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This question was answered on Mon 12, May 2008 09:07am by Dr Bobby V, MD

BREAST CANCERDiagnosed with IDC in both breasts. (Grade 1 left & Grade 2 right) Neo adjuvant endocrine therapy. pre menopausal.


    
Asked by user (Female; 50; Diagnosed with IDC in both breasts. (Grade 1 left & Grade 2 right)Neo adjuvant endocrine therapy. pre menopausal. Surgery - wide local excisions removed both tumours and axillary claerance on left. Waiting to start chemo and then radiotherapy; Relevant drugs:WAs receiving prostrap and femara . Now stopped in preparation for chemo. ) on Wed 07, May 2008 06:03pm

Pathogy report states both tumours contained high grade DCIS. PLease explain how a high grade DCIS is contained within low grade IDC ? Does this increase chance of recurrence ? Pathology shows clean margins. 6 out of 13 nodes in left axilla were positive and tumour was grade 1 and 5cm what stage is this cancer ? What is my risk of recurrence after 6 cycles of FEC ? Both tumours were 8/8 ER and PR positive
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Answer by Dr Bobby V, MD  on Mon 12, May 2008 09:07am:

Hi, Thanks for the precise question, and for providing relevant details. DCIS or Ductal Carcinoma In Situ, is a neoplastic growth that is confined within the breast ducts, ie it has not yet breached the basement membrane lining the duct. IDC or Infiltrating Ductal Carcinoma is a malignant growth originating in the breast ducts, and which has infiltrated into the breast parenchyma. This is what is commonly known as “breast cancer”. The two (DCIS and IDC) entities may be present within the same surgical specimen. The portion within the duct is the DCIS component, and the invasive portion is the IDC. The “grade” of the tumor depends on certain microscopic characteristics which pathologists describe as “tubule formation”, “nuclear polymorphism” and “mitotic figures”. DCIS and IDC are graded separately. Hence it may be possible for a high grade DCIS to be contained within low grade IDC. Your prognosis will largely be determined by the invasive or IDC component, and will not be influenced much by the presence of the high grade DCIS. Tumor Stage is determined according to the American Joint Committee on Cancer (AJCC) staging system. This incorporates size of the tumor (T stage), lymph node involvement (N stage) and metastasis (M stage). According to the information you have provided, your tumor is stage T2N2M0. This corresponds to Stage IIIA. Mathematical modeling results show that your chances of recurrence after 10 years without any further therapy are 51.9%. If you take hormone therapy, you will derive a benefit of 24%. If you take chemotherapy, you derive a benefit of 15.7%. If you take chemotherapy, plus hormone therapy, you derive a benefit of 33.4%. In other words, your chances of recurrence after 10 years will be approx 15%. I wish you all the very best of luck.

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