the plan would be lumpectomy just to be sure if it was cancer. Well, the bx was DCIS but my MRI picked up an entirely new area not on mammo so it ended up being a moot point for me. Some cancers are so small the core biopsy takes most/all of it

Dx 10/11/2013, DCIS, Stage 0, Grade 1, 0/3 nodes, ER+/PR+ Dx 11/8/2013, DCIS, Stage 0, Grade 2, 0/3 nodes, ER+/PR+ Surgery 11/22/2013 Lymph node removal: Left; Mastectomy: Left; Reconstruction (left): Tissue expander placement Surgery 2/17/2014 Reconstruction (left) Surgery 2/17/2014 Reconstruction (right) Surgery 6/23/2014 Reconstruction (left)
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Jul 11, 2018 12:31AM - edited Jul 11, 2018 12:33AM by Mackadoo

I had a core biopsy that dx dcis 4mm high grade. Had a lumpectomy and no dcis found. Doctor said biopsy had gotten it all. So radiation was questionable, but I asked for the Oncotype DX for DCIS, which was ordered. Oncotype score came back with high probabability of reoccurance, so I opted for hypofractionated course of radiation. Biopsy also had said it was ER positive, but weakly, at 10 percent. Oncotype test said it was ER and PR negative! Tumor board agreed that the Oncotype test took precedence over the original biopsy result ref ER/PR negativity. So that changed the protocol from having to take hormone blocker, to not taking one, as it is not effective for ER and PR negative dcis.

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