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Topic: Mixed Type BC

Forum: Mixed Type Breast Cancer — Meet others who have mixed type breast cancer.

Posted on: Aug 13, 2011 01:57PM

prayrv wrote:

Dear Mods,


Dx 4/27/2007, IDC, <1cm, Stage IA, Grade 2, 0/5 nodes, ER+/PR+, HER2-
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Aug 14, 2011 06:19AM dogeyed wrote:

Hi PrayRV (and Day when she comes here) and anyone else who comes here,

This morning I noticed down in the Moderator section in the forum list, that Day had asked if there was a place for those who have mixed diagnoses for their breast cancer, and this be the place, so thought I'd just put a few intro type words in here on mine, which is listed in the little section at the bottom of each person's post:  IBC, IDC, and Melanoma. 

They did not biopsy my Inflammatory, it was a clinical diagnosis, it was very swollen, heated up, hard on the end (that's what took me to a woman's doc), pain came later, and then I got a marking on my skin in the front that looked like a smudge of lipstick.  Then I was biopsied specifically at the site of my growth (which I never felt), and came back with Invasive Ductal, I had one 5cm+ tumor and two smaller ones off to the side, and right above the large growth is where that smudge came, so I couldn't swear if it was IBC or the IDC that made it do that, but I thought from seeing pictures of IBC that it was part of an Inflammatory presentation.  AND THEN, I had a mole on my breast that, as my breast got larger and larger and became painful, that mole really started to change, it was kind of a medium-sized and -colored mole with a couple freckle type moles near it, and it all merged into one very dark looking mole, so I knew melanoma was possible, particularly since mother and father had had it, and alerted doc to it, and he said he would take the mole off during surgery.

So, after five months of chemo (I had wanted surgery first, but had to follow protocol), and then surgery, the doc indeed took the mole off with margins at same time as mastectomy that removed my breast (no reconstruct).  When the labs came back that the mole was indeed melanoma, well, he was to consult with an expert on margins for melanoma, to make sure he did that right.  Also I asked the nurse if there was anything in my labs about the Inflammatory cancer situation, and she said there was nothing there.  I KNOW my doc didn't forget about it, so I will ask him this Thursday when I'm scheduled to see him.  The LAST thing I want is recurrence, and if I have to go back into surgery (God forbid), by golly I will immediately, becuz even tho I would cry a river at that news, it's better to get it all done in this "round," than to have a year or two go by and have to face this awful music all over again, with perhaps even worse stats than I face now. 

I will say this one personal note on my "mixed" diagnosis.  I absolutely could NOT believe I had cancer, and such a wild type, so aggressive, the picture in my mind's eye of it spreading was so scary to me, and I simply cannot believe that in my entire life I had never gotten such a disease or any disease remotely close to such a disastrous diagnosis as cancer like mine.  I did have a grandmother who had ovarian cancer, and so I had kept up with checks about that when I reached her age, but never thought of breast cancer.  And I keep trying to imagine WHAT did this to me.  Did I stand too close to a microwave oven too often?  Did I eat something strange at a restaurant?  Was it the antifreeze in the pipes of the new place I moved to in the dishwasher before I found out? 

And now that I've finished chemo and surgery, with radiation coming up soon, I find myself praying that the researchers will try to find some new way to treat this awful disease without having to torture so many of the female (and male) of our population, the stats are unbelievable (but of course I've forgotten now).  I am 60 years old and disabled by spinal injuries from a car accident to begin with, and so I'm not up to all this stuff like maybe the younger ones.  But I imagine ALL women (and men) who have this breast cancer routine are truly fed up with just how much pain and discomfort and exhaustion that treatment unloads upon us, and it lasts SO LONG, and no amount of being glad to survive will change how hard it is to stand up to this particular torture.  I believe this is why we're called "brave."  Oh, I'm a happy camper knowing that I have bought some years with this treatment, and my eyes were opened in a big way going thru this about what a gift life is, but please, won't someone come up with a way to make this easier on people?

