Invasive Ductal Micropapillary Carcinoma
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Congratulations to the both of you! I just recently celebrated 1 year. Your stories give me hope there are many years ahead.
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My mother just diagnosed with this rare form of breast cancer. She is 63. Thanks God no distant metastasis in PETCT but there are axiller lympadenopathies. I think She is stage 3 now.
Our Onc decided to give neoadjuvant TEC regimen which means taxotere epirubicin cyclophosphamide. After 2 cycle we will have an USG for tumour response. He will compare it before treatment and decide how we will continue.
Old article about this tumour is really terrible. But I found an article from 2013 It is the largest patient group ( 600). It says there is no difference from invasive ductal carcinoma if they are in the same stage. This is the link
http://www.ncbi.nlm.nih.gov/pubmed/23246269Fighting with cancer is not easy and the first months are diffucult emotionally.
It is perfect to hear hopeful stories in this forum. I hope we can be one of them.
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Welcome Vildanbt! Once your mother is feeling up to it see if you can encourage her to post as well. This is such a supportive board for women with breast cancer and their family members as well.
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Hi. I'm from Poland. My grandma, 79, also has Invasive Ductal Carcinoma with Micropapillary Pattern. As you can see tumor was diagnosed as locally advanced disease. Unfortunately, it's very typical for this subtype. I've also read the article written by Albert Chen & Co. about IMPC, but I saw many older and worrisome articles about this subtype. I've found one more article about IMPC BC: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0106564
You're very brave women. When I read your stories, I've got into a new hope!
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Hi Gohan1983
The older are Real'le worrisome. I am also medical doctor and I can say it is diffucult to trust statistics for rare diseases. For example if you see a disease 1000 patients and 10 of them dies because of disease it means %1. But if you see disease 50 people in the public and when 1 of them dies it means %2. And then statistics say it is double worse. So when a disease is rare statistics say bad things. Even 1 bad result change lots of thing.
This pathologic pattern identified in 1990s. So it is new and there are a lot of thing to learn about.
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Vildanbt,
I am 63 and was just diagnosed with focal Micropapillary Cancer, No lymph nodes involved. There is very little literature and it is a bit scary. I saw two oncologist and both were very positive and encouraging. Mine was a higher ER/PR positive and HER- Although I took 5 equivocals before a negative HER. If possible I would recommend a second opinion. I went to a major cancer hospital for my second opinion. That was a big help for me. The one thing I was told is that these cells are small and it is almost impossible to pick up on a pet scan until it is advanced. It is a good sign that there are no distant metastases. I have finished rads and started hormone treatment. The RO did require an extra boost because of the grade. Both the RO and the MO have indicated that my treatment and prognosis are the same as for anyone else with a similar stage and grade.
Chemo was determine to be of a 4% benefit in 5 years and 2% over 10 years. I opted out. I have no control over what happens from here. I have decided that I am moving on with my life and pushing worry to the back burner. Yes it is there but I am trying really hard to live my life to the fullest. Caner is a reminder that life is short. I had a 45 year old friend die from a heart attack this year we never know what is in our future.
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IMPC tends to be highly ER positive but also high rate of Ki67 and mitotic count (in our case 30 mitoses/10 high power fields and Ki67 30%) About 40% IMPC has co-expression hormone and HER-2 receptor. It seems to be quite similar to luminal B NST, but in fact IMPC has distinct genetic profile, which is slightly different than "ordinary" luminal B IDC. It's interesting but IMPC hardly ever is triple negative phenotype (it's very rare). So, IMPC together with other rare subtype like Invasive Pleomorphic Lobular Carcinoma are "luminal B-like special type" tumors, but not the same as luminal B IDC of course.
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Stage IA is a very early stage. I think you will not be same with other cancers you will be same like you don't have cancer. Life is a chance and you can not know what is in the future? While many cancer patients continue living lots of people are dying because of cardiac problems, traffic accidents, otoimmun diseases and a lot of things more. We all should live our lives.
