high grade breast dcis with micropapillary and microinvasion

Hi

It's nearly 2 months since I was first examined in the breast clinic and i'm still know nearer having effective treatment. I've had an operation but that was said to be papilloma and turned out to be something entirely different. It's getting really difficult to trust the hospital I am at as they have also told my doctor that I have just DCIS 

The operation they did was said to be a papilloma on discharge note and margins were not taken all the way around.. so histology says it's all DCIS and microinvasion 

I remain concerned that they are not taking this cancer seriously because it is not entirely true that it is just DCIS there Is certainly microinvasion and the histology report indicates it's believed that there are  multiple foci of microinvasion 

It also says immunohistochemistry P 63 And I think that may mean it is more aggressive than normal DCIS and it has micropapillary structures as well as solid structures is high grade, and I understood that lymph nodes should be tested and this might be more likely to reoccur 

 

uts going to be weeks before I get the MRI results and I am not sure the small town hospital really knows about a cancer with these features...

 

can you tell me is it more aggressive or is it just dcis 

 

thanks 

 

  • Hello Elaneh and thank you for posting,

    I am so sorry you feel let down by your hospital team. I can appreciate that when unexpected results come back it can be unsettling. Tissue specimens are sent to the laboratory to be sure what is the matter, and sometimes they come back with a different result to whatever the doctor's originally thought. I know this has come as a shock and I think you need to talk this over with the breast clinic team and ask them to explain.  I am afraid they are the only ones who can interpret your results and put them in context. Unfortunately, we cannot go through anyone's histology results because it isn't something nurses are trained to do.

    If you are concerned that things are not happening as they should be it might be worth discussing this with PALS team at your local hospital, information on this here. 

    The decisions made about your case will be discussed at an MDT (multidisciplinary team meeting) where experts discuss each person's situation and a treatment plan, in line with NICE (National Institute for health and Clinical Excellence) guidance, is created.

    Take care and I am sorry I am unable to help you further. I hope you get the information you need soon.

    Sarah.

  • Thanks Sarah. The MRI Found a 9.5 cm suspicious area where I had felt problems and a second opinion says bigger but also highlights another suspicious  10mm area at the back of breast which the hospital didn't report so now awaiting biopsies so no further treatment for at least a month

    meanwhile I have a couple of questions about the biopsy which will be mammogram guided. 

    do stereo mammograms find areas not seen on the original mammogram? as am a bit worried they will miss it again

    and are punch biopsy's Guaranteed to find cancer with micropapillary structures within a duct if there are also benign cells there? 

    man hoping to speak to the nurse at the hospital later but kn case they are too busy to get back before the biopsy thought would ask you

    thanks 
     

  • Hello Elaneh and thanks for updating us, 

    I'm afraid I'm not able to provide certain answers to either of your questions, but they seem reasonable things to be asking about and I hope the hospital nurse has been able to tell you more and explain things.

    I can appreciate that not having much certainty at the moment is difficult and I hope you know more soon. 

    Best wishes, 

    Julia

  • Three months after first appointment biopsies confirm very large multiple points of ER negative microinvasive cancer which was occult on mammogram and US and where I had asked the surgeon to check but he refused.

    I have found some peer reviewed studies on this from 2020 with large cohorts which all say that this isn't the same as DCIS, and is a bit more dangerous, some even say it is akin to invasive but the surgeons in my hospital think it is "just DCIS"

    do you have any information on multiple points of microinvasion?

  • Hello and thank you for getting back to us.

    I am afraid that we do no have information about multiple points of microinvasion , I also cannot find information other than clinical research information about it.

    Reading through your posts I can appreciate the worry the results are causing you. However, I am sorry to say that we are not the best people to know what should happen in your situation. This is because we are nurses not involved in your care.

    We suggest that you go back and discuss this with your breast team. If after doing this you feel you need the opinion of another breast specialist you might want to ask for a second opinion. Your GP may also be able to arrange a second opinion for you. I am not sure if this would be possible or help but you might still want to ask. We have information about this on our website, you can see it here 

    I hope you can get more information soon and that you will be ok.

    Take care

    Caroline

  • Thanks. My GP has referred me to a specialist and they are seeing me.