In closing, I want to say that my treatment, I have no idea how it stacks up to others with Inflammatory Breast Cancer, I've visited my chemo website when I was doing chemo, and the surgery website when I did that, and I looked in on IBC and glanced at their treatments, and it seems types of chemo and order of surgery, etc., varies from individual to individual, diff diagnoses get same treatment and vice-versa. But maybe someone rather smarter than I am KNOWS more about IBC and its standard protocols, when compared to IDC and melanoma and Lord knows what else.  Oh, and while my IDC growths were shrunk to ZERO after chemo, I have enough Ductal Carcinoma left to call it DCIS (Ductal Carcinoma in Situ), I think those are the initials and names for that one.  GG

IBC, IDC, Melanoma/ 5 mos ACT chemo, mastectomy, rads to 11/2011, Arimidex 1 mo, NED 9/2012, two+yr survivor 5/2013 Dx 2/14/2011, IDC, 5cm, Grade 3, 2/11 nodes, ER+
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Aug 14, 2011 12:02PM roseamy wrote:


I am also a mixed type bc, I had one large tumour with both idc and ilc in it. It was also er+ pr+ and Her2+, with skin involvement. I was mis diagnosed at 36 and was eventually diagnosed at 40.

I often flitted between the ilc/ idc forum and wondered if any one else had one tumour with mixed types. I am also er+ pr + and her2 +. I know when I am offered a choice of puddings I always say " oh I'll have a little of each" did not quite expect to get the same with my bc diagnosis!

So Hello to all of you with mixed types.

Dx 9/30/2008, ILC, 5cm, Stage IIIB, Grade 2, 0/4 nodes, ER+/PR+, HER2+
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Aug 14, 2011 01:35PM mspradley wrote:

My tumor was not mixed, but I had IDC and Paget's Disease

Diagnosis: 11/23/2009, IDC + Pagets, 4.5cm, Stage III, Grade 3, 3/21 nodes, ER+/PR+/HER2+, BETH trial 1/2010-1/2011,6-TCH + Avastin 12-Herceptin + Avastin, 33 rounds of rads, 3/21/2011 DIEP flap bilateral reconstruction, 5 years tamoxifen
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Aug 16, 2011 08:49AM - edited Aug 16, 2011 08:54AM by Shrek4

Since I got the MX pathology report it was always hard for me to find my place and hovered between ILC and IDC (no forum for cribriform lol).

My tumor was mixed. DCIS, LCIS, IDC, ILC and ICC, a 4cm area with the largest tumor 4 mm, so they considered the whole area a tumor and I was staged at IIb (sentinel node was positive with a 3 mm tumor). I went in first with DCIS diagnosed through stereotactic biopsy. Did a BMX (didn't want to go through this again later) and the mastectomy pathology showed all these types. My breast surgeon (who is a breast oncology surgeon) told me that something like this is very rare (one in over 200k cases) so yes, that made me feel very special... not! I think I might be the only one here with so many different types of tumors. Figures lol

The problem with the mixed type is that the prognosis is different. And the risk of recurrence. So the treatment is a little difficult in terms of decisions.

For example, I was grade 2. But, due to the ILC, the decision was made that I need to have chemo. It may have been overkill for the other two types of cancer, but the ILC had a Ki-67 of 19 - the other types had it only at 8 and respectively 12. Also, the invasive cribriform by itself is a rare type of breast cancer, but with quite good survival rates and low recurrence risk rate.

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Aug 17, 2011 01:54PM sweetbean wrote:

Rosemy, we are very similar.  My tumor was 5 x 4.5 x 3 and was IDC and ILC.  I'm also triple positive.  No skin involvement, though.  I just finished radiation in July and am still on Herceptin and, of course, Tamoxifen.  Nice to meet you mixed type ladies!

Dx 11/18/2010, ILC, 5cm, Stage IIIA, Grade 2, 2/15 nodes, ER+/PR+, HER2+ (FISH)
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Aug 19, 2011 02:19PM mom_of_2 wrote:

Me too...IDC and DCIS triple positive.

mom_of_2 Dx 6/2/2008, IDC, 2cm, Stage IIB, Grade 2, 1/23 nodes, ER+/PR+, HER2+
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Aug 19, 2011 03:55PM nwest125 wrote:

I had IDC and ILC in right breast so I kind of know what you mean by being mixed. My BS told me that when you have 2 different types in one breast that they want to do a MX. I never did question that and I did have a BMX but now 8 mouths later sometimes I wonder what if I had told her no and go ahead and do another Lumpectomy wonder if she could have done  that and what my outcome would be. I know I am not suppose to say What if but I do to myself. I have never said that out loud to anyone.


