DCIS + IDC > T2 to T1?

Hello Everyone,

Caregiver here ! :slight_smile:

My wife (30 years old) has been diagnosed back in September with Stage 2 Triple positive breast cancer (ER+PR+/HER2+)
1/2 Sentinel Lymph nodes positive with macromets (largest one was 1.00cm)

Now onto my concern:

The surgeon staged her (anatomic stage) as T2 N1 M0 - Stage 2B

However, I am finding conflicting information on how one’s tumor gets measured.
Although in fact the size being over 2cm = T2, at least 20% of it was found to be DCIS. I thought only the IDC component of the tumor was used for the measurement?

Core biopsy results : 20% DCIS - 80% IDC
Post surgery (lumpectomy) Report : one single tumor and DCIS was not measured separately. However, DCIS is “Spanning in 19 out of 20 slides”. My understanding would then be that DCIS is extensively present in the tumor ???

Even sticking with the initial 20% measurement of DCIS presence >> Wouldn’t that mean T1 ?

If she’s indeed T1 N1 M0, well… that would change some things. She would then be anatomic Stage 2A and prognostic stage (AJCC 8th edition) 1A.

I understand why it doesn’t make any difference to her MO/ BS (no change in treatment) … however it does for us… MENTALLY! :slight_smile:

If anyone has experience with this, I would love additional feedback, to make sure we are not trying to idealize things lol

Thanks in advance everyone, stay well !

Cheers!

1 Like

Arghh I forgot to mention the size of the tumor … 2.3 cm at its largest
So to make my question shorter >> can we do 2.3 cm - 20% = T1?

THANKS!!!

I’m curious to see the answer to this. I was originally diagnosed with a 1.8cm invasive tumour and 9cm DCIS after imaging tests and a few biopsies. After surgery, they said there were multiple invasive foci in the DCIS area, and went on to describe my cancer as a 12cm tumour as a whole. The histology report is really confusing. So now I’m classed as stage 3… Needless to say, hearing that was the worst moment of my life.

Hi jb-336

Thanks for posting.

It sounds as though you and your wife have had a lot of complex information to deal with since her diagnosis of breast cancer, so it’s not surprising that you feel some of this seems to be conflicting.

As you are already aware there are many factors taken into consideration before your wife’s treatment team decide upon the final staging. The TNM staging system you refer to is the most common way to stage breast cancer in the UK.

It isn’t possible for us to comment on individual pathology results but where DCIS and invasive breast cancer are found together, the pathology report will usually give their combined size. However, as ductal carcinoma in situ (DCIS) is a non-invasive breast cancer it is not included in the measurement used for staging the size of the breast cancer. You can read about this and the other information given in the pathology report in our booklet Understanding your pathology results.

Although you acknowledge that this wouldn’t make any difference to the treatment your wife is receiving, it’s clearly having an impact on the way you both feel about her future prognosis. You may wish to consider discussing this with your breast care nurse or surgeon so that they can help clarify this for you.

Nearly everyone who has been treated for cancer worries about it coming back (recurrence) and you and your wife are not alone in being anxious about this. The uncertainty and fear of breast cancer returning is very real.

Many people are surprised at how emotional they feel when their treatment finishes. Adapting to life after treatment can be difficult and often the need for information and support continues.

You and your wife may be interested in our resources that are particularly for those who have come to the end of their main hospital treatment. These are known as our Moving forward services and include our Moving Forward book and Moving Forward courses.

Talking to someone who has had a similar experience can be helpful and our Someone Like Me service can arrange for one of our volunteers who are trained to provide support to talk to you by email or telephone. Our volunteers have had a personal experience of breast cancer and include partners of those who’ve had a breast cancer diagnosis.

You can ring the Someone Like Me team on 0345 077 1893 or email them at someone.likeme@breastcancernow.org, so they can then match you to your volunteer.

Do call our helpline to talk this through more or ask any further questions. The helpline team have time to listen, talk things through and signpost you to more support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks. The number is 0808 800 6000, (Relay UK -prefix 18001).

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Our usual opening hours are Monday to Friday 9am - 4pm and 9am -1pm on Saturday.

Out of hours you can leave a message and we will call you back when we next open.

Best wishes

Julie

Breast Care Nurse

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