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Micropapillary pattern is generally poor prognostic factor in many type of cancers, except ovarian micropapillary cancer, breast cancer and maybe prostate cancer, but for example stage 1 lung adenocarcinoma with micropapillary pattern has signifanctly poorer prognosis than stage 1 lepidic, acinar and papillary adenocarcinoma. I've read recently article about comparison IMPC and IDC. It was the largest study (936 cases of IMPC and 2100 IDC). Conclusion was that IMPC and IDC has comparable prognosis with the same stage, maybe IMPC has even slightly better outcome, when matched stage for stage (5 year DSS 92% for IMPC vs 88% for IDC). Unfortunately I missed the link to this article (probably it was deleted). The results of studies were shown at The American Society of Breast Surgeon Annual Meeting 2014. Reaserchers supposes that IMPC has better outcome because of its luminal phenotype or more sensitivity to systemic treatment. I've heard that IMPC may be resistant to anthracyclines. My Grandma wasn't given "red devil" because of her age.
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Do you remember where did you read anthracyclin resistance for IMPC?
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onnection.ebscohost.com/c/articles/71340684/hif-1-activation-induces-doxorubicin-resistance-mcf7-3-d-spheroids-via-p-glycoprotein-expression-potential-model-chemoresistance-invasive-micropapillary-carcinoma-breast
The same mechanism is responsible for drug resistance in basal-like breast cancer. In fact, despite resistance, many patients has excellent response after anthracycline treatment.
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My mother had 2 cycle neoadjuvant chemo. We just had ultrasonography. When compared before chemotherapy there is no shrink. Axiller lymph nodes shrink little but tumour size is same. Do you have any like that? Is it early or our chemo is not working ?
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Well gee whiz - wow, I admire you - a half marathon - enjoy
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Hello,
I've just made it past my one-year anniversary and had a clear mammogram. I must say it was a bit stressful! How does everyone cope with trying to be positive yet trying to ready yourself for some bad news?
Journeygirl
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I am glad to hear you made it past the one year mark. I am January will be 6 months. No testing but routine blood work in January. It is a bit nerve wracking. I want to move on but it is so hard. It seems like it is always in the back of my mind.
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Brutersmom,
I know. I want to continue to move forward but when I have a doctors' appointment it's a reminder that I may only think all is well. If anyone has a coping mechanism, please tell.
I also see you are on hormonal therapy. How is that going for you and how did you decide on Arimidex? Currently, I'm on Tamoxifen but will be switching to an aromatase inhibitor soon. Does anyone know of studies that compare which AI to use?
Best to all,
Journeygirl
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Journey Girl, So far the only thing that I am experiencing is hair thinning due to the loss of estrogen. The local MO told me that is the one that they like to start with. I went to Fox Chase for a second opinion and they felt that that was a good choice. FC also told me that being on an aromatase inhibitor reduced my chance of recurrence compared to Tamoxifen.
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Congratulations Journeygirl on your one year anniversary
I worry a lot but I try to keep it in check so I don't ruin my life with anxiety. I've found Mindfulness meditation to help me. It's easy and just the slow breathing calms me down fairly quickly.
I try to think to myself "there is no reason why I can't live well into my 70's or 80's" and this stops my obsessing about getting a recurrence or another cancer. I suppose it's a form of positive thinking. But it certainly isn't healthy to worry all the time or to be under stress.
I was on tamoxifen about 3 1/2 years and then once in menopause was put on letrozole (femara). The worse side effect for me has been the hot flushes. I find it better than the tamoxifen though. Everyone reacts differently. Just before I was diagnosed with BC I had my oestrogen levels checked and they were found to be 15 times the normal level. Quite scary. I didn't connect that I might have BC despite having a lump in my breast - because the lump had been biopsied six months prior and I was told there were no cancer cells found.