IDC 11-1-10 Lumpectomy 11-15-10 reincision/ found ILC 12-16-10 BMX with no reconstrution Dx 9/21/2010, ILC/IDC, Right, 1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2-
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Aug 21, 2011 06:57AM dogeyed wrote:

My doctor discovered early on that I get upset easily over my cancer situation, so he is careful to only let out enough information to keep me in the program.  I saw him again a few days ago, and turns out my labs indeed referred to my Inflammatory Breast Cancer part, where cancer cells were still floating around in the lymph vessels of the skin.  He said it is in the skin part of the breast, and thus my rads should be the 6-week version (instead of 3-week that I wanted) because the skin has got to be covered really well by rads. I'm to see a melanoma specialist, too, when I see my rads doc, to make sure we're all on the same page about how that was handled surgically and how it will be handled as I continue along on this long treatment program. 

Recently I have found myself occasionally worrying over my lousy stats, but I counter it quickly with KNOWING I will survive at least a couple more years because I tracked survival years of the women who have bad percentages of recurrence, and if they do all these treatments, I've added it up and divided and came up with how I've bought about two years for myself cancer-free, and hey, I'm going to take those two years and be happy.  I told husband if I get recurrence, we are going to sell everything and move to the Bahamas until I die, which I'll take morphine on the beach as I fade away, and then he is to go live with his daughter in Florida at their extra trailer on their property and get him a plate of food every day in order to survive.  He smiled at that.  It's just a daydream, folks, becuz if I can actually MAKE IT to the Bahamas (I'm disabled from an old car wreck that hurt my back), it'll just be for a visit.  Charleston SC is a little closer, but have to wait for spring to visit there, again IF I can make the trip.  GG

IBC, IDC, Melanoma/ 5 mos ACT chemo, mastectomy, rads to 11/2011, Arimidex 1 mo, NED 9/2012, two+yr survivor 5/2013 Dx 2/14/2011, IDC, 5cm, Grade 3, 2/11 nodes, ER+
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Aug 29, 2011 12:49AM Susan56 wrote:

Dogeyed - I  have to tell you I just about cried when I saw your diagnosis. I also had melanoma in my breast. When They did the biopsy it showed I had breast cancer and melanoma in my right breast. After the surgery it was 2 separate tumors in the same breast. I had a mastectomy with no reconstruction. We are still wating on last of all my pathology reports to come back. 

I have had 2 rounds of Adriamycin.  I go this week to see the radiologist because the melanoma nodules have come back with a vengence. In the last 5 days one of them has grown and is pinching a nerve in my right shoulder and is making my right hand useless. I am right handed so this last weekend has been very frustrating. It is not easy for me to ask for help. DH is being a real angel this week!!

Dx 5/20/2011, IDC, 6cm+, Stage IIIA, Grade 3, 3/15 nodes
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Aug 31, 2011 07:13AM - edited Aug 31, 2011 07:22AM by dogeyed

SUSAN, wow, I finally got back here am shocked to hear your melanoma had come back!  Did they show up on the skin, or are they only detectible by a scan? The way mine worked is, I had a bad mole on my skin of my breast, and my treatment plan started out with chemotherapy, five months of it.  THEN came surgery, mastectomy no reconstruction AND they took the melanoma off.  That's when they were positive the mole was melanoma.  Radiation is coming up.  I also will be seeing a melanoma expert middle of next week, rads start shortly thereafter.  The melanoma doc will decide if any other treatment is to be done, altho I cannot imagine what else they can do!  The surgeon said the margins were perfect on the mole he surgically removed along with the breast, but the preferred margins are somewhat larger, so the melanoma expert doc will decide if we're clear.  My breast surgeon and I agree it's good enough, tho, but we'll see what she says.

