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Oct 25, 2020 02:17AM
"The mammogram which would be able to see DCIS....didn't even see my tumor." No, not all DCIS is visible on a mammogram, and it certainly won't be visible if it's extremely tiny, which is often the case when DCIS is associated with IDC. Lots of people have tiny amounts of DCIS, never seen on imaging, that is found in their pathology.
"I believe ultrasounds can't see DCIS at all." Generally that is true but in the rare cases where DCIS does form into a mass, it may be visible on a ultrasound. As always, there are exceptions to every rule.
"can a person like myself have DCIS that isn't seen on mammo, ultrasound or missed during surgery?" As I said in my previous post, if the IDC developed from DCIS, then the DCIS would be in the same area as the IDC and therefore would be removed during surgery and found when the tissue is examined in the pathology lab. This happens all the time. So the fact that no DCIS was found with your IDC means that there was none, or at least that any DCIS that initially developed had evolved to become IDC so that no DCIS remained.
"Thank you for sharing that photo. That definately looks like scattered density though. Mine was all white as I recall." I have extremely dense breast tissue and my calcifications were visible, although not as large an area was visible on the mammogram as on the MRI. Here are a couple of images of calcifications in dense breast tissue:
I don't understand why you are concerned about this. Approx. 15% of patients do not have any DCIS found with IDC - so while this isn't the norm, it's not unusual either. And your imaging and surgery found the IDC, which is the more serious condition. DCIS is harmless - the concern with DCIS is that it might develop to become IDC. If your diagnosis did start as DCIS and it did develop to become IDC (a lot of DCIS never progresses any further), well, the IDC was found. So what's the concern?
The simple truth is that it's always possible that a few cancer cells might be left in the breast after surgery. This is why radiation is always recommended after a lumpectomy. And of course nothing is impossible so yes, it could be that somehow you had some DCIS associated with your IDC that was never seen on imaging and was so tiny and away from the IDC (which frankly would make no sense) and was therefore left in your breast. But your greater risk of recurrence comes from the fact that you had invasive cancer, and a few rogue invasive cancer cells might have been left after surgery. DCIS cells need to undergo a biological change process before they become invasive cancer; that progress can take years and often never happens at all. Invasive cancer cells are already invasive. So when you consider the risks associated with your diagnosis, you are worrying about a much lesser concern. I'm not saying any of this to scare you - hopefully every cancer cell was removed from your breast during surgery and you never have a recurrence - but after having IDC, worrying about some rogue DCIS cells seems to be missing the bigger picture.
“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke