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Topic: Secondary cancer in the same breast

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

Posted on: Sep 8, 2012 08:51AM

mrskimber47 wrote:

Just diagnosed with IDC a month ago and having mastectomy this Tuesday. Onc told me initially that I had 2 tumors, both IDC but didn't talk much about the third tumor, so I assumed it would be the same type. Saw my surgical onc in Boston a few days ago and apparently he thinks I have another type in the area around my nipple. They haven't done much for diag on this area because they are removing the entire breast and will biopsy at that time. 

I know many of the members on this board have been diag with multiple cancers, but I can't find any threads discussing this.

I am freaking out because I was just able to process the firs diag and now am faced with another. I am scared about what type it might be and how this will affect staging and treatments. Anyone with any info, PLEASE post! I am freaking out... 

Dx 8/2/2012, IDC, 2cm, Stage IIIA, Grade 2, 5/14 nodes, ER+/PR+, HER2- Surgery 9/11/2012 Mastectomy: Right; Reconstruction (right): Tissue expander placement Chemotherapy 11/6/2012 AC + T (Taxol) Surgery 2/19/2013 Reconstruction (right) Hormonal Therapy 4/19/2013 Radiation Therapy 5/2/2013 Breast
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Sep 8, 2012 09:00AM Moderators wrote:

Hi Mrskimber --

You may also want to try posting in the Second or Third Breast Cancer forum, where others who have been diagnosed with more than one primary breast cancer can discuss.

Hope this helps!

--The Mods

To send a Private Message to the Mods: community.breastcancer.org/mem...
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Sep 8, 2012 09:04AM pupmom wrote:

My initial pathology from biopsy showed ILC. After the lumpectomy they found that the largest area was IDC. I also had an area of DCIS. I was told this is not uncommon. Having the different types would not have affected my stage. Finding 2 positive nodes, unfortunately, did. Bumped me up from Stage I to Stage IIA.

Main thing is to just get it all out! Best wishes for your upcoing surgery! 

Life is what happens while we're making other plans. Dx 10/18/2011, IDC, Right, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-
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Sep 8, 2012 09:15AM mrskimber47 wrote:

thanks Mods and Yorkiemom. 

I know the most important is to get it out, just freaked me out a little. What other types that occur near the nipple are there? I can't find much info and the info I find is for very rare types... 

Dx 8/2/2012, IDC, 2cm, Stage IIIA, Grade 2, 5/14 nodes, ER+/PR+, HER2- Surgery 9/11/2012 Mastectomy: Right; Reconstruction (right): Tissue expander placement Chemotherapy 11/6/2012 AC + T (Taxol) Surgery 2/19/2013 Reconstruction (right) Hormonal Therapy 4/19/2013 Radiation Therapy 5/2/2013 Breast
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Sep 8, 2012 09:19AM pupmom wrote:

Mrskimber74, all of mine was behind the nipple. I think every type of bc can occur anywhere on the breast. It's an equal opportunity monster.

Life is what happens while we're making other plans. Dx 10/18/2011, IDC, Right, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-
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Sep 8, 2012 09:27AM mrskimber47 wrote:

Yeah, its probably stupid for me to try and figure it all out, not a doctor, but should consider NOT googling so much!!!! Sometimes the Internet is our enemy. Yell Too much information and half of it might as well be in Latin for the sense it makes to me. 
Dx 8/2/2012, IDC, 2cm, Stage IIIA, Grade 2, 5/14 nodes, ER+/PR+, HER2- Surgery 9/11/2012 Mastectomy: Right; Reconstruction (right): Tissue expander placement Chemotherapy 11/6/2012 AC + T (Taxol) Surgery 2/19/2013 Reconstruction (right) Hormonal Therapy 4/19/2013 Radiation Therapy 5/2/2013 Breast
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Oct 16, 2012 12:37AM BCagain wrote:

Is there any hope -- I don't want a mastectomy? 

I had an IDC less than a 1/4 inch in right breast 14 years ago with no spread to lymph nodes and had lumpectomy and radiation. 

Now I had 2 breast ultrasound biopsies (1 before an MRI and 1 after).  Biopsy reports show that left breast has mixed ductal and lobular invasive cancer in outer breast and ILC in the inner breast.  Both are estrogen positive, but mixed is also positive for progesterone and ILC is negative for progesterone.  Reports also show HER2 is equivocal -- mixed futher test shows not amplified but ILC biopsy is still testing on HER2.  Nuclear grade is to be determined on resection for mixed, and grade is 2 for ILC.  However, the proliferation index is 5% for the mixed ductal and lobular and is only 2% for the ILC.  So, these are slow growing tumors.  Is there no way I can have a lumpectomy instead of a mastectomy?  Thank you.