Perhaps your radiologist will zap those melanoma nodules right away, so they'll go away?  My radiation doctor is fully aware of the melanoma and I assume will do her plans accordingly.  She wants me to see a dermatologist to look at my other moles on my body.  My whole breast area and lymphs to my neck will be radiated, and the whole breast is because of the inflammatory breast cancer I have, which occurs in the skin.  I am supposing the radiation will kill any melanoma problems, too?  The radiology people ARE going to do a CT scan Thursday, so if any has come up elsewhere nearby, I reckon they'll see it.   

But you know what, I am really not sure about treatment for melanoma, and I forgot to ask the radiologist doc about what effect rads will have IF any melanoma has popped up anywhere else in the vicinity of the breast.  But I will ask the melanoma doc about that, now that I've heard your story, and of course a dermatologist will at least be able to tell if my other moles look funny or not.  Maybe the melanoma doc will do a full-body scan of some kind to make sure, I just don't know how far away the melanoma will go.  Thanks so much for sharing, it will help me.  GG

IBC, IDC, Melanoma/ 5 mos ACT chemo, mastectomy, rads to 11/2011, Arimidex 1 mo, NED 9/2012, two+yr survivor 5/2013 Dx 2/14/2011, IDC, 5cm, Grade 3, 2/11 nodes, ER+
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Sep 14, 2011 08:04PM Hattie wrote:

I had cancer soup!  idc, ilc, suspicious junk, one big @##$% tumor that got chemo. lump, surgery again. rads.  a funky shaped breast, no more tumor and 6 more years of great living.  pick your treatment with the best info and then keep moving on.  i didn't worry so much about the dx after the initial shock.  hope you all do well and move forward.  deal with your hand but keep playing!

Take care,


life is good
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Sep 22, 2011 11:11PM Heidenia wrote:

Hey Mixed Gals.  Wow.  I don't know what to say except that I am glad I found you and pray for your continued healing and thriving not just surviving.  I was told in the winter "well a lot of people are really overtreated for stage one cancers." Uh excuse me "do I have stage one cancer?" "No but I am just saying come back in May." In May, 2nd doc in same firm says "I don't know what this is but it's not cancer so we'll see you in a year."  In July had double modified radical mast (no muscles). Diagnosed with invasive carcinoma ( of the muscinous type ) at stage one with DCIS and LCIS all in the same breast. I opted for double/bilat for a host of reasons. Though images didn't show much on right unaffected breast. 11 nodes later and 4 path reports later atypcial lobular hyperplasia found throughout right breast. Crazy. It feels a little weird to have so many different things show up. Like I was cancer waiting to happen. Thankfully a persistent friend made me get another opinion. No chemo and no rads. Just surgery (done) drains still in 30 days later with TEs and then foobs. And Tamoxifen with it's moody PMS for the next 5 years. Choosing to thrive. But eeesh. Who has time for all this?  Dogeyed I vote for the Bahamas and morphine. But I should have voted for that a long time ago. You go girl. Just tell us which island incase we can visit! And Susan my sister in law has melanoma and is really able to keep in under control with every few months mapping and removals. She has had much success with this and done it for at least the last 5 years. I hope you can get it under control too. blessings to all!

Dx 7/6/2011, IDC, 1cm, Stage I, Grade 2, 0/11 nodes, ER+/PR+, HER2-
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Sep 30, 2011 06:14AM dogeyed wrote:

I'm back again, and SUSAN I hope you drop by and give me the latest scoop on your melanoma situation.  Mine began as a mole gone wrong, and I am wondering how they found out about more of yours springing up, was it a scan, or ultrasound?  How will they treat it?

I went to the melanoma expert, waited over an hour for her, and because of back problems I could not wait another second, so that's on hold.  I am not sure there is anything else they can do than they've already done for my "regular" cancers.  Chemo, mastectomy, rads...  My cancer doc said it was not critical I see that doc, but hopes I will go back.  I don't think so.  Maybe I'll get a dermatologist to remove all my other larger moles in my body, I don't know.  GG

IBC, IDC, Melanoma/ 5 mos ACT chemo, mastectomy, rads to 11/2011, Arimidex 1 mo, NED 9/2012, two+yr survivor 5/2013 Dx 2/14/2011, IDC, 5cm, Grade 3, 2/11 nodes, ER+
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Oct 3, 2011 12:06PM VictoriaB wrote:

