Invasive lobular cancer and treatment choices

Posted by denisesjourney123 @denisesjourney123, Feb 9 6:59pm

I was diagnosed with ILC in dec2023. I just had a lumpectomy and they removed 3 small tumors grade 1 and 3 lymph nodes. My lymph nodes were negative but my margins were positive. I’m scheduled for a mastectomy and estrogen blocker in the future.I’m waiting to hear if I need chemo. I am considering reconstructive surgery later. How many of you with ILC would get the mastectomy ?My right breast is fine so far. How many of you would take the estrogen blocker knowing the side effects? Thanks

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I'm only one year into Letrozole for ILC and my bone density pushed into osteoporosis. I'm 58 yrs, rather thin, small build who does all the calcium, vit D and strength exercises. The endocrinologist really thinks best option is to start with weekly Fosamax. I am in remission with my Chrohn's but there is a possibility I will have to go with the annual infusion of Reclast if I don't properly absorb Fosamax. I am very anxious as side effects seem terrible and no way of knowing if I will in fact have any spine fractures which my doc is most worried about. The doc also said root canal, crowns would NOT be an issue but extractions, implants would be procedures he would recommend getting before going on the bisphosphates. Anybody have advice....xooxox

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I had invasive lobular cancer in my right breast, tumor was 3.1 cm with additional nodules around it. Had 1 positive lymph node and one with ITC cells. Left breast invasive ductile cancer with 4 mm tumor. Both cancers were estrogen+, progesterone+ and Her2 -, I had double mastectomy with 7 weeks radiation including boosted radiation for positive margins in right breast. I did not have chemo due to low oncotype scores and no advantage.
I took the hormone blocker arimedix for 18 mos but lost 14% bone mass in my lower spine and hips within that time, memory loss, arthritis in hands, severe insomnia, mood disturbances, depression, etc. so quit the medication. I still see my onccologist but also see an md who is a functional medicine, naturopath as well. I take dozens of natural AI's and do intermittent fast along with rigourous exercise at least for days a week. I had my estrogen levels checked a few days ago and they were 14pg/ml. I contacted my oncologist office and they as I thought the labs were positive but they told me my levels should be 1-3pg/ml. I am worried now. Has anyone else taken the path I have successfully? Anyone had there estradiol checked while on hormone blockers? Any advise would be appreciated...

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@semurrey

I'm only one year into Letrozole for ILC and my bone density pushed into osteoporosis. I'm 58 yrs, rather thin, small build who does all the calcium, vit D and strength exercises. The endocrinologist really thinks best option is to start with weekly Fosamax. I am in remission with my Chrohn's but there is a possibility I will have to go with the annual infusion of Reclast if I don't properly absorb Fosamax. I am very anxious as side effects seem terrible and no way of knowing if I will in fact have any spine fractures which my doc is most worried about. The doc also said root canal, crowns would NOT be an issue but extractions, implants would be procedures he would recommend getting before going on the bisphosphates. Anybody have advice....xooxox

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My rheumatologist put me on reclast to avoid digestion problems

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@semurrey

I'm only one year into Letrozole for ILC and my bone density pushed into osteoporosis. I'm 58 yrs, rather thin, small build who does all the calcium, vit D and strength exercises. The endocrinologist really thinks best option is to start with weekly Fosamax. I am in remission with my Chrohn's but there is a possibility I will have to go with the annual infusion of Reclast if I don't properly absorb Fosamax. I am very anxious as side effects seem terrible and no way of knowing if I will in fact have any spine fractures which my doc is most worried about. The doc also said root canal, crowns would NOT be an issue but extractions, implants would be procedures he would recommend getting before going on the bisphosphates. Anybody have advice....xooxox

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I had ILC. 12mm. Lumpectomy. Last Sept. Had hysterectomy a year before that because I had endometrial cancer. I am also thin but otherwise healthy except two years ago diagnosed with RA. I control it with methetrexate and plquenil. Because of the testing I have had there is a 92% chance I will not get my BC back so I did not have radiation and opted not to do the hormone blocker. Because I have osteopinia and the blocker would throw me into osteoporosis. I lift light weights and walk and use elyptical 5 days a week. My mammos every year with ultrasound did not show my breast cancer. I found the lump myself. It showed up with mri with dye. I am having only mris now and ultra sounds but am having a hydration iv to clear the gadioleum dye from my system. My hair thinned but taking neutrofol everyday. We will see. I just. Keep moving and checking my self. Good luck to you.

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@kstar077

I am lucky. I also a year prior to my ILC had a hysterectomy. I had a pelvic ultrasound that I made my gyne order after I had an mri of my back. The radiologist suggested the ultra sound of my pelvis because my endometrium was 7mm thick when it is suppose to be 4mm. I sent my report to my gyne. He said it was sine and wait for my annual with him which was 6months later. I had a bladder infection and went to my urologist. He took one look at my ultra sound report and said you need a biopsy. Did it and had a small cancer on my endometrium. Yikes! Had hysterectomy. No cancer in lymph nodes nor ovaries nor margins. But again I was my own advocate. The only place my cancer can come back is in my vagina and my surgeon is checking me in April. I just had a customer checking my bladder because I keep having bladder infections and it was clear. Good luck I hope no more cancer. For both of us.

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I am having followup ultra sounds and mris to my breast cancer. I will be doing ultra sound of left breast in may and mri of breasts with gadolinium dye in july. I am having a hydration infusion right after mri to clear the dye from me. Has anyone done the hydrating infusion after mri for followup to ILC? My margins were clear and lymph nodes too. My cancer did not show up on mammo nor ultra sound. I felt lump. Mri showed it but the dye is not good for me. So I am having the hydrating infusion to clear the dye from my body after the mri in july. Has anyone done the hydrating infusion after mri?

