DCIS, Ducts, and MRIs

I have two questions.  I was diagnosed with noninvasive DCIS  after a biopsy five years ago and didn't have surgery. Since I didn't have the DCIS removed beyond what was removed from the procedure, is it possible that the safety of the ducts in containing the DCIS was compromised? Is it possible that the biopsy may have released the safely contained DCIS cells into surrounding tissue?

Second, what does an MRI tells a doctor when it comes to examining DCIS? Can they tell if noninvasive DCIS has become invasive and moved out of the duct?

And, I would appreciate it if judgement is not passed on my decision.  I'm just curious about the answers to my questions.  Thanks!

[Cleveland Clinic]

Dear MLawe:  DCIS are abnormal ductal cells that do not spread

[lizziecee]

Interesting questions - firstly, I don't think a biopsy can cause the DCIS to move outside the ducts. If it is going to spread by natural progression it will.

However, DCIS can turn into invasive; I don't know if it always does.
When I was dx with a 2cm invasive tumour (non palpable, found on a normal 3 yrly mammo we get when over 50 in England), I was shocked to read my pathology report after the lumpectomy, which showed I also had DCIS, both comedo and cribriform. Neither my surgeon nor Oncologist told me I had DCIS in addition to the invasive tumour and lymph node spread. I feel with hindsight, if I had had annual mammos, perhaps the DCIS would not have spread outside the ducts and into my lymph nodes. I am grateful though, that the DCIS was removed surgically along with the tumour and all lymph nodes, as 4/18 were cancerous.  I am now gratefully in remission 4 years later.

I didn't have any MRI's  so not sure what they can show - they are not generally done in England. I know my invasive tumour was quite clear on both the original mammo, which is why I was recalled, then the compression mammo, and the ultrasound. Indeed, the Radiologist had my husband look at the ultrasound screen to show him the tumour. The tumour was spiculated, and looked like a starburst, whereas a benign tumour is usually smooth and rounded.

Hope I have answered your questions to the best of my limited knowledge, but I am not a doctor or even a nurse, just someone who has had breast cancer and wish I knew then what I know now.

You have an inalienable right to decide on whatever treatment to have or not, and I hope we are not judgmental here, just wish to share our experiences and hel, in any way we can - even if it is only some cyber hugs.
Take care.
Liz.

[stresscase123]

You might want to do an internet search for "needle-track seeding" if you want to know about needles or biopsies possibly spreading cancer cells.  There are various schools of thought about this...

An MRI will only show areas of *potential* abnormality within the breast - and there is a fairly high rate of false positives.  It is only a screening tool, not diagnostic.  If you want to know specifically about DCIS and microinvasion - the *only* way to get accurate information is via a surgical biopsy/excision, and thorough a pathology evaluation...

Hope this helps!

[EmilyJones]

Someone I know had a pathology report it said:
Right breast 7 o clock, ultrasound guided needle core biopsy, DCIS, solid pattern, intermediate grade with foci of microcalcification. Focal infiltrating ductal carcinoma, nuclear grade, Black's 3. Please can you expain what this means ? Do you what treatment would be offered. My friend is 50. Many thanks. EJ

[boninclyde]

You need to get a copy of thr path report. See if you kind find out size, the status of the er, pr and HER2. Then post to the doctor here at the breast cancer forum above. We only get 2 questions a day so post in the early morn.

[EmilyJones]

states: Right breast 7 o'clock, are four cylindrical cores of gray-white focally tan-yellow fibrous tissue intermixed with sparse amount of lobulated yellow fat. The specimens range from 1 to 1.6 cm in length with a maximum diameter of 0.2 cm.

Microscopic description: The levels show multiple foci carcinoma in situ with a solid growth pattern, intermediate histological grade.

Please can someone explain this. Thank you EJ.

p.s. Is ovarid patches a progesterone only medical given for breast cancer?

[lizziecee]

Hi Emily - good of you to care so much for your friend that you have taken the time to post on her behalf.

I didn't get a path report when I had a mamm/ultrasound and stereotatic biopsy, basically because I didn't know enough then to ask for one, but the tumour (2 cm) was clear to see on mammos and u/s. I only got path reports after my lumpectomy and sample node removal, and then another one after total node removal, as 3/8 nodes were positive. I then had to go back for total axillary node removal a month later. Another node was found positive, so it was the correct treatment.

From your post, I understand that your friend has both an invasive (infiltrating) tumour and DCIS, which as it happened, I had. My invasive tumour and the DCIS were removed by a lumpectomy. Because my cancer had already spread to my lymph nodes I was then strongly advised to have chemotherapy and radiotherapy.  I live in England, and any patient with a tumour over 1 cm, at my hospital at least, is strongly advised to have chemo and rads. I had everything they offered me and am thankfully still here 4 years later.

I am sorry but I don't understand the term "Black's 3" - not a term I have come across. It may mean stage 3 (mine was stage 2) and therefore surgery and other treatments are probably necessary. I would imagine that if your friend has either a lumpectomy or mastectomy, she will also have sentinel node removal (this was not available in England in 2003 when I was dx) to check for any spread to her lymph nodes. This is not as invasive as the surgery I had.

Hope between us all survivors we have answered your questions - do come back if there is anything else we can help you with.
Your friend is blessed in having such a caring person in her life.
Liz.

[EmilyJones]

Hi Liz

You have been very kind & very helpfull. My sincere best wishes to you & your family. EJ