Thank you for this thread, prayrv! I was diagnosed in July and it has taken me two months and two operations to realize I have "mixed" bc. I have IDC (with LVI) and DCIS (with close margin). So although my surgeon says we are done with surgery (lumpectomy), I am going for second opinion because I've read all the stats about DCIS and recurrences. I am wondering if any of your doctors are giving more aggressive treatment options because the cancer is mixed? VB

Breast cancer is a thief! Dx 7/28/2011, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Oct 3, 2011 03:43PM nwest125 wrote:

VictoriaB, Yes when my second cancer was found after 2 surgeries my BS recommended a MX. She told me that when 2 Cancers was found in the same breast that is what she recommends. Beings my was IDC and ILC which is a sneaky one and had not been detected by Mammogram, US or MRI I never thought twice about a MX matter of fact I choose a BMX because I never wanted to worry about the other side, This is just my  doctors opinion. I am sure they are all different.


IDC 11-1-10 Lumpectomy 11-15-10 reincision/ found ILC 12-16-10 BMX with no reconstrution Dx 9/21/2010, ILC/IDC, Right, 1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2-
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Oct 11, 2011 07:20PM TXBadboob wrote:

I don't know if this counts as mixed, but I had ILC in left breast, and IDC in right.  They only found the IDC after I had BMX for the ILC.(BRCA2+)  That IDC was still there after 6 mos of chemo.  Scary.

Deen BRCA2+, ILC left breast, IDC right breast, neo-adj chemo, BMX, ooph, Arimidex, Zometa Dx 8/4/2008, ILC, 2cm, Stage IIA, Grade 1, 0/2 nodes, ER+/PR+, HER2-
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Oct 12, 2011 08:49AM Raili wrote:

Glad to see this new forum.  Interesting topic...

In 2009, I was diagnosed with mucinous breast cancer (invasive) and DCIS, and a week ago, I was diagnosed with melanoma.  I'm having a hard time dealing with the fact that at age 32, I've been diagnosed with two different cancers!  That means I have to be vigilant about these two cancers for the rest of my life, getting regular checks of my breasts and skin...

Nancy, I'm sorry you're having the "What If"s... it can be difficult, I know.  I'm in the opposite situation - even though I had two different types of breast cancer at once, plus "atypical ductal hyperplasia" (e.g. pre-DCIS), and I had unclear margins TWICE, my surgeon didn't tell me I needed a MX.  In fact, I was scared and leaning towards having one, but she kind of talked me out of it and we went for another re-excision!  Overall, I'm glad I just got the lumpectomy, but... now that I've been diagnosed with a second cancer, I'm a bit freaked out about my body and wonder if it would have been better to just be extra safe and get the MX.  I'm not saying the melanoma has anything to do with the fact that I had a lumpectomy, or has anything to do with my breast cancer at all (although it MIGHT - I'm researching the connection between brCA and melanoma), but now I'm feeling scared like I have a "cancer-prone" body... ugh.  And I hate it that the treatments for breast cancer increase my risk for other cancers. What an awful rock-and-hard-place.  The radiation to my breast, because I had just turned 31, increased my risk (only very slightly, but still) for other cancers down the road...and the Tamoxifen increases my risk (again, very slightly, but still) for endometrial cancer and Planned Parenthood is wanting to do an endometrial biopsy because I've been bleeding for 15 days straight, and the radiation made my skin more sensitive to the sun, and then I was diagnosed with skin cancer.... It's TOO MUCH!

Dx 11/2009, 1cm, Stage I, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Oct 15, 2011 08:16AM dogeyed wrote:

RAILI, wow, that's some long bus ride you've been on with cancer!  My melanoma, one cancer sister told me it had to do with my Inflammatory Breast Cancer IBC.  And this I think is true, because IBC causes the boob to swell up much larger than the unaffected one and changes skin too, and that's when I noticed this mole on my breast turned into what looked to me like melanoma, and indeed it was when they removed it along with my breast.  So, for me anyway, I'll always figure the IBC aggravated the mole. 

Some people get melanoma from sun exposure, I do believe, but my mole was not exposed.  But since sun exposure can create skin cancers, it stands to reason mechanical radiation can do the same thing.  In my view, I think the deal is if your skin or anything else in the body suffers from a breakdown of some kind, from injury (via sun, disease, etc.), biochemistry changes (including hormones, genetics), infection microbes, toxins, illness, it opens the door to any cancer.