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My experience with ILC is that I had a lumpectomy, but the margins were not clear , so I need a second surgery. However, the surgeon is giving me a choice between a second lumpectomy plus radiation therapy OR a mastectomy. The long-term survival rates are identical (no statistical significance between them.) The surgeon advises a mastectomy. The oncologist advises the lumpectomy plus radiation. For those who had a mastectomy, even though you might have had a lumpectomy plus radiation, how are you feeling about it now? Do you regret it or are you glad you did it? Thanks for any advice! (I will still need Anastrozole with either surgery, but no chemo with either, due to the small size of the tumor - 2 mm).

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@dlst

My experience with ILC is that I had a lumpectomy, but the margins were not clear , so I need a second surgery. However, the surgeon is giving me a choice between a second lumpectomy plus radiation therapy OR a mastectomy. The long-term survival rates are identical (no statistical significance between them.) The surgeon advises a mastectomy. The oncologist advises the lumpectomy plus radiation. For those who had a mastectomy, even though you might have had a lumpectomy plus radiation, how are you feeling about it now? Do you regret it or are you glad you did it? Thanks for any advice! (I will still need Anastrozole with either surgery, but no chemo with either, due to the small size of the tumor - 2 mm).

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Your situation sounds like mine. I have invasive lobular estrogen positive with 3small tumors that they found. 1-31-24 I had a lumpectomy with 3 lying nodes removed. My nodes were great but my margins were not. My surgeon suggested a left breast mastectomy. On 2-23-24 I had the mastectomy. My surgeon said my cancer is gone so is my breast. I meet with an oncologist Monday. Never have met before. I’m told I will need a horrible blocker. I ‘m not a fan! My surgeon said I will not need radiation or chemo. Hallelujah! Now onto the next step. I’m hoping to get reconstructive surgery and a lift on the other breast in the near future. Keep in touch. If you have any questions let me know.

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@denisesjourney123

Your situation sounds like mine. I have invasive lobular estrogen positive with 3small tumors that they found. 1-31-24 I had a lumpectomy with 3 lying nodes removed. My nodes were great but my margins were not. My surgeon suggested a left breast mastectomy. On 2-23-24 I had the mastectomy. My surgeon said my cancer is gone so is my breast. I meet with an oncologist Monday. Never have met before. I’m told I will need a horrible blocker. I ‘m not a fan! My surgeon said I will not need radiation or chemo. Hallelujah! Now onto the next step. I’m hoping to get reconstructive surgery and a lift on the other breast in the near future. Keep in touch. If you have any questions let me know.

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Denisesjourney,
Thank you for replying so quickly. You are the first person I have met that seems to have the same situation I have had. Mine is also invasive lobular estrogen positive. What made you choose the mastectomy over the lumpectomy the second time? I know it's still early, but how do you feel about your choice? I will also not need chemo, nor radiation if I get a mastectomy (which is one reason I am leaning that way, also just to know that the cancer is gone. This kind is sneaky, and I'm not convinced they will detect it by mammogram or MRI at an early stage if it re-occurs - I think I just got lucky this time). I will have to take a hormone blocker - we'll see how it goes. Hope your recovery goes well!

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@dlst

Denisesjourney,
Thank you for replying so quickly. You are the first person I have met that seems to have the same situation I have had. Mine is also invasive lobular estrogen positive. What made you choose the mastectomy over the lumpectomy the second time? I know it's still early, but how do you feel about your choice? I will also not need chemo, nor radiation if I get a mastectomy (which is one reason I am leaning that way, also just to know that the cancer is gone. This kind is sneaky, and I'm not convinced they will detect it by mammogram or MRI at an early stage if it re-occurs - I think I just got lucky this time). I will have to take a hormone blocker - we'll see how it goes. Hope your recovery goes well!

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I asked my surgeon what she would do in my situation with unclear margins. She said she would get the mastectomy. That was my next move. If my margins were clear I would have kept to the lumpectomy and radiation. Invasive lobular is very sneaky. They found my 3rd tumor by luck with ultrasound. The mammogram or MRI never caught it. It’s been a week since the mastectomy. I have one drain out and one to go. I’m healing but is a much harder surgery emotionally and physically than the lumpectomy was for me. I hope this helps.

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@denisesjourney123

I asked my surgeon what she would do in my situation with unclear margins. She said she would get the mastectomy. That was my next move. If my margins were clear I would have kept to the lumpectomy and radiation. Invasive lobular is very sneaky. They found my 3rd tumor by luck with ultrasound. The mammogram or MRI never caught it. It’s been a week since the mastectomy. I have one drain out and one to go. I’m healing but is a much harder surgery emotionally and physically than the lumpectomy was for me. I hope this helps.

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Thanks, Denise, it does help. My surgeon is male, but that is basically what he answered when I asked him what his recommendation would be for his wife or daughter. Since I didn't have clear margins, the oncologist recommended a second lumpectomy plus radiation, but I'm not quite as confident of his advice, even though it is statistically the same outcome. But the oncologist also didn't know what PLCIS (pleomorphic LCIS) was and that it required a further surgery if the margins weren't clear. He had to look it up, which is OK with me, since it is a rare type of breast cancer, but my surgeon knew exactly what it was and what was required, so I trust his opinion. Yes, I have been reflecting on the emotional and physical toll of a mastectomy. It's more the emotional that concerns me, since physically it will eventually heal. I'm 68 and still working at a job I love. My husband is very supportive, no matter what I chose. I don't plan to get reconstructive surgery unless I just can't live with the results. I thought I would give it six months to a year to see how it goes. I don't really want more surgeries. But that's a different topic. I really , really appreciate your comments! I pray for good healing for you, both physically and emotionally. - DSLT (Deb)

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