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Oct 16, 2012 12:52AM Lou10 wrote:

mrskimber - I had two tumours, one of which was IDC and the other DCIS. The DCIS was irrelevant to my staging or treatment for the invasive cancer. A friend of mine was just diagnosed again (4 years ago she had DCIS), and she has IDC of mixed type plus DCIS, with the DCIS being in her nipple area. Your additional tumour may not affect your staging or treatment. Sorry you're having to face this ... it sucks big time.

BCagain - So sorry you're facing this again. I was able to have a lumpectomy with two different tumours, but they were in the same quandrant of my breast. The second one was discovered shortly before surgery and the surgeon felt she could get them both and still conserve my breast. Ask your surgeon ... may depend on the size of the tumours and whether removing breast tissue from both sides would leave you with a reasonable outcome??

Diagnosis: 12/15/2010, IDC (plus DCIS & ILC), 2.5cm IDC, Stage IIb or III (unknown -- radiation to lymph nodes instead of ALND surgery), Grade 2, 2/2 nodes (sentinel and intramammary fully involved with extracapsular extension), ER+++/PR+++, HER2- Surgery 1/25/2011 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 4/13/2011 Cytoxan (cyclophosphamide), Ellence (epirubicin), Fluorouracil (5-fluorouracil, 5-FU, Adrucil), Taxotere (docetaxel) Radiation Therapy 9/14/2011 Breast, Lymph nodes Hormonal Therapy 11/7/2011 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 8/22/2012 Femara (letrozole) Hormonal Therapy 7/10/2013 Aromasin (exemestane) Hormonal Therapy 7/12/2014 Femara (letrozole)
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Oct 16, 2012 01:46AM BCagain wrote:

Thanks very much for your reply.  No time is a good time for this.  However, right now, I don't think I can handle mastectomy/reconstruction decisions because of current work/insurance/family issues.  Since  I won't see the surgeon again until 10/24/12, I just keep obsessing over this.  The position of the cancers in the left breast is 11 o'clock and 2 o'clock, so I assume that's different quadrants.  So, I'm thinking I will be advised to have a mastectomy on one or both breasts (even though they found nothing in my right breast).  Am I being unreasonable to think that there just should be another option to have a lumpectomy?  Why couldn't the surgeon just do two different lumpectomies on different dates under local anesthetic?

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Oct 16, 2012 02:00AM Lou10 wrote:

BCagain -- I've never heard of a lumpectomy being done under local anesthetic ...  There may be a possibility of removing both tumours if they're very small and will leave you with enough breast tissue, but I'm just guessing! If you don't have an option, you could have a unilateral mastectomy as there's nothing in the right breast. Also, you don't have to make reconstruction decisions now ... you can have delayed reconstruction (or none). My friend is having a unilateral mastectomy and her surgeon said immediate reconstruction is not for her, perhaps because of additional treatments she's facing (there's cancer in her lymph nodes).

Diagnosis: 12/15/2010, IDC (plus DCIS & ILC), 2.5cm IDC, Stage IIb or III (unknown -- radiation to lymph nodes instead of ALND surgery), Grade 2, 2/2 nodes (sentinel and intramammary fully involved with extracapsular extension), ER+++/PR+++, HER2- Surgery 1/25/2011 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 4/13/2011 Cytoxan (cyclophosphamide), Ellence (epirubicin), Fluorouracil (5-fluorouracil, 5-FU, Adrucil), Taxotere (docetaxel) Radiation Therapy 9/14/2011 Breast, Lymph nodes Hormonal Therapy 11/7/2011 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 8/22/2012 Femara (letrozole) Hormonal Therapy 7/10/2013 Aromasin (exemestane) Hormonal Therapy 7/12/2014 Femara (letrozole)
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Feb 23, 2013 01:30AM markcleveland wrote:

My wife was diagnosed with stage 2, non hormonal, DC. 4 months into chemo, her breast inflamed into a "non diagnosed" IBC. After her treatment with ixebipalone(sp?) and a mastectomy, her cancer went her skin. They put her on 6 weeks of radiation 2x a day along with zeloda. It's been two weeks and another spot just appeared on her skin next to the radiation field. Probably cancer again. It's a long battle. Fight hard.

How are you doing??

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May 16, 2013 10:12PM wcerda wrote:

Hello everyone,

This is my first time in a forum. My mother was diagnosed with ILC and had her mastectomy April 26th and her recovery is going very well. We just got pathology report which came back with her having ILC and IDC and when they re tested lymph nodes the 2nd one came back with cancer. Now she needs to go back and have all her nodes removed. Anyone in this situation???