 I hope your edometriosis biopsy turns up negative, but if it's positive, thank goodness they're getting it straight now.  I do want to know if your melanoma derived from an existing mole or not, and also if it appeared on your breast.  GG 

IBC, IDC, Melanoma/ 5 mos ACT chemo, mastectomy, rads to 11/2011, Arimidex 1 mo, NED 9/2012, two+yr survivor 5/2013 Dx 2/14/2011, IDC, 5cm, Grade 3, 2/11 nodes, ER+
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Oct 19, 2011 06:44AM Raili wrote:

Thanks, dogeyed.  My melanoma was on my lateral thigh.

I'm in the beginning stages of learning about melanoma, so there's a lot I don't yet know or fully understand... but I was under the impression that melanomas are usually caused by UV sunlight exposure and can also show up in places on your body that haven't been exposed to much/any sun.  People sometimes have melanomas in odd places like between their toes!  I wonder if radiation therapy makes your whole body more sensitive to sunlight, or just the area that was irradiated?  What you say makes sense to me, re: when your body suffers from a breakdown, new doors are opened for other problems... I've been doing my best, since the BC dx, to build up my immune system through increased fruits and veggies/better diet, anti-cancer supplements, stress relief, meditation, etc.  It's easy to get frustrated and think it was all useless, since I was just diagnosed with another cancer, but on the other hand...maybe all of my anti-cancer strategies dramatically slowed the growth of the melanoma.  It was tiny and in situ.  Maybe if I hadn't been doing all of those anti-cancer things, it would have grown and spread faster.  Impossible to say, I guess.

I'm not sure if my melanoma derived from an existing mole... I've been getting annual skin checks for a few years now, but this year when my dermatologist saw that mole, she couldn't remember if it was a new one or if she had just somehow missed it during last year's check.  I couldn't remember seeing the mole before, but I also couldn't say for sure that it was new... so she just removed it.  And thank the gods she did!

Dx 11/2009, 1cm, Stage I, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Oct 24, 2011 05:13AM - edited Oct 24, 2011 05:14AM by dogeyed

RAILI, thanks for the reply and info!  I think the melanoma happened to me on account of getting Inflammatory BC, which is a skin thing, so it just took the existing mole and ran with it.  In other words, the "breakdown" of tissue I referred to was the IBC...hmmm...a breakdown of a breakdown!

ALL, I had posted this in my old surgery group, but wanted to bring it up here, since it has to do with either my IDC or IBC cancers.  I had a discoloration mark on my boob that appeared just before I was diagnosed, and I told cancer surgeon several times to be sure to get that off, but postsurgery it appeared maybe a 1/2-inch piece of that discolored part was still there!  I was so annoyed.  So, doc looks at it and says it's probably just a bruise from surgery.  Well, folks, that was three months ago, I'm almost done with rads, and that thang is STILL THERE.  Last week rads doc was marking me for final week of boosts, I told her at outset about that mark, and again I reminded her of the place and asked her could she please blast it to kingdom come, and she said, "I think that can be arranged."  I hope it explodes and vaporizes and leaves an ugly crater after this week.  Obviously when I see my cancer surgeon in a few weeks, I'm a gonna whine about it, if it doesn't burn off.  

If anybody knows, are those skin discolorations part of my Inflammatory BC or the Ductal BC that was just under it??  I was thinking it was from the IBC, and since it is so deadly, you can see why I'm all tore up about it.  And I REALLY don't want to go thru all this again (chemo, surgery, rads).  GG 

IBC, IDC, Melanoma/ 5 mos ACT chemo, mastectomy, rads to 11/2011, Arimidex 1 mo, NED 9/2012, two+yr survivor 5/2013 Dx 2/14/2011, IDC, 5cm, Grade 3, 2/11 nodes, ER+
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Oct 28, 2011 06:11AM scd wrote:

