wondering how many had DCIS plus her-2+ invasive cancer

I have been wondering about the connection between DCIS and her-2+ invasive bc, since most DCIS is + for her-2. I had a large area (6cm.)of DCIS and 2 other tumors (1-2cm. and 1-1cm.)of invasive in my right breast. I will always wonder if the 2 invasive tumors were cell escapes from the DCIS since they were her-2+. How many others had DCIS present in the breast with the invasive tumor or tumors? My DCIS was the very aggresive comedo type and it was just slightly broke out of the duct in one minut spot. Could that have caused my invasive tumors to grow in other parts of the breast?

Hi, mine was/is similar, I found a lump in 1998 and had a mammogram which did not find anything, the lump in my opion was squashed by the mammo because I couldn't feel it after but within 12 weeks I had invasive cancer with a tumour that had tripled in size, hence a radical mastectomy of the left breast with 16 out of 16 glands all positive and not hormone responsive, a few years later a skin biopsy was tested for Herceptin and I was HER-3, it seems that agressive BC responds to Herceptin.

Hugs Lyn

Dear Tracie,

The question you pose is a good one. Unfortunately, it is the subject of some controversy. For example, Susan Love, MD and Dennis Slamon, M.D., Ph.D. (credited with the discovery of herceptin) have two somewhat different perspectives.

At Susan Love's cite, one of her "frequently asked question" responses is as follows:

"HER2/neu is not useful in guiding DCIS treatment because it is more common for DCIS to be HER2/neu positive than it is for invasive cancer to be HER2/neu positive (we don't yet know why this is). Also, we have no data on treating women with DCIS with Herceptin, which is the treatment used for HER2/neu-positive tumors. This is, though, an area of active research."

Dennis Slamon is quoted on the Abbott Laboratories website within the following context:

Most breast cancers begin in the milk ducts, narrow passageways that radiate throughout the breast. A few cells, for reasons that are not completely understood, start accumulating genetic mistakes that cause them to grow abnormally. Eventually the cells develop into DCIS (ductal carcinoma in situ). The good thing about dcis cells is that they haven't spread beyond the milk duct. The bad thing is that they are malignant. "Some people call DCIS precancer, but it's not precancer," says Dr. Dennis Slamon, director of breast-cancer research at the UCLA School of Medicine. "It's preinvasive. It's cancer that hasn't invaded outside the breast ducts."

It appears that Slamon leans toward your thinking that DCIS is malignant preinvasive cancer. It also appears that we do not know why a large percentage of DCIS is HER-2 positive, yet a lesser percentage of invasive cancer is HER-2 positive.

Traci,

Mine is almost identical to yours....7 cm of DCIS, two invasive ductal carcinomas (1.2cm & 1.3 cm) 15 of 19 positive lymph nodes. Ironically, I had been very carefully monitored for the previous 10 years, having several surgical biopsies of fibroadenomas (all benign), aspiration of cysts, etc. I religiously had mammograms, ultrasounds, you name it and was seen every 4 months. With all that it still did not appear until the DCIS showed up on a mammogram. It is a very aggressive disease in my opinion. Ironically, this showed up in my right breast, which is the same one that my original biopsy 10 years earlier showed benign tumor. I believe it is all connected. Thank God for Herceptin and the newest treatments.
Kitty

Hi -
My main tumor was ductal, invasive and Her2+++. It had infiltrated and was in 8 of 18 nodes. Within my lumpectomy they did find another tiny DCIS forming, but that was the only one and the margins were clean. Breast MRIs showed no more tumor (that can be picked up on MRI).
I had a mammogram just 4 months before I found my lump. My tumor was small at less than 2cm.
I agree that the DCIS is the stage just before breakout and should be treated as such.

Tracie
I had both, the invasive ductal was very small, and when I had the mastectomy, the path report noted DCIS also...no positive nodes, but Her2 3+...then recurrence 1 1/2 yrs. later ..
Hugs
Sheila