Hi. I was diagnosed with grade 2 Invasive ductal carcinoma late Jan. Since had lumpectomy and SNB which was negative. All margins were negative too. However the tumour first thought to be 12mm was 27mm and grade 3 (ER positive HER2 negative) after histology which I understand can happen. Surgeon explained this and said I’ll have to have chemo now and has referred me to Royal Marsden. In the letter to RM(which I received a CC copy) he mentioned DCIS intermediate and ER 7/8 but never explained what this meant. I have rough understanding of the ER but the DCIS. Does that mean there is another area that is in situ at the moment but could become cancerous? I’m worried that it’s going to become invasive in the future. Will I have to have a mastectomy? Would have been better to have a masectomy in the first place?
Hi shahz416,
Thanks for posting. It is understandable that you are confused and have questions after receiving your letter outlining your histology results. As you say, sometimes postoperative pathology results differ to the biopsy results, and this can be confusing. This is because surgery removes more tissue and allows for more accurate measurement and analysis.
ER refers to the oestrogen receptors on the cancer cells and a score of ER 7/8 means that the cancer is strongly sensitive to oestrogen and will benefit from hormone treatment.
You say that your report showed intermediate grade DCIS and ask if this means that you will need a mastectomy. DCIS is in situ or pre invasive breast cancer and is sometimes removed at the same time as invasive cancer. This is called an incidental finding and if your margins are clear, no further surgery would be required. However, it is important to ask your breast care nurse or treatment team to explain your results to you in more detail. They will be able to answer your questions and explain what further treatments are recommended and the reasons for them.
We offer a range of free supportive services for anyone who has had a diagnosis of breast cancer which you may be interested in. They include face to face and online courses and events.
For more details about all of these services, please see the information on the link, or call our free helpline if you would like to talk this through or have 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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