October 01, 2013 -- Diagnosis

The diagnosis of cancer is initially not very straight-forward or clear until after surgery.  That’s when the doctor can actually see it and the pathologist tests the tissue the doctor removed.  My current diagnosis is Invasive and Ductal Carcinoma in Situ (DCIS).

All DCIS is considered stage 0 cancer – the earliest stage possible.  “Stage” describes how far the cancer has spread beyond the site of the original tumor.  Even though DCIS is always considered stage 0, it can be any size and be located in any number of areas inside the breast.

Invasive ductal cancer means the cancer cells have broken beyond the breast duct.  The breast cancer is no longer a DCIS, but an invasive ductal carcinoma, the most common type of breast cancer.

The lobules (mammary glands) produce milk during pregnancy and breastfeeding.  The ducts carry milk for the lobules during breastfeeding to the nipple.  Fatty tissue fills the spaces around the ducts and lobules.  My films show two masses or tumors.  One is in a milk duct (DCIS), and the other is behind the first in the fatty tissue (Invasive).  It’s the second tumor which has me currently labeled as Stage I.

Stage I.  The tumor is 2 cm or less in diameter.  It has invaded the surrounding breast tissue, but has not spread to the underarm lymph nodes.

Stage II.  The tumor is larger than 2 cm or has spread to the lymph nodes under the arm.

Stage III.  The tumor is larger than 5 cm and/or the tumor has spread to the skin, chest wall, or nearby lymph nodes.

Stage IV.  The tumor has spread to the bones, lungs, or lymph nodes far away from the breast.

Both of my tumors together are just about 2 cm in total.  When the sentinel lymph node is removed during surgery and tested, we’ll know if I’m still in the Stage I category or if the cancer has progressed to Stage II.  We’re hoping for Stage I because it is by far the easiest to treat.  For my favorite medical wonks, the complete diagnosis is:

Invasive and Ductal Carcinoma in Situ – Breast, right, mass at 10 o’clock.  Size: 7.0 mm as measured from the slide.  (The mass in the milk duct is 0.7 in centimeters (cm); the second mass is behind it and harder to see or measure.)

Stage I

Grade 3 – middle, moderate

Estrogen & Progesterone Hormone Sensitive

HER2 – negative

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