I was diagnosed on Sept 12 of this year with both DCIS and ILC in my right breast. Hormone positive,  HER negative, Ki-67 25-35%. I had a modified radical mastectomy and sentinal node biopsy last Wed (10-19-11) and the path report came back with the classification T4b, N1, MX. I see my surgical oncologist this morning for follow-up and hopefully he'll give me a definite staging, but from all I can discover on my own, the path report puts me as a Stage IIIB. Am I interpreting this correctly? And if I am, what is the best course of treatment and the prognosis? My doctors chose to do the mastectomy before chemo because the ILC doesn't respond as well to chemo - my tumor was 2.7 cm and 2 axillary nodes out of 10 taken were positive for both types of cancer. I've only met with my medical oncologist once, and that was before I had done much research into this. Now I'm concerned that he may not have treated anyone with a mixed diagnosis like this and at this stage, so am planning on trying to talk to him again before beginning chemo to see if I might need to find another doctor. Just how rare is this type of mixed diagnosis? I was given the T4b designation because the skin of my aureola and nipple was fully involved - also I was told that if I had chosen to have a lumpectomy, they would have had to go back and remove the breast anyway. I'm also planning on a prophylactic mastectomy of the left breast and reconstruction of both after finishing chemo. I'd love to hear from anyone else who has been in my situation - information is difficult to come by and I don't feel as though I know enough to make the best choices for myself. Also, since I'm new here and don't know protocol, is it customary or is anyone interested in seeing pictures? I have a close-up of my nipple/aureola area showing the cancer but didn't know if it was appropriate to post or not.

Sandra Dx 9/12/2011, ILC, 2cm, Stage IIIB, Grade 2, 2/10 nodes, ER+/PR+, HER2-
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Oct 28, 2011 09:11AM roseamy wrote:

Hi scd,

I was dx with ilc and idc grade2 with skin involvement like you. I had neo adj chemo which did downsize my tumour by 50%, then mastectomy, then rads.I am also her2 positive so had further treatment with herceptin.

I was dx in 2008 and have been ned for 2 1/2 years now, I don't think the mixed diagnosis will make much difference to your treatment what does is the her2+ and er+, pr+ bits which determine whether you will get herceptin or hormonal treatment, I had all three positive  so needed both, I also had rads to the chest wall as mine had gone into the skin and was 5cm+.

I have since had an ld flap recon and reduction and lift on the good side. In the uk where I am  they do not do prophylactic mastectomies unless you have a family history or a very high risk of bc on the other side.

I do not know how rare this dx is in fact my onc and surgeon have treated it as though it is an everday dx and both are pleased with my progress.

 good luck.

Dx 9/30/2008, ILC, 5cm, Stage IIIB, Grade 2, 0/4 nodes, ER+/PR+, HER2+
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Nov 9, 2011 08:15AM amsk wrote:

scd -

I too have a diagnosis of mixed cancer:  DCIS and mammary invasive cancer with mixed ductal and lobular features.   According to my research most cancer (about 80%) is ductal;  lobular cancer is less common (about 15%).  "Mixed" cancer is about 4% - so it somewhat rare based on what I have been able to determine.

My research has also indicated, consistent with what Roseamy said, that having a "mixed cancer" diagnosis of this nature may not have clinical significance.  Treatment of the cancer may depend more on whether it is estrogen/progesterone/HER2 positive or not, and/or whether it has been found in the lymph nodes or elsewhere, rather than on the mixed nature of the cancer.

Did you receive a final staging of your cancer from your BS?  Do you have a date for the MX of your other breast?   Did you begin your chemo treatments yet?

I hope you are getting some anwers and reassurance from your drs.  So sorry you are having to go through all this.  Let us know how you are doing.  thinking of you - amsk.  

ps - I am scheduled for a BMX in December.  Tentative date right now is 12/4. 


Dx 10/4/2011, IDC, 4cm, Stage II, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Nov 19, 2011 06:29PM lizcarolan wrote:

I have DCIS and cribiform. It is so hard to find info on that.

Liz -- Cribiform Carcinoma BMX with TE's Dx 9/2011, 2cm, Stage IIA, Grade 1, 0/3 nodes, ER+/PR+
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Dec 8, 2011 11:28PM BlueCowgirl wrote:

I didn't realize there was a forum just for us mixed gals- don't know how I missed it! 

