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Topic: Invasive BC with mixed ductal and lobular features

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

Posted on: Sep 17, 2013 05:45PM

Nahelton12 wrote:

Just got this finding on biopsy path report. Sound familiar to anyone? The surgeon explained it to me iin a 90 minute appointment. Thought I understood it but now .... I think she said that the specimen had both ductal cancer cells and lobular cancer cells. Also their is no tumor or mass just a "density" or she sometimes says lesion that is 10 cm by 8 cm covered with powder-like microcalcifications. It was a small cluster of these micros that she biopsies. She said she was surprised that it was invasive and mixed. Said she didn't suspect that. Because all of that microcalcification area could contain cancer, and because the area is huge (her word, not mine) I must have a mastectomy. Gosh, is this ever confusing.

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Feb 3, 2018 06:40PM determined2018 wrote:

I had two tumors first one was IDC with lobular features. The second tumor was ILC. After mastectomy pathology is calling it just ILC. Confusing to me. Asking MO for more clarification. Should oncotype be done on both tumors?

Dx 11/15/2017, ILC, Right, 4cm, Stage IIB, Grade 2, 1/2 nodes, ER+/PR+, HER2- (FISH) Hormonal Therapy 1/15/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Feb 4, 2018 01:44AM Meow13 wrote:

I think so, but I only received one oncodx number. I don't know which tumor they used.

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Feb 4, 2018 12:56PM Georgia1 wrote:

Hi there Determined. After surgery there is a comprehensive pathology lab test done which often changes the preliminary results of the pre-surgery biopsy, so that's pretty normal, but it's a great idea to have your MO explain all of the pathology report findings to you.

On the Oncotype DX test, it is only ordered in special circumstances (like early stage and ER+) so that's a good topic for discussion with your MO as well. Insurance companies often fight about paying for it, so I believe the likely outcome is just one test. And it could be the pathology report shows both tumors with very similar characteristics; that's what happened to me.

Cancer touched my breast so I kicked its ass. Dx 9/3/2017, ILC/IDC, Right, <1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- Dx 10/10/2017, LCIS, Right, 0/1 nodes Surgery 10/10/2017 Lumpectomy; Lymph node removal: Right, Sentinel Radiation Therapy 11/27/2017 Whole-breast: Breast Hormonal Therapy 1/2/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Feb 5, 2018 03:51PM Amie03 wrote:

Hi Ladies,

I'm totally confused as how to proceed and was hoping to gain some clarity from those who have already experienced it. I was dx with IDC with Lobular features, had BX and tumor was 2.0cm GRADE 2, Stage IIA, with LVI, 1/3 nodes positive with extranodal extension. Onco came back 20, intermediate, so I have had 1 MO said no chemo needed, second said yes.....Now I'm very confused! Help!

Dx 12/12/2017, ILC/IDC, Left, 2cm, Stage IIA, Grade 2, 1/3 nodes, ER+/PR+, HER2- (IHC) Surgery 1/3/2018 Lumpectomy: Left; Lymph node removal: Sentinel
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Feb 5, 2018 07:27PM Georgia1 wrote:

Hi Amie and I'm so sorry that you are facing this decision. My MO based her recommendation partly on family history and ER+ status, because the higher your ER + score the better Tamoxifen or an AI will work. Do you have that information?

Cancer touched my breast so I kicked its ass. Dx 9/3/2017, ILC/IDC, Right, <1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- Dx 10/10/2017, LCIS, Right, 0/1 nodes Surgery 10/10/2017 Lumpectomy; Lymph node removal: Right, Sentinel Radiation Therapy 11/27/2017 Whole-breast: Breast Hormonal Therapy 1/2/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Feb 5, 2018 10:42PM Meow13 wrote:

Also if you are er+ but pr- AI drugs seem to work better than tamoxifen but the joint pain and possible bone loss are the negative aspect.

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Feb 6, 2018 06:38AM Amie03 wrote:

Hi Georgia1 and Meow13,
Thank you for your response. My sister who is 2 years younger than me was dx 1 month before me with IDC, Grade 1, Stage 1.
I am ER positive 89%, I am still pre-menopausal . We are still working out the details for which drug, I would be best suited for. I just received my Genetic tests back and found out that I have NBN, which I have found out carries up to a 30% increase of breast cancer, and has some association with increased risk with radiation. So now I am rethinking my plan. I am meeting with my MO om Friday to discuss details. This is such a journey, not a race, I guess?!

I appreciate your help.
A

Dx 12/12/2017, ILC/IDC, Left, 2cm, Stage IIA, Grade 2, 1/3 nodes, ER+/PR+, HER2- (IHC) Surgery 1/3/2018 Lumpectomy: Left; Lymph node removal: Sentinel
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Feb 6, 2018 12:14PM stunned wrote:

Hi Amie,

I am like you with IDC/ lobular features, but also multifocal. 3 separate tumors IDC 1cm, IDC 1cm and ILC 4mm. I also had 1 of 3 nodes positive. I am 49 and premenopausal with no family history. Because the one node was positive, I am starting 4x TC this week and every 3rd week for the next 3 months. Seems doable and not too debilitative from what I am reading - fingers crossed. So yes, chemo was advised. I hope you find the answers to your questions. It's so difficult to weigh in all the factors and side effects. Sending you strength..

