Solid apaillary carcinoma and micropapillary DCIS

I was recalled after a breast cancer screening where I was not expecting anything unusual. The biopsy diagnosis was solid papillary carcinoma and micro papillary DCIS. Three lumpectomies later, which all showed a margin of less than 1mm, I am facing a mastectomy. The scans (mammograms & ultrasound done at the initial biopsy) have underestimated the extent of what is there. Micropapillary cancer is very rare. Have you come across this? I am also having a sentinel node biopsy at the same time as the mastectomy and hope that these are clear.

I am interested in whether it was only the solid papillary carcinoma that showed up on the initial screening mammogram or whether they could also see the micro papillary bit (even if they did not know that it was micropapillary at that stage). I would like them to compare this to what the end result shows after the mastectomy, but it looks as if they will not be doing that. Do you know how I could request this please? I am worried that if I have/get micropapillary cancer in the other breast that it will not show up on a mammogram. Do you know of any other tests that would show any micropapillary up? It looks as if they would not do a mastectomy on the other breast unless they were sure that there was cancer there. Do you have any experience of patients getting a mastectomy on the other breast if it has not been confirmed that there is cancer there?

  • Hello Margaret AB and thanks for posting

    I am sorry to hear about your situation and that you are now needing a mastectomy, this must be a difficult time for you.

    As you say Micropapillary carcinoma is a rarer type of cancer. As it can be quite fast growing in nature the team looking after you will be wanting to make sure they have removed all the cancer. This is why they are also going to carry out a sentinel node biopsy to check out the nearby lymph nodes, just to be on the safe side. It sounds like they are being very thorough, which should be reassuring.

    From what I can see it seems that both mammography and ultrasound are sensitive enough to pick up abnormal areas of micropapillary carcinoma on the images. It is very unusual for patients to have scans following surgery, so I don't think this is something you can request, I'm afraid.

    After treatment, women who have had breast cancer will be followed up with regular mammograms on the other breast to check for any changes. You are right in saying that is it unusual for women to be offered a double mastectomy if there is no cancer in the other breast but do express your concerns and ask about this.

    I hope this is helpful but please get back to us if you need any more information or support.  You may find it helpful to talk things through with one of the nurses on our helpline.  The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5pm Monday to Friday.

    All the best

    Naomi