Lobular Breast Cancer: Let's share and support each other

Posted by mjay @mjay, Jul 28, 2022

Since lobular breast cancer is only 10-15% of all breast cancer diagnoses and now understood to be a unique subset of breast cancer as a whole with different characteristics than ductal breast cancer necessitating different treatments and inherently different risks, I would like to see a separate category under the breast cancer forum so that the most appropriate info is being disseminated for this specific subset of BC. Just a thought.

Interested in more discussions like this? Go to the Breast Cancer Support Group.

@lhwoz

Hello all -
I have ILC, diagnosed in Dec, had lumpectomy and sentinel node removal and then re-excision bc margins weren't clear. Likely starting radiation in a few weeks and then anti-estrogen meds after that. My nodes were technically deemed negative, however 1 node had what they called micrometers, or an isolated tumor cell, still deemed node-negative though. This concerns me, of course.

Although we don't meet again until Monday my Med Oncologist let me know that my OncoScore was 22. I am 55, and thus the chemo cutoff score is 26 I believe? I was expecting my score to be lower to make the Chemo decision a bit more defined/clear, but wit ha score of 22 I find myself a bit distraught over being somewhat close to the "can go either way" category?

Can anyone shed light on their scores and decisions? I am getting more info before I meet with her on Monday.

Thanks so much-
laurie

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Hello @lhwoz I had invasive DCIS, which I know is different than ILC, but my oncoscore was 25. I was 54 at the time of diagnosis. With an oncoscore, as with many other types of test scores, there’s usually a range that the actual score might be. My score was 25, but it actually could have been as low as 22 or as high as 28. I don’t remember the standard error of measurement, but my point is, my score might have been higher than what was actually reported. I was 54 at the time deciding whether I should get chemo. My cancer was stage 1 with no lymph node involvement and genetic testing was negative for all cancers tested. My medical oncologist said had I been 50, chemo would definitely be recommended. She also said since I’m 54 and with an oncoscore that might actually be higher than 25, that she recommended chemo. I had 4 rounds of chemo, which I’m glad I did even though it was a scary decision to make, which I don’t regret. It gave me peace of mind knowing I did everything possible to reduce my chances of any cancer remaining. I know this is my story with a different cancer, but that was the decision I made. I hope this gives you a little more information to help you with making a decision whether to have chemo. I wish you well and all the best 💗

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@timely

This was the Radiation Oncologist who said this. The first time he said his hospital group is advocating mammogram only as the new guidelines and implied that the other groups were wrong and in past. The 2nd time I asked him, he said that most women do not want MRI's. (His hospital group may not do them without a push on my part.)
The other group is doing mammograms + ultrasounds in the same visit. But ultrasounds do nothing and show nothing for LCI.

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Hello @timely - honestly, I would push for the MRI. You can always get a second opinion, as well. Reading your post, it doesn’t seem like you are comfortable with the recommendations given by your radiation oncologist, so I’d advocate to have the MRI. There’s a reason why you feel the way you do, so go with your gut and push for the MRI. I wish you all the best!

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"When people ask about MRI and radiation, they typically want to know if MRI produces radiation in the same way that X-ray imaging or CT scans produce radiation. Unlike X-rays and computed topography, MRI scans do not expose the patient to ionizing radiation." “There are no known harmful side-effects associated with temporary exposure to the strong magnetic field used by MRI scanners.”

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@delormv

Hello @lhwoz I had invasive DCIS, which I know is different than ILC, but my oncoscore was 25. I was 54 at the time of diagnosis. With an oncoscore, as with many other types of test scores, there’s usually a range that the actual score might be. My score was 25, but it actually could have been as low as 22 or as high as 28. I don’t remember the standard error of measurement, but my point is, my score might have been higher than what was actually reported. I was 54 at the time deciding whether I should get chemo. My cancer was stage 1 with no lymph node involvement and genetic testing was negative for all cancers tested. My medical oncologist said had I been 50, chemo would definitely be recommended. She also said since I’m 54 and with an oncoscore that might actually be higher than 25, that she recommended chemo. I had 4 rounds of chemo, which I’m glad I did even though it was a scary decision to make, which I don’t regret. It gave me peace of mind knowing I did everything possible to reduce my chances of any cancer remaining. I know this is my story with a different cancer, but that was the decision I made. I hope this gives you a little more information to help you with making a decision whether to have chemo. I wish you well and all the best 💗

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Thank you so much for your reply. I hate being in the grey area (at least in my mind it's a grey area). I will see what my Med Onc says today and go from there ❤️

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@lhwoz

Thank you so much for your reply. I hate being in the grey area (at least in my mind it's a grey area). I will see what my Med Onc says today and go from there ❤️

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Please let us know what the Med Onc recommends.