My original pathology from core biopsy showed 2 tumors, both with ductal and lobular features, and sentinal node with same features. I thought straight off I'd have a BMX - since I did neoadjuvent chemo due to tumor size, my BS talked me into a lumpectomy...Well, margins were terrible so again I thought BMX, but surgeon convinced me to do uni...Still trying to decide whether or not to have MX on other side.

Surgical pathology showed IDC, ILC and DCIS. I thought I had a lot of different cancer going on in that breast...but so sorry that some of you here have dealt with that plus so much more!

Best wishes to you all, and please, will anyone post if they know of any studies of IDC+ILC mixed? Just curious, thanks and hugs. 

Lettuce weight and sea. Dx 2/16/2011, 6cm+, Stage IIIA, Grade 2, 3/13 nodes, ER+/PR+, HER2-
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Dec 10, 2011 12:34AM BlueCowgirl wrote:

Liz...Just re-read my path report and I had some cribiform too!

Also curious to know if anyone's surgeon has strongly recommended BMX due to mixed types in one breast where other breast is apparently normal...My BS is great, but soooo anti BMX unless patient is BRCA+ which I am not.

Lettuce weight and sea. Dx 2/16/2011, 6cm+, Stage IIIA, Grade 2, 3/13 nodes, ER+/PR+, HER2-
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Dec 10, 2011 08:54AM - edited Dec 10, 2011 08:54AM by nwest125

My BS only recommended my Right one that had IDC and ILC but when I told her I wanted a BMX neither her or my Insurance Company had any problem with it. I have a family history but I  am BRCA -


IDC 11-1-10 Lumpectomy 11-15-10 reincision/ found ILC 12-16-10 BMX with no reconstrution Dx 9/21/2010, ILC/IDC, Right, 1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2-
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Jan 1, 2012 08:15PM Spinnerpom wrote:

Glad I found this board.  My intial biopsy on 11/14 showed DCIS and IDC, stage 1, and subsequent biopsy showed LCIS and path after my lumpectomy showed a microscopic single focus of ILC.  Seriously, WTH?  It's a cancer smorgasbord...grab a plate!!  :Surprised
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Feb 10, 2012 06:04PM Lulu22 wrote:

Mine was first diagnosed as IDC, stringly ER/PR+, Her2-. When the cancer was removed the original diagnosis stood for most of the tumor, but they also found a section that was weakly ER+, PR/HER2- metaplastic BC. I did my chemo pre-surgery, but according to my BS and MO the treatment would have been the same anyway.

Dx 9/7/2011, IDC, 5cm, Grade 3, ER+/PR+, HER2- Surgery 9/8/2011 Lymph node removal: Left, Sentinel Surgery 1/18/2012 Lumpectomy: Left Dx 12/17/2014, IDC, Left, 1cm, Grade 3, ER+/PR+, HER2- Surgery 1/8/2015 Lymph node removal: Left, Right, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Saline implant; Reconstruction (right): Saline implant Radiation Therapy Breast Chemotherapy AC + T (Taxol) Hormonal Therapy Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Apr 7, 2012 04:44PM - edited Apr 12, 2012 07:36AM by Tesoro

I'm not the only one who went for the Breast Cancer Variety Pack!  - I had been wondering.Wink  After feeling a small lump and having a mammogram, ultrasound and biopsy, I was dx with IDC in November, when I had an MRI with contrast fluid a week later my whole other breast lit up, another biopsy revealed ILC that had not shown up on my mammogram. The tumor of ILC was so large that it required a MX. (There was also some LCIS) With cancers in both breasts and the fear that more might grow, I went ahead and had a bi-lateral mastectomy. My oncotype DX testing came back with a fairly low score for both, so no chemo - 5yrs of Tamoxifen though. I opted for re-construction with tissue expanders. It hasn't been fabulous but I thought the re-construction was going okay - until I started Radiation. I currently have been having an interruption in my treatment due to blistering, I should start up again on Monday. Aside from that, the side that I'm having the radiation on is so much firmer and tighter, and my other side has relaxed to such an extent that the scar on my left side is now lower than the scar on my right side. Frown (They had been even) I don't get the impression that this is a situation that will remedy itself and I'm honestly pretty disappointed.  It has been a miserable, painful road that I am still plodding along on. I'm just trying to do the best I can to power through.

Hugs and Wishes

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