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Thread: ? About Pathology Report

  1. #1

    ? About Pathology Report

    I was diagnosed with DCIS and had to have a mastectomy because of the size of the calcifications. I was treated at a teaching hospital and one of the interns was reviewing my pathology report and said my calcifications were withing .3cm of the margin and did anyone talk to me about chemo. When the surgeon came in she was floored that she said this because DCIS does not require chemo. I aksed her about the pathology report and she said she removed all the tissue. She explained it to me but I still don't understand what it says and I was hoping you could help me.

    It reads like this:

    The deep margin is inked black and the specimen is serially sectioned to reveal an ill defined 5.0x3.5x3.0 cm area of blue stained dense breast parenchyma deep to the nipple extending to wthin .3cm of the deep margin.

    This information is under the specimen information where they list the various containers of tissue. It's not under the diagnoses information.

    The diagnoses info reads:

    Three foci on intraductal carcinoma (largest focus .5 cm) high grade with comedo necrosis. Inked deep surgical margin negative for tumor.

    It doesn't say how deep the marhin was though. Another thing is that I had 3cm of calcifications show up on the mammo. What happened to the other 2.5 cm? I looked back on the pathology report from the biopsy and it says they removed 3.0 cm of tiisue and found.4 cm of calcifications. Could they have removed most of it with the original biopsy? It was a stereotactic biopsy.

    I'm concerned for 2 reasons. Number one I have a rash on my chest that my dr. says looks like excema. They biopsied it today at my request because I'm nervous and I'd like to know for sure that it's not cancer. Number two, when they originally did the pathology from the mastectomy they didn't find any cancer. My surgeon had them redo it and then they found the three foci of calcifications. Also, the mastectomy was skin sparring where they only removed the nipple and got the tissue out from there. I had her remove the biopsy scar too because I understand that cancer can come back in that area. The other opinion I rec'd was going to cut a line across my chest and I'm wondering if I should have had it done that way so more skin was removed.

    Ughhh....I thought I was moving on but this rash has me scared. The dr. said due to my diagnosis of DCIS he is sure it's not cancer but I'm really nervous about it.

    Thanks for your help.


  2. #2
    Lisa S

    ? on pathology report

    After re-reading this I guess I should clarify something. My surgeon was upset at the intern saying the cancer was close to the margins and that I needed chemo because of what the 1st section said...that there was ill defined breast parenchyma deep to the nipple extending to within .3cm of the deep margin. This is the part I don't understand. Does this mean cancer was found in this area or is this just decribing the tissue? The other part said the margins were negative for tumor.

    Sorry for the long post and for not making much sense. I think it's the fear taking me over.

    Thanks again to anyone that can help me understand this.

  3. #3
    Hi, Lisa, I am not sure what the path report says, but I am sure Dr. Leo will stop in and help you with the technical words. If you don't understand, I would ask the doctor to explain in simple words. Keep pushing until you do understand. As for chemo or no chemo, treatment options differ. IMHO I don't think that anyone would ever say chemo is NEVER recommended for DCIS. Hugs, Lauri

  4. #4
    Lisa S

    ? on Pathology report

    Thanks for your response MNLady. I hope someone can come along and help me with this. I've never read anything about someone ever getting chemo for DCIS. The standard treatment is lumpectomy and radiation or mastectomy if necessary.

  5. #5
    Senior User
    Join Date
    Oct 2004
    Hi Lisa,

    Actually, on some of the other boards I've seen a lot of ladies get chemo for DCIS. It might be based on the fact that some DCIS can be very high grade (comedo,etc.) Also, some ladies have said that sometimes there can be a chance of a small amount of undetected invasive cancer in there, too. I think it all depends on what kind of DCIS you have. I know it is not the same in all people.



  6. #6
    Lisa S

    ? on Pathology

    The only time I've ever read or heard of someone getting chemo for DCIS is if there was also invasive cancer found. I've studied information on DCIS since my dignoses of 3/04 and never have I seen chemo done for a diagnoses of just DCIS. If you know of something that mentions this I'd like to see it.

  7. #7
    Nope. Only what I've read from others on the boards. I think some are offered chemo as a pecaution, just in case there was a little invasive cancer in there that was not caught. I myself had invasive ductal. There is probably overtreatment in this area as well as overtreatment in the area of invasive ductal, for fear of someone not benefiting from all the tools available. Of course, in the end, it is up to the patient to decide what they want to do.

    Good luck.


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