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I have just last week had my diagnosis of stage 2 invasive lobular Cancer. Measuring 6mm on MRI. ER positive, Herceptin negative. Ultra sound not detecting a spread to the lymph nodes. I am still waiting for an appointment for MRI and to see the surgeon. As I have transferred my care to closer to home, and a place and people I trust and have worked with before. They have recommended breast conserving surgery followed by radiotherapy, with no chemo.
I am told that as long as the MRI confirms the size and it isn’t anywhere else (being that lobular cancers does not always form in lumps and can hide very well in a monogram)
I am reading that a lot of women have a mastectomy at stage 1, or that within a few years go on to have a mastectomy if having an earlier lumpectomy.
I feel
I have been left wondering scared and without a plan. The way they discussed it with me was that it is good news, easily treated with will have a positive outcome. My head is spinning and I feel like I am a fraud for having a good news (if there is such a thing) regarding the Cancer I have. It has been minimalised by the consultant parting the result to me. He literally told me how lucky I am!
Well I don’t feel lucky, I am terrified, trying to keep it together because my family are in so much emotional distress. I have to be strong for them, and feel that I can not break. I was so relieved to find this group. As I am at the start of my journey.
Any advice you can give me will be appreciated.

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Your case is very much like mine. They will likely take out a couple of lymph nodes when the cancer is removed to make sure there is no cancer spread. You will have some exercises to do daily for a few weeks. Depending on how much radiation you have, there will be recovery from that. I consider myself fortunate not to have needed a full mastectomy or chemo. Just having the cancer diagnosis and going through treatment is a life changing experience but it helps to educate yourself so you are more comfortable making decisions for yourself. This blog is a great place to get additional information. We are all supporting each other!

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My ILC has the same size, 6mm. I will have Lumpectomy, not mastectomy, possibly radiation and aromatase inhibitors for about 7 years. I feel sort of lucky:) It diagnosed early, hopefully did not spread to lymph nodes, it is treatable with a small surgery. My stress level came down after I talked with a team of doctors and read about this stage of cancer. I am optimistic about the treatment outcome.

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We sure go on a roller coaster trip when we get our diagnosis! No matter what the size of our tumor or what our treatment, we are scared, feel blessed, feel cursed or somewhere inbetween. During my initial testing, I felt blessed. Small nodes were found in my lung, a renal aneurysm and spots on my liver. Never would have known any of that until the aneurysm broke! The nodes appear from old diseases, the aneurysm was causing no problem at the time. I chose to finish my breast cancer treatment for stage 2 ILC (HER 2+). That included Chemo, mastectomy, radiation and more chemo. I'm waiting for my exchange. I recently had the aneurism dealt with. The liver seems to be fine as well. This has been close to a two year journey. I'm very happy that it is coming to an end. It hasn't been easy, but it hasn't been awful either. I look on the bright side and try to stay in the moment. I wish you the best on your journey.

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@lhwoz

Hello there - fairly new here with Invasive Lobular. I am sorry to hear you story and can feel how much this is to digest and endure. I wish your family all of the best health and care coming your way!

I found my lump the night my mom passed away - after a long day of all that entails the passing of a parent and caring for her for this past decade and the last year in particular ups and downs. The evening she passed I was taking a shower and just letting all the grief/sadness/relief/exhaustion and so much else just exhale from me when I felt the lump. I could not believe it. I can 100% understand how you are feeling - we had some illnesses and passings in our friend group (I am 55) and I felt that
1) I didn't want to burden anyone with more baggage of a "friend with cancer"
2) I didn't want to have this be the topic of all my interactions for the foreseeable future, and
3) I could barely say the words as it opens the floodgates and also felt like an out of body experience - as in this cannot be me who is saying "I have cancer". It still feels that way to some degree.

They were all so supportive when my mom passed (flowers, cards and even meals to us!) and for that month (this past December ) but I kept my tests/biopsies just between my husband and that felt right for me/us. I needed time to understand more and that worked for me. It wasn't easy though. I have found that letting people know over time has helped, it gets easier to talk about, and most definitely my friends care, want to help and be there for me. I do waffle with emotions though and have some really good conversations with my husband and a few friends on the co-existance of "staying positive" but also feeling all the feels and not denying myself the emotions that come with this. If I skip over those I am not doing myself any good as I move forward.

I, too, wrangled with the idea of mastectomy vs. lumpectomy but all MDs and research indicated lumpectomy had same outcome. In addition, given same outcomes with the research they have, mastectomy is a long haul surgery and most wouldn't recommend unless needed or genetics warranted (my understanding) . I will say that I was told chance for re-excision after lumpectomy was perhaps 10%, but I did have to go back in 2 weeks later as my margins were not clear. I know have read re-excision rates can be upward of 60%. If doing it again I would ask surgeon to take a wider approach to lumpectomy to better chances for only 1 surgery. I am now 4 weeks post 1st lump/sentinel node removal and 2 weeks post re-excision, feeling like myself, hiking, walking and slowly getting back to some routine.

Take care - this site is a gem.
laurie
(Bay Area, CA)

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Thanks so much for your reply.
So sorry for the loss of your mother...what an awful time to add a lump to the mix.
Like you I didn't want to add to my daughter's already heavy load with her husband, and I thought, at 71, and living a life that hasn't afforded me much.. except, of course, I am grateful for my children and grandchildren, but I never had means to do much to make their lives easier so, I just ignored it for a few months, until my daughter saw I had dimpling and I had to admit I had a lump.
Well, you know what comes next...I had a lumpectomy this past Monday..but I don't have word on lymph nodes yet.
I am a wreck. I won't do Chemotherapy but I guess I would do radiation, if necessary.
Can you tell me what your journey has been like so far?
Thank you so much for replying./ Lois

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