I've just been diagnosed with DCIS grade 2 which is all that I know thus far. What is the usual treatment for this type of cancer? Does this have a high cure rate? What are the chances of it being invasive?
Dear Carol in Pittsburgh: DCIS (ductal carcinoma) is a non invasive form of breast cancer that, theoretically, should not have the ability to spread elsewhere in the body. DCIS has an excellent prognosis when treated surgically with either mastectomy or breast conserving surgery (lumpectomy) which is usually followed by radiation therapy. If left untreated, however, DCIS could develop into an invasive cancer. In addition, DCIS can be associated with an invasive cancer which would likely alter the treatment recommendations. For pure DCIS, there is no need for chemotherapy. For DCIS that is estrogen receptor positive, tamoxifen is frequently recommended following breast conserving surgery and radiation to further reduce the risk of local recurrence and to reduce the risk of a new cancer on the other side.
DCIS, by defintion, is not invasive. It should have nearly 100% cure rate (it's true that without being able to slice the samples so thin as to be able to see every single cell, it's possible to miss a tiny area of invasion. But the "IS" of DCIS stands for in-situ, which means it has not crossed a certain barrier and therefore is non-invasive and can't spread beyond the breast. It can, however, spread within the ducts of the breast. Treatment aims to get rid of all the tissues at risk for intraductal spread. The decisions are based on several details of the DCIS a person has: it can be very tiny, and, depending on age, may require only a small area of excision with no more treatment except, in some cases, taking hormone-blocking medication. In other situations it requires lumpectomy and radiation. If it's extensive enough, simple mastectomy is done. Hormone blockers are usually used, no matter what direct treatment the breast gets. It also depends on specifics of how it looks under the microscope: is there enough within a duct that the duct is expanded outward; are the cells in the center of the DCIS dying? Grade 2, in and of itself, is not enough info on which to say for sure what's best. The good news is that with treatment, cure is nearly guaranteed.
Now I'm really confused. Will I have to have my breast removed with DCIS even if it shows signs of invasive cancer? Would the mammogram or biopsy have shown that was the case?
If DCIS is slow growing limited to the ducts, what is the likelihood especially given that I've had yearly mammograms that never showed any evidence of micro calcifications that this would be invasive? I do not have a history of any cancer in my family. If it were invasive, is it likely that I could do the lumpectomy w/radiation? I am so afraid of having my breast removed and chemotherapy. What is the likelihood of this?
I meet with my breast surgeon next Monday...I've been trying to gather all the info that I can until that time. I've been really scared by all of this.
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