Hello, I was diagnosed with a grade 3 IDC and had a lumpectomy in May. The subsequent biopsy showed an unclear margin plus 1 out of 3 lymph nodes with cancer. When I received the histology report it also referred to an area of high grade DCIS 'within the boundaries of the invasive tumour'. Approx 5% of the IDC tumour was not removed and this is adjacent to the high grade DCIS which has resulted in the unclear margin. The pre-surgery MRI did not identify the DCIS and none of the post-surgery discussions or letters made any mention of high grade DCIS either. Following the lumpectomy I was put on a 6 month course of chemotherapy with the plan to re-excise the margin and possibly undertake a full lymph node clearance after the chemo.
The oncologist has said that the chemo is adjuvant, to mop up any stray cells and prevent a recurrence, and there is no need for any scans during chemo (despite not all of the IDC tumour & DCIS having been removed). They also recently advised, when I asked about the DCIS, that this would not respond to chemo so they had been focussing on the IDC. The surgeon has recently said that the plan is still to re-excise the margin after chemo and to now definitely have a full lymph node clearance. I asked about the removal of the high grade DCIS, and the apparent lack of information with regards to how large this is, and asked if a mastectomy would be more appropriate and was told not at the moment, but there are no guarantees that the margins would be clear so options would be discussed after the next surgery if necessary. I asked how much breast tissue would be removed - quite a lot has already been removed - but was told that they wouldn't know until during the surgery. I was also told that they won't be able to tell if the chemo has worked, although there may be some evidence of this within the removed lymph nodes and depending on how much cancer is found they may need to consider re-staging and other treatment options (CT & Bone scans 6 months ago showed no spread).
So, I'll be having the re-excision approx 9 months after the first surgery but there are no plans to have a further MRI before this to check on the size of the remaining IDC tumour and area of high grade DCIS (I will keep requesting this). I'm concerned that the high grade DCIS appears to have been overlooked during my care plan and the re-excision won't be successful, so it would be good to hear from any others who have had margin re-excisions which were successful first time, or had a re-excision on a joint area of IDC & high grade DCIS. Thanks x