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For sharing Lifelover. It is good to hear someone share positively. It looks like you are about to reach you 5 year anniversary in February. That is great. I think what makes this hard is that the articles on Micropapillary CA are so depressing. I was blind sided by my diagnosis and I just finished radiation treatment last month. The only Cancer in my family was when people hit there late 70's. Just wasn't prepared and it was years ago when there were few treatment options and cancer was pretty much a death sentence. Intellectually I know that I have an 86+% that I will never see this disease again but emotionally I know what it did to my family members 30-40 years ago.
I sell Real Estate and this is my slow time of year. Which gives me a little to much time to think. I am looking forward to January when I start to get busy and move toward the spring market to help refocus my thinking.
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Aromatase Inhibitors should considered in luminal B rather than Tamoxifen, regardless of HER-2 status, because it's much more effective in highly proliferative HR+ tumors. In premenopause women IA + LH-RH analogs may be an option.
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hi everyone! I was diagnosed 11/11/15 with invasive micropapillary carcinoma, stage IIIA e+. I'm 33, and currently 29 weeks pregnant. What shitty news to get while you're pregnant (it took us 6 years to get pregnant). Found out today that it's not in the organs, getting the MRI tonight to check the bones...chemo set to start probably soon after. I'm happy to find others that can relate to me. Doctors won't tell me much as far as how successful we are going to be, but it sounds like lots of you are making the best of life and staying strong! Hope to get to know you all
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Memily9 welcome to this group and sorry you are hear. Please go to the setup page and post your information when we share information. I can't imagine what you must be going through right now after trying to get pregnant and finding out you have breast cancer. Have you had your surgery. Did you get a second opinion or are you very comfortable with the Dr's that you have. I got my best and most positive information from the Dr at the teaching hospital that I went to. Of course we will be happy to share what we know and what we have experienced.
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Hi Memily9-
We want to welcome you to our community here at BCO. We're so sorry for the circumstances that have brought you here; getting a cancer diagnosis is never easy, but it's got to be especially difficult to be diagnosed during pregnancy. That's great news about the organs! We'll keep our fingers crossed that your bone scans are equally promising.
We know it's a scary time, but just know, you are not alone. And you have this entire community to help you get through this!
The Mods
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Hi Memily9. So sorry you are joining us here. This is the best site for support and information. You can be yourself and share how ever you feel like sharing whether it be positively or negatively. We are here for you.
There is a lot of information out there but try to read the recent information especially when reading about micro papillary. My oncologist says I shouldn't worry about it. And I've been cancer for almost 5 years
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http://www.nature.com/bjc/journal/v111/n3/full/bjc...
This is the largest study of IMPC :
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Memily, such tough news to bear during your pregnancy. We are here for you. Take all the support your can get and rally the troops; family, friends, coworkers, strangers, I don't care, everyone to help. Every bit offers a sense of comfort and hope. It's your time to be selfish in taking care of yourself.
Gohan1983, loved the last posted article! It's great to see we have great odds to live long and healthy lives. Although cancer really sucks we are fortunate to have a fairly curable type. I don't particularly consider myself an optimist, more of a realist, but know maintaining an optimistic attitude is beneficial. These stats definitely offer us some good news! Gives us something to smile about today:) Stay strong!!
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I was diagnosed on October 21st and had a DMX on Nov. 4th. My path report reads as IDC w/2 separate tumors, DCIS w/cribriform, comendon, mircropapillary involvement, angiolympahatic invasion, Paget's disease and 1/1 positive lymph node.
I have one AC treatment left and then 12 taxol's plus a year of HP. Oh lets not forget 30 days of radiation.
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After surgery today we got our Pathology. Tumour is 2 cm and 6 lymph nodes have metastasis. After neoadjuvant chemotherapy Pathology showed no response. Tumour has no necrosis.
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I am sorry to hear that. I hope they find something that works. What is her ER+PR+ percentages. Have they considered adding hormone therapy?
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ER %80, PR %20 (less than trucut biopsy)
They will check again for HER status. I talked about chemosensitivity test but doctor did not advise in vitro test.
We haven't talked about antihormone therapy sö about new protocol. We are waiting FİSH results
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