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Topic: Chemo and Rads necessary for stage 0 DCIS?

Forum: Triple-Negative Breast Cancer —

Share with others who have ER-/PR-/HER2- breast cancer.

Posted on: Mar 23, 2019 03:11PM - edited Mar 23, 2019 03:12PM by Stitch

Stitch wrote:

I'll find out more once my MRI & DNA test comes back. I'm adopted and know no family history. I see Dr again April 9th. Just wondering if anyone here had stage 0 DCIS high grade, triple neg and had chemo. Pathology says size is “several foci of DC in situ ranging from 1 to 4 mm. Background of densely sclerotic breast parenchyma. I had fibrocystic breasts in my early 20's. Definitive invasive component not identified. Has anyone similar to this DX able to avoid chemo? My doctor wasnt clear on chemo. She talkedmore about surgery and rads. Next to the chemo section of the sheet she has >5mm written. I guess my total size is at least that based on pathology listed above. So I'm thinking my chances are high on chemo. I ask because I've not found one article on my type DX. All I find is no chemo for stage 0 DCIS.

And one more question - would it seem like over treatment since it's triple neg to insist on MX (left side only). Sorry I don't know all the acronyms yet! I do know that this did not show up 6 mo ago. I was having a re-check on a non suspicious little area with smooth edges that hasn't grown but possibly has shrunk over the last year. I'm so thankful they did 2 6 month follow ups!

Dx 3/2019, DCIS, Left, Stage 0, Grade 3, ER-/PR- Surgery 4/25/2019 Lumpectomy: Left
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Mar 23, 2019 03:29PM KBeee wrote:

Your surgeon will help guide surgical decisions and a medical oncologist will guide the decision for chemo. You have some time until the tests come back, so seeking additional opinions would be beneficial. Don't just ask what they recommend, but ask why. What's their rationale? Once you hear the why, it will help you to make the best decision.

Karen. Dx 8/5/2013, IDC, Right, 1cm, Grade 2, 0/1 nodes, ER+/PR+, HER2- (IHC) Surgery 8/26/2013 Mastectomy: Left, Right Chemotherapy 9/20/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 12/12/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 1/23/2014 Reconstruction (left); Reconstruction (right) Surgery 1/29/2015 Lumpectomy: Right Dx 2/2/2015, IDC, Right, 1cm, Grade 2, 0/0 nodes, ER+/PR-, HER2- (FISH) Dx 2/25/2015, IDC, Right, 1cm, Grade 3, 0/13 nodes, ER+/PR-, HER2- (IHC) Surgery 2/25/2015 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary; Prophylactic ovary removal Chemotherapy 3/31/2015 AC + T (Taxol) Radiation Therapy 8/25/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Femara (letrozole)
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Mar 23, 2019 03:42PM - edited Mar 23, 2019 04:58PM by Beesie

If your final diagnosis is pure DCIS with no invasive component, chemo will not be given. Chemo is a systemic (full body) treatment and DCIS is a localized condition (breast only) and therefore chemo is not a necessary or appropriate treatment for DCIS. This is true regardless of the size of the area of DCIS, the number of foci, or the hormone status (i.e. even triple negative).

Radiation is a localized treatment, and normally is recommended after a lumpectomy for DCIS. It is not however usually necessary after a MX for DCIS, unless there are involved surgical margins at the chest wall (which does happen, but rarely).

Dx 9/15/2005 Right, 7cm+, DCIS-Mi, Stage IA, Gr 3, 0/3 nodes, ER+/PR- ** Dx 01/16/2019 Left, 8mm, IDC, Stage IA, Gr 2, 0/3 nodes, ER+/PR-, HER2- (FISH) ** Surgery 11/30/2005 MX Right, 03/06/2019 MX Left ** Hormonal Therapy 05/2019 Letrozole
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Mar 23, 2019 04:03PM Stitch wrote:

Bessie THANK YOU!!! I won’t worry so much till the 9th then, and I won’t get chemo supplies until I talk to the doc. I do realize things could change with the MRI. But I’ll remain hopeful. I thought the triple neg changed everything. I was even considering mastectomy to ward off all evils lurking in the future. Many thanks

Dx 3/2019, DCIS, Left, Stage 0, Grade 3, ER-/PR- Surgery 4/25/2019 Lumpectomy: Left
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Mar 23, 2019 05:08PM Beesie wrote:

Stitch, here are screen shots of the most current (March 14, 2019) NCCN Treatment Guidelines for DCIS (physician's version). You can see that chemo is never even mentioned. Hormone status only comes into the discussion in consideration of whether or not endocrine therapy (Tamoxifen or an AI) should be recommended after surgery

Good luck with the MRI and the final pathology. Hoping that this is pure DCIS, Stage 0.



Dx 9/15/2005 Right, 7cm+, DCIS-Mi, Stage IA, Gr 3, 0/3 nodes, ER+/PR- ** Dx 01/16/2019 Left, 8mm, IDC, Stage IA, Gr 2, 0/3 nodes, ER+/PR-, HER2- (FISH) ** Surgery 11/30/2005 MX Right, 03/06/2019 MX Left ** Hormonal Therapy 05/2019 Letrozole

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