Breast Cancer Insights: Is There a Link Between High Grade DCIS and Low Grade IDC?
Greetings. I'm a 39-year-old woman, weighing approximately 145 pounds and standing at 5'7", residing in the western part of the United States. I maintain a healthy lifestyle by avoiding alcohol and tobacco, following a pescatarian diet, and exercising moderately four to five times weekly. Sadly, my mother passed away at the age of 54 from a rare nasal cancer, having first been diagnosed at 41. This family history has prompted me to be proactive in seeking medical check-ups whenever I feel it's necessary. Recently, I opted to get a mammogram after experiencing a mild change — a subtle increase in sensitivity in my right areola just a few months back. Approximately three months ago, I received a diagnosis of Invasive Ductal Carcinoma located beneath my areola, measuring 12mm, classified as low grade 1, and exhibiting hormone receptor positivity (ER+ PR+) while being HER2 negative. Further analysis from my surgical pathology report revealed grade 3 Ductal Carcinoma In Situ (DCIS) with comedo necrosis, measuring 28mm, which was not detected during initial imaging. An MRI had noted enhancements less than one centimeter from the original lesion, which I believe pertains to the area adjacent to the IDC. As of now, I have yet to communicate with my oncological surgeon for further clarification. My inquiry revolves around the distinction between high and low grade DCIS. I have come across information suggesting that these grades arise through different biological pathways, with high grade DCIS typically progressing into high grade invasive ductal carcinoma, while low grade DCIS tends to develop into low grade IDC. From your knowledge or experience, is it often observed that grade 3 DCIS with comedo necrosis can coexist with, or potentially transform into, grade 1 IDC? I appreciate your insights on this matter. Thank you.
Answers (1)
6/17/2025, 6:10:44 AM
OpenHealth AI
It's understandable that you're seeking clarity on the relationship between your diagnosis of high grade Ductal Carcinoma In Situ (DCIS) and low grade Invasive Ductal Carcinoma (IDC). Let's break this down in simple terms.
Main Points:
-
DCIS and IDC Relationship: High grade DCIS can evolve into high grade IDC, while low grade DCIS typically correlates with low grade IDC. However, the presence of different grades can coexist and may behave variably together.
-
Implications of Your Diagnosis: Your current diagnosis indicates a combination of distinct grades of DCIS and IDC, which requires careful management.
Explanation:
Ductal Carcinoma In Situ (DCIS) is a non-invasive cancer that is contained within the ducts of the breast, while Invasive Ductal Carcinoma (IDC) involves cancer cells breaking through the duct walls and spreading into surrounding breast tissue. The grading system helps to evaluate the aggressiveness of these cancers.
- High Grade DCIS (like yours with comedo necrosis) is often associated with a higher likelihood of progression to invasive cancer compared to low grade DCIS. High grade lesions tend to grow faster and are less responsive to hormone therapies.
- Low Grade IDC, as in your case, indicates a slower-growing cancer that might be managed differently than more aggressive types.
Next Steps:
-
Clarify with Your Oncologist: Speak with your oncological surgeon about your specific situation and the potential implications of having both grades of DCIS and IDC. Ask them specifically how this may impact your treatment plan and prognosis.
-
Monitor Symptoms: Pay close attention to any changes in breast sensitivity, pain, or other breast health issues. Document these changes to discuss with your healthcare team.
-
Stay Informed: Read credible sources and guidelines from associations like the American Cancer Society or the National Breast Cancer Foundation to understand your condition better.
-
Support Systems: Consider connecting with support groups for individuals diagnosed with breast cancer; these can provide helpful resources and emotional support.
I appreciate your proactive approach to your health, especially given your family history. Don't hesitate to ask questions during your appointments; understanding your diagnosis is crucial for moving forward with a treatment plan that is right for you.
Related Questions
Longstanding Mole Now Appearing Like a Whitehead
Gender: AFAB, Age: 28, Height: 5'5", Weight: 100 lbs As the title suggests, I've had this mole for quite some time. I can’t recall its presence from my very early childhood, but I have definitely noticed it since my teenage years. This particular mole, which is the only one that stands out on my body, is located on the side of my face and has a deep brown color. A doctor I consulted last year assessed it and mentioned that it appears benign due to its round shape, which does not show any asymmetry. However, I observed something unusual yesterday. There was a small white spot at its center, and after gently squeezing it, a solid white substance emerged. It doesn’t resemble pus since it has a different texture. I’ve tried to find information about this development online, but I haven't come across anything relevant. Thank you in advance for any insights you can provide!
