A shocker was DCIS then went to the bloodstream stage 4

[dlaxague]

So sorry to hear what you've been through. The most-likely explanation for your very-unpleasant surprise is that the initial pathology missed the invasive component of your diagnosis (iow, it was not "just" DCIS). They do not inspect every cell in the biopsy specimen, alas. These mistakes are rare (thankfully, though it doesn't help you any), and I don't know if they are just due to chance, or to poor quality care. If you're interested, it might be worth it to have your original pathology reviewed, in light of what you now have experienced.

There are no studies to confirm your opinion that finding stage IV bc at any particular stage or size changes outcome (based on the evidence that the metastatic be either does or does not respond to treatment, regardless of how/when it's found).

There are many on this forum who disagree with that perspective, but there equally many who will say that once you're dealing with stage IV bc, it's better to be slow to respond to changes and progression because that leaves more tools in the toolbox for longer periods of time.

I do not know the answer to this controversy, but I would guess that it's a matter of style and (perceived) qol. If you feel like immediate detection/treatment of progression is of value to you - then it is. If you feel like a more leisurely approach suits your style and prolongs your life - then that's the way for you to manage your cancer. Each person needs to find an onc whose style is suited to (or can adapt to) each individual's preferred style, when managing any disease, but especially stage IV breast cancer.

Debbie Laxague