Dx 12/7/2017, IDC: Tubular, Right, 1cm, Stage IIA, Grade 2, 1/3 nodes, ER+/PR+, HER2- (IHC) Surgery 1/18/2018 Lumpectomy: Right Chemotherapy 2/8/2018 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy
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Feb 6, 2018 12:26PM determined2018 wrote:

Thank you! I’ve got an appointment set up this Thursday with my MO to go over things again. Appreciate the response.

Dx 11/15/2017, ILC, Right, 4cm, Stage IIB, Grade 2, 1/2 nodes, ER+/PR+, HER2- (FISH) Hormonal Therapy 1/15/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Feb 6, 2018 03:50PM catlady44 wrote:

Initially I was diagnosed with IDC Stage 2b, grade 2, ER/PR + HER2-. had one positive axillary lymph node. I'd had a clear mammo 6 months prior, so the cancer was on the move. They rushed me into chemo - 12 Taxol's and 4 A/C's. I then had surgery and although the chemo punched a bunch of holes in the tumor, it was already traveling to the lobes. That's how I ended up with the diagnosis of invasive mixed ductal and lobular carcinoma, and lobular carcinoma in situ. I also had 6 weeks of radiation. Even though it was rough, I'd do it all over again because I'm now cancer free. During my first consult, I told the doc to do whatever he had to, to kill the cancer, and I'd just get through it. Still, treatment wasn't nearly as bad as I expected!

Dx 11/2014, LCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 1/14 nodes, ER+/PR+, HER2- Chemotherapy 12/11/2014 TAC Surgery 6/4/2015 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy Arimidex (anastrozole) Radiation Therapy External: Lymph nodes, Chest wall Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Surgery Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Feb 6, 2018 09:44PM Amie03 wrote:

Thank you for some clarity. Meeting again on Friday with MO. I hope to get this figured out and get this started and over with! I know I can get through whatever they want, I just need to make a decision and be comfortable with it!

Thanks again!
A

Dx 12/12/2017, ILC/IDC, Left, 2cm, Stage IIA, Grade 2, 1/3 nodes, ER+/PR+, HER2- (IHC) Surgery 1/3/2018 Lumpectomy: Left; Lymph node removal: Sentinel
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Mar 5, 2018 01:37PM catlady44 wrote:

Best of luck to you! Let me know if you have any other questions. It sounds weird, but it seemed like the time I was on chemo went by quickly. It could be that I was just too wiped out to notice! I slept a LOT.

Dx 11/2014, LCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 1/14 nodes, ER+/PR+, HER2- Chemotherapy 12/11/2014 TAC Surgery 6/4/2015 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy Arimidex (anastrozole) Radiation Therapy External: Lymph nodes, Chest wall Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Surgery Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Jan 29, 2019 10:49AM LizM wrote:

I was diagnosed almost 14 years ago with invasive mammary carcinoma with ductal and lobular feastures. Tumor was 2.1 cm and had one sentinal node positive with 8mm. My biopsy showed only IDC, ER/PR positive, her2 neg and high KI-67. My final pathology showed mixed IDC/ILC grade 1, which shows you that tumors can be hetereogeneous. At that time, my positive node was my ticket to chemo. I had a bi-lateral, reconstruction, chemo and radiation and also 10 years of Femara. I also removed my ovaries. I was very aggressive with my treatment because I didn't want to regret if my cancer came back I didn't do everything I could. I read the latest articles that say IDC-L (which is the new name for it) has a better prognosis than ILC and also responds better to an aromatase inhibitor than tamoxifen. I am fortunate that I am still cancer cancer free. My advice is to follow your gut in your decisions and ask your self if you decide not to do something, that you can live with yourself if your cancer comes back.

Dx 9/19/2005, IDC, 2cm, Stage II, Grade 1, 1/8 nodes, ER+/PR+, HER2-
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Feb 14, 2019 12:03PM 60notpretty wrote:

Hi All,

I was diagnosed with DCIS in Dec and had partial mastectomy on Feb 8th (last Friday). All went well and then went back for my follow up this morning and they said they found ILC too so now I guess it’s mixed DCIS/ILC. This is all so confusing! So now I’m scheduled for another surgery for node testing. I meet with radiation oncologist next week to get that started. I really thought I would go back in today and all would be clear but that was not in the cards yet. Hoping someone can shed some light on this mixed.