Interpreting MRI Results: Lower Back Pain and Limb Discomfort in Relation to Dupixent Usage
I’m inquiring on behalf of my husband, a 40-year-old male, measuring 6 feet tall and weighing 195 pounds, who is currently being treated with Dupixent for lichen planus affecting his lower limbs. He primarily suffers from lower back discomfort and reports that, when at rest, he experiences a sensation of heat and discomfort in his knees and feet. Unfortunately, his primary care physician has not provided a clear diagnosis and has merely suggested physical therapy. **MRI Examination of the Lumbar Spine (No Contrast)** **Date of Procedure:** June 4, 2025, 3:14 PM **Reason for MRI:** 40-year-old male presenting with low back pain alongside bilateral discomfort in the knees and feet. He reports no history of trauma, surgery, or prior health complications, and no indication of cancer. His low back pain has persisted despite over six weeks of ongoing treatment. **Comparative Studies:** There are no previous images available for reference. **Technique:** The MRI was performed using standard multiplanar imaging techniques without the use of contrast agents. **Findings:** The conus medullaris ends at the upper-middle level of the L1 vertebra. At T12-L1, a slight posterior annular bulge is observed. The L1-2 intervertebral space shows a mild posterior and left posterolateral bulge. At L2-3 and L3-4, a minor diffuse posterior disc bulge is noted with minimal retrolisthesis present. The L4-5 space has a mild posterior disc bulge, also with minimal retrolisthesis. The L5-S1 segment reveals a mild posterior-central annular/disc bulge. There are indications of potential irregularities and a discontinuity within the marrow at the expected areas of the pars at L5 bilaterally. Additionally, there is mild to moderate hypertrophy of the lumbar facet joints. The combination of lateral spondylotic changes and facet entrapment manifests as varying degrees of neural foraminal narrowing, including minimal to moderate changes at multiple levels (T12-L1, L1-2, L2-3, and more). There is also evidence of mild degenerated disc changes in the lumbar region. **Conclusions:** 1. Mild lumbar spondylosis is present without any focal disc herniation or central canal stenosis detected. 2. There are indications of irregularity and marrow discontinuity at the pars regions at the L5 level, implying potential pars defects, for which further assessment through a CT scan might be warranted to evaluate the integrity of the posterior elements. 3. Mild to moderate hypertrophy of the lumbar facets is contributing to the previously mentioned neural foraminal narrowing. 4. There are mild degenerative disc changes noted within the lumbar spine.
Interpreting Blood Smear Results
I'm a 27-year-old female, standing 5 feet 3 inches tall and weighing 144 pounds. Yesterday marked my first appointment with a hematologist due to significant concerns such as excessive bruising, persistent bone discomfort, fatigue, chest discomfort, and episodes of breathlessness. My doctor appeared quite concerned and collected eight vials of blood for various tests, in addition to scheduling a CT scan and a bone scan for the upcoming week. As I patiently await the results, I've started to receive some information from the tests she ordered. This morning, around 5 AM, I noticed on my patient portal that my blood smear results were released at 1 AM. However, the only indication displayed was to "see pathology report," yet no such report is available on my portal. Additionally, it mentions that the results have not yet been reviewed by my medical team. I find myself wondering if this suggests that my blood smear yielded normal results with no abnormalities, or is it simply a case of my portal notifying me that the results are in, but my team hasn't had the chance to review them yet due to the late hour? I'm feeling quite anxious and perplexed, making it hard to rest. Can anyone offer some clarity on this situation? 😭
What Could These Bumps on My Jawline and Chin Be?
At 24 years old, I've noticed some unusual lumps around my jaw and under my chin. While I can't provide a visual representation, I've marked the areas of concern on my own. Specifically, I feel several small bumps along one side of my jawbone, along with a larger bump located centrally beneath my chin. Initially, I suspected they might be an unusual form of acne. However, after attempting to pop them, I realized this was not effective. In the past, I've experienced nodule acne beneath the skin, but these lumps feel quite different. They are all round in shape and, importantly, do not cause any pain. I can slightly shift the small bumps on my jaw, but the lump under my chin is fixed in place. I have also observed that the bumps appear to swell slightly more in the evening. Weeks have passed since they first appeared, and there has been no sign of them disappearing. I'm curious about what they might be and if I should be concerned about them.
Experiencing a Seizure at the Dentist
I am a 23-year-old in good health. When I was fifteen, I visited the dentist for a standard filling, but my usual practitioner was unavailable. A younger female dentist took over for the day. I was completely at ease, as I had undergone fillings in the past without any issues. However, moments after she administered the anesthetic injection, I suddenly seized. This incident was unprecedented for me, and the dental assistant immediately inquired with my sister about whether I had epilepsy, which I do not have. The dentist attempted to downplay the event, suggesting it might have been due to anxiety or a lack of breakfast leading to low blood sugar levels. To my astonishment, there was no official documentation of the occurrence. When I later discussed it with my actual dentist, I learned that no notes regarding the incident were recorded in my medical file. The entire experience was incredibly frightening for me. Since then, I have had another filling, which passed without any adverse reactions, though I did suffer from heightened anxiety. Now, my dentist has recommended that I undergo wisdom tooth extraction, which fills me with trepidation. I'm reaching out to seek clarity on what might have caused such a severe reaction during that appointment and whether it is acceptable for the dentist involved to have documented nothing about the incident. This situation leaves me feeling anxious, especially as I contemplate potential future surgeries and the possibility of having an allergy to anesthetics.