for Jean, Robin P and all those who started with DCIS with microinvasion (recognized

[TSund]

Hi all,

Could someone explain WHY DCIS has a higher HER2+ rate? When Ruth had her biopsy, it showed both DCIS and the regular stock invasive ductal carcinoma.

Does all IDC start as DCIS? why would the Her2+ rate go down once it gets to IDC (if it indeed does?)

Thanks so much,

Terri

[mcgle]

Good questions. I, too, would be interested in any replies.

Mcgle

[Jean]

Terri,
I certainly do not have an answer on Her2 rate associated with DCIS or
less with IDC....

But, when I had my mammogram the first words from my dr. was it was
so small that they were very positive it was DCIS...also the breast surgeon told me that currently DCIS is now being treated as a cancer.
Yes, it is a pre-cancer...and it would be staged at 0 it really means
that the cancer has not become invasive. As small as my tumor was
a portion of it had become or was...invasive. DCIS still requires treatment.
Also one is at a higher risk when being dx. with DCIS for the cancer to come back, therefore, treatment is advisable. Lumpectomy, radiation.
There are different grades of DCIS...maybe that is where the Her2 rate
may show more information (I do not know)....I would gather that Her2
is not in all DCIS but would be judged by the personality of the DCIS.
I do know of any studies done on DCIS rates with Her2.

Jean

[TSund]

huh? DCIS has a higher rate of recurrence? I thought DCIS was usually the least dangerous bc>?

[Jean]

Terri,
Did not say that DCIS has a higher rate of recurrance said, when you have had DCIS, you are a higher risk for the cancer coming back or developing a new breast cancer than a person who has never had breast cancer before. Once again it depends on the personality of the DCIS.

Jean

[TSund]

Ah, that makes much more sense.

You know, with all of the trauma over Ruth's multi-focal invasive cancer, it never even occurred to me that since biopsy also showed DCIS then I should be paying attention to the DCIS comments also!

Arrrgh...there is just so much to digest it becomes overwhelming.

Do I remember correctly that someone said DCIS does not shrink from the chemo? Does that mean that Ruth will still have DCIS cancer even if her tumors end up responding to the chemo quite well?

TRS

[Hopeful]

Terri,

I don't know your wife's pathology, but my tumor was combined DCIS/IDC, so I have done some research on it. Here is a link to a paper that found that the presenced of DCIS confers an improved prognosis for patients with T1N0MO invasive breast carcinoma: http://www.scielo.br/scielo.php?scri...lng=pt&nrm=iso

I know you haven't been a member here for that long, so here is a link to a thread from the Articles Forum from last year where the topic of IDC/DCIS was discussed: http://her2support.org/vbulletin/sho...eferrerid=1173 There is some good information there, too.

Hopeful

[TSund]

Hopeful,

THis was very informative and very helpful!!

Ruth's cancer was multi-focal and total area was large unfortunately. I do not know the % of DCIS vs. IDC. I do not know if there is a way to tell this pre-surgery. I think they only needle biopsied the largest tumor (about 2 cm) However, this is interesting info as all docs (2 oncs, 2 surgeons, 1 GP, 1 nurse practioner) were so sure there would be node involvement, and yet there has been no substantive proof of that; no papable nodes much to their surprise I think. Scans all negative. Of course that does not rule out microscopic invasion. I wonder if this element contributes to this fact.

We are fighting the odds given the extent of Ruth's disease, but there have been other good markers, no lymphatic invasion seen, hormonal ER+/PR+ positive, etc. And the pre-adjuvant TCH chemo has been making an apparant immediate affect, which I was surprised at given the fact that she is so strongly hormonally positive. 100%+/95%+

I pray that this chemo is getting at cells that have floated elsewhere. Who knows.

Terri

[Lani]

Genes May Not Affect Odds
Of Surviving Breast Cancer
By JOSEPH PEREIRA
July 12, 2007; Page B6
Breast-cancer patients carrying two well-known genes linked to the disease have the same survival chances as noncarriers of the genes who develop the disease, according to a study by Israeli and Canadian researchers.

The study was aimed in part at shedding light on whether breast-cancer treatment should be tailored differently for women with the two gene mutations, known as BRCA1 and BRCA2. The results provided no decisive answers on that question, but could provide some comfort to carriers who might feel the odds stacked against them.

The study of 1,545 breast-cancer patients found 10-year survival rates of 49% for women carrying BRCA1, 48% for carriers of BRCA2 and 51% for noncarriers, including deaths from other causes. The slight differences weren't statistically significant. The study was published in this week's New England Journal of Medicine.

The differences in death rates from breast cancer among the three groups also weren't statistically significant. After 10 years with the disease, about 33% of both noncarriers and carriers of the BRCA1 gene had died from it.

"As a result of the study, we can offer to the medical community the assurance that there is no difference in the prognosis between carriers and noncarriers," said Gad Rennert, the study's lead author and chairman of the medical faculty at Israel's Technion university in Haifa.

The finding is somewhat of a surprise, as carriers of the mutant genes tend to develop a more virulent form of the disease that strikes before age 50, and can be resistant to certain types of treatments. Previous studies have produced conflicting results, partly because they were conducted on a smaller scale. But researchers say that this study -- conducted by scientists at Technion and the University of Toronto -- is by far the largest of its kind, giving more weight to its conclusion.

One problem that has stymied researchers is a scarcity of patients with the condition. Less than 1% of the general female population carry the BRCA genetic mutations. But among Jewish women of Ashkenazi, or European, descent, the two mutations are especially prevalent. For the study, researchers culled their breast-cancer subjects from the Israel National Cancer Registry, gathering medical records and tumor-tissue samples from patients dating back to the late 1980s.

It remains to be seen whether the study's results will influence the treatment of patients with the mutation. Simply learning that a patient has the genes "may add little to the clinician's ability to select a therapy or predict the course of the disease," writes Patricia Hartge, a National Cancer Institute researcher who wrote an accompanying editorial. She added, however, that the finding gives women who know they have the mutation and their doctors another factor to consider as they ponder such precautionary measures as prophylactic surgery before the onset of the disease.

Dr. Hartge said one perplexing statistic in the study involves a small number of patients who died within 10 years even though their tumors were small and hadn't spread to the lymph nodes. While the overall conclusion of the study is "generally comforting," she said, "there is this little disturbing footnote that is calling for further research on the subject."