60notpretty Dx 12/13/2018, DCIS, Right, Stage 0, Grade 2 Surgery 2/7/2019 Lumpectomy: Right Dx 2/14/2019, ILC/IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 3/20/2019 Lymph node removal: Sentinel Hormonal Therapy 4/2/2019 Arimidex (anastrozole) Radiation Therapy 4/22/2019 Whole-breast: Breast
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May 23, 2019 11:49PM - edited May 23, 2019 11:53PM by beep7bop

MY core biopsy said IDC my double MX showed Mixed IDC and ILC both breast. I am taking Anastrozole

Dx 3/11/2019, ILC/IDC, Both breasts, 1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery Lymph node removal: Sentinel; Mastectomy: Left, Right
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May 24, 2019 01:09PM meeko1452 wrote:

Just adding my dx to the thread for people who are doing searches.

I was diagnosed with a intraductal papiloma with atypia of the left breast via core bx after a small "suspicious finding" on screening mammogram. Because of the atypia, lumpectomy was recommended.

After my lumpectomy (BS took a total of 5 cm, the suspicious area on mammogram AND MRI was about 1 cm), my diagnoses was upgraded to DCIS grade 3 with comedonecrosis. Lumpectomy did not yield clear margins, and so my BS recommended left MX with Sentinel node biopsy.

After my MX, in addition to the DCIS, they found a 5mm aread of invasive "lobuloductal" carcinoma. Node was negative. Ki67 is 5.

My MO is sending it for oncotype testing, and is also going to get a second pathology opinion since "lobuloductal" carcinoma is uncommon.

At this point, with the invasive cancer being Her2- and my node being negative, she is not recommending chemo, but will want me on Tamoxifen for 10 years (or I guess until menopause strikes and she can transition me to an AI).


47 at dx, Brca negative, BRIP1 gene with variant of unknown significance Dx 4/4/2019, DCIS, Left, Stage 0, Grade 3, ER+/PR+ Surgery 4/17/2019 Lumpectomy: Left Dx 5/9/2019, IDC, Left, <1cm, Stage IA, Grade 1, 0/1 nodes, ER+/PR+, HER2- (FISH) Surgery 5/9/2019 Lymph node removal: Sentinel; Mastectomy: Left; Reconstruction (left): Silicone implant Hormonal Therapy 5/23/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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May 27, 2019 05:24PM Rosanne7 wrote:

Hello everyone,

I am very confused, also.

Was diagnosed w/ IDC w/ lobular features (bi-lateral/ post-surgery biopsy).

I understood this as IDC-L -- but a rad onc resident wrote clinic notes claiming it's "IDC/ILC" & strongly recommending re-irradiation. (I've already had bi-lateral mastectomy, intermediate Oncotype score, Grade 2, ER +, on anastrozole one month now.

2nd opinion med onc is re-testing pathology to see if there's a role for chemo...

My understanding is that IDC-L and ILC have differing prognosis for post-menopausal women. So, how do I correct the errors resident wrote in my medical record?

Thanks,

Roseanne7

Dx 5/2007, DCIS, Left, Stage 0, ER+/PR+, HER2- Dx 9/2007, LCIS, Left Surgery 2/29/2008 Lumpectomy Dx 8/2011, DCIS/IDC, Left, 2cm, Stage IIA, 0/1 nodes, ER+/PR+, HER2- Dx 11/1/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR- Surgery 2/14/2019 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Tissue expander placement Hormonal Therapy 4/30/2019 Arimidex (anastrozole) Radiation Therapy Breast, Lymph nodes Surgery Lumpectomy; Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Saline implant, Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery Lumpectomy: Left
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May 28, 2019 02:51AM Veeder14 wrote:

Rosanne7,

You can request an amendment to your medical record under HiPPA and submit this to the health information medical records dept or HiPPA coordinatorIf you are seen at a hospital clinic. if at a small medical office you can submit your request to the physician in charge of the resident or the owner dr of the medical office. You write up you what believe to be the corrected information. Even if the doctors don’t agree your opinion will be seen as it’s supposed to be attached to your medical records. I’ve done this before and the drs agreed the resident made an error. The records were corrected and I was refunded the extra charge for services I didn’t receive. feel free to send me a pm if you have questions.

Dx 1/2/2018, ILC, Left, <1cm, Stage IB, Grade 1, 0/7 nodes, ER+/PR+, HER2- Surgery 1/25/2018 Lumpectomy: Left; Lymph node removal: Sentinel Radiation Therapy 3/7/2018 Hormonal Therapy 2/28/2019 Hormonal Therapy
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May 29, 2019 12:59PM Rosanne7 wrote:

Thank you, Veeder14 ! Excellent info -- :)

Dx 5/2007, DCIS, Left, Stage 0, ER+/PR+, HER2- Dx 9/2007, LCIS, Left Surgery 2/29/2008 Lumpectomy Dx 8/2011, DCIS/IDC, Left, 2cm, Stage IIA, 0/1 nodes, ER+/PR+, HER2- Dx 11/1/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR- Surgery 2/14/2019 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Tissue expander placement Hormonal Therapy 4/30/2019 Arimidex (anastrozole) Radiation Therapy Breast, Lymph nodes Surgery Lumpectomy; Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Saline implant, Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery Lumpectomy: Left

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