First Oncology appt not till the 28th. Anyone know what kind of prognosis for these types of situations. Im trying to inform myself as much as possible to help and support her, but there isnt too much info on mixed BC.

I appreciate any info or suggestions.

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May 19, 2013 04:37PM Michele2013 wrote:

Wcerda- I have idc/ilc and had the traditional AC/Taxol. 33 rads.

I had a petscan and 4 lymph nodes lit up, so when my port was placed my bs took the 4 out and path report came back as 3 positive for cancer. 2 had extra capsular extension. When I was done with chemo and had my bilateral mastectomy, my bs took the remaining lymph nodes. 1 came back with extra capsular extension. Meaning the chemo did not stop the cancer. So I am wondering if the mixed cancer made it so aggressive.

Gentle hugs

Stage 1 Thyroid Cancer. Chemo induced cardiomyopathy, now have a defibrillator. Dx 10/29/2012, IDC, 6cm+, Stage IIIA, Grade 3, 4/13 nodes, ER+/PR+, HER2- Chemotherapy 11/27/2012 AC + T (Taxol) Radiation Therapy 4/28/2013
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May 19, 2013 05:02PM - edited Oct 15, 2013 12:32PM by Moderators

i am not sure chemo helps within the lymph system especially if the pathways had been "interrupted" by prior lymphnode removal.

"I will sit right down, waiting for the gift of sound & vision" David Bowie, Rest in pax, my beloved changeling... Dx 6/8/2012, IDC, Right, 1cm, Stage IIIC, Grade 3, 25/30 nodes, ER+/PR+, HER2+
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May 19, 2013 05:12PM Michele2013 wrote:

Thank you, I kind of get what your saying.

Guess I was hoping for a clean path report. Then again, we all are.

Stage 1 Thyroid Cancer. Chemo induced cardiomyopathy, now have a defibrillator. Dx 10/29/2012, IDC, 6cm+, Stage IIIA, Grade 3, 4/13 nodes, ER+/PR+, HER2- Chemotherapy 11/27/2012 AC + T (Taxol) Radiation Therapy 4/28/2013
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Jun 1, 2013 12:25PM wcerda wrote:

Hi Michelle,

Thanks for your reply. We FINALLY saw Oncology. She is a stage IIA Er+,Pr+ ,Her-
She will start TAC chemo about 3 weeks after node removal. 6rounds for 4 months

They had her scheduled for MRI to scan the left side and make sure it was clean, if not, they could address it when they take out the nodes. Unfortunately, they couldn't do the MRI because of the expander she has on the right side. No they will have to take out the expander when they take out the nodes. So they can do her MRI after.

She is so scared and nervousness since they told her that the other side could be affected too. Since the beginning, she requested a bilateral mastectomy, but her insurance wouldn't cover because they have to prove its affected. We are now waiting on her surgery date for the lymph node and expander removal. The waiting game begins again :(

Thanks for all your info. I am trying to be as informed as possible to help her. I have visited a few TAC chemo forums and lymphedema info. Any suggestions for more info would help.

Again, thanks
Wcerda

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Jun 1, 2013 01:35PM wirdgirl118 wrote:

Paget's disease of the nipple is a form of breast cancer. It can be on or in or near the nipple, if I understand correctly.

Post mastectomy pain syndrome, taking Neurontin Dx 12/6/2012, Paget's, Stage 0, ER-/PR-, HER2+ Surgery 1/15/2013 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Right
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Jun 11, 2013 12:02PM Dyvgrl wrote:

I had originally planned on having a lumpectomy, but because my MRI showed 4 other suspicious sites, I opted for the mastectomy instead of multiple biopsies and hoping / waiting. I wanted it all gone, no messing around. It's a good thing I made that choice. My original Grade 2 tumor turned into a Grade 3 tumor IDC and had another DCIS, and LCIS tumor, Grade 2. My sentinel node was also affected so my surgeon took the entire axillary pack. None of those were affected so I'm very hopeful we've gotten it all. I would not have known any of this had we gone with a lumpectomy. I really have no intention of going through this drama over and over again. Get it all out, do all the treatments you need, and let me get on with my life!

Dx 4/6/2013, IDC, 6cm+, Stage IIIA, Grade 3, 1/9 nodes, ER+/PR+, HER2- Surgery 5/22/2013 Lymph node removal: Right, Sentinel, Underarm/Axillary Surgery 5/22/2013 Mastectomy: Right Chemotherapy 7/16/2013 AC + T (Taxol) Surgery 5/7/2014 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap

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