invasive ductal cancer with high grade DCIS and chemo



Diagnosed yesterday from core biopsy results. The diagnosis is invasive ductal cancer with high grade (grade 3) DCIS. 35 mm mass which is 25mm from nipple upper outer quadrant of left breast. Oestrogen receptor 8/8 and progesterone receptor 7/8. On the ultrasound one lymph node looked thickened so they did fine needle aspiration and found metastatic carcinoma. I am transferring over to a consultant recommended by a close friend. The one i saw today told me i would need mastectomy, I’m only an A cup so he said with size of mass in proportion to the breast he would want to remove it. He was unsure if i would need chemo afterwards or not. My friend who was with me said because of lymph node involvement and fact it’s grade 3 i would probably need chemo. Just wondered if anyone on here has had the same and can offer any insight?


Thanks in advance,

Hi, I don’t know if it helps but here goes - first off, sorry you’ve had to join that club where none of us wanted to be, you will find a lot of help here . . . 


I’m 63, diagnosed in March this year, after I randomly found The Lump one night.  There is no BC in my family as far as we know, so being a bit of a fatalist, I’d torn up mammogram offers and didn’t self check as a matter of fact.  When I found The Lump, I self referred quickly to my GP and within the 2 weeks I was in the fast-track system. I told no one else at all, not husband, no one.  This had to be my decision, and I needed time to take this in.


That appointment led to a diagnosis on the first appointment after mammogram, and ultrasound biopsy,  of definitely a cancerous lump and a lymph node affected.  Lying there having this ultrasound done, my only thoughts were that I shouldn’t be here and this was surely a mistake.  I was very cool and calm, until they told me a few hours later that I was that 1 in 10.  I burst into tears.


CT scan, bone scan to check for further involvement came back clear.  Full biopsy results 2 weeks later indicated 2.2cm  Grade 3 invasive ductal upper outer quadrant, same hormone results as you, HER2 inconclusive, and lymph node involvement. 


I’m not large breasted, 34B/C at most. I made it clear at the off that I would not consider chemo, whether it be recommended or not.  That’s a long held opinion, and that’s about ‘me’ not about the diagnosis.


I had WLE and axillary node clearance about 8 weeks after diagnosis.  The consultant had pretty much got the measure of me, and what I would or wouldn’t do/have.  They found some DCIS mixed in with the invasive, they didn’t get the best of margins because being smaller breasted there was no more tissue to take at the margins, and they removed 11 lymphs and cancer present in 1. Radiotherapy was always on the agenda, particularly because I had refused any chemo, and the R/T would hopefully ‘mop up’.  I had 20 zaps in the summer.  I am on Letrozole due to the hormonal aspect of the cancer.  I refused bisphosphonates.


In essence, my breast cancer had to be dealt with in the way that my head and views see life.  I’m older, my kids are all adult, albeit the youngest still only 23.  I have always had very strong views about medical intervention and have been lucky to get this far in life before needing to think so urgently about it.  The Lump had to go because that was just a medical fact.  The R/T had to happen because it was integral to the surgery being given the best chance to be fully effective, as was my understanding, and to have refused R/T as well as chemo made me feel thatI would be wasting the surgeon’s time? If that makes sense?  Chemo lurked in the equation because of the lymph node involvement, but as I say, I have long-held mistrust of chemo, so it has never troubled me to refuse it.


After the op, at the post-surgery appointment with results, my consultant explained it all - and quietly and rationally explained that because of all the above factors, there was a chance/good chance that this BC would be back to haunt me.  But to his credit, he ‘understood me’ and respected my stance.  He did say that ‘these days’ there is an opinion that maybe some cancers are being over-prescribed, with chemo being recommended, when surgery and R/T are producing parallel results.  The oncologist of course took a completely different position, and didn’t support my refusal for chemo in a polite but cool manner. (Speaking with the specialist oncology nurse she said that 50% of patients she had seen this year were refusing chemo, so I wasn’t quite the anomaly that I might be feeling that I was!)


I can’t say that my way is the right way - but it’s the right way for me, and the sort of person I am and always have been.  My three kids all understand and relate to my feelings of quality of life being paramount, other half and elder sister find my stance difficult to understand - but this is ‘me’  -  I have always been this person with these views, and BC has challenged me big time on those views.


Apologies if I have rambled, but I just wanted to explain myself clearly, and I truly wish you all the very best with your unwelcome journey. x