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Topic: Invasive mammary?? anyone else?

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

Posted on: Aug 7, 2015 12:45PM

wrmbrownie wrote:

I thought I had IDC. After surgery last week, it was diagnosed as Invasive mammary carcinoma with ductal and lobular features. It made sense as the surgeon was surprised with the extensions out of the tumor that they hadn't seen before. I don't see a whole lot about this. Anyone else have it? Or know what the prognosis is? If I had known this before, I would have opted for a mastectomy.

Dx 1/8/2015, IDC, Left, 3cm, Stage IIIA, Grade 3, 9/19 nodes, ER+/PR+, HER2- (FISH) Chemotherapy 1/29/2015 Taxol (paclitaxel) Chemotherapy 4/23/2015 AC Surgery 7/28/2015 Lumpectomy: Left; Lymph node removal: Left Radiation Therapy 9/1/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 10/14/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 10/22/2019 Arimidex (anastrozole)
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Aug 8, 2015 12:42PM kareenie wrote:

Mammary just means breast.

ILC 1994 & 2009, Endometrial CA 2005, DES dau, Chemo, Rads, Femara, Prolia, MRM L, ALND, PNSMX R, LE, FG
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Aug 8, 2015 01:29PM BarredOwl wrote:

Hi:

I hate it when the surgical pathology finds other stuff. There was no way for you to know that when you made your decision.

I did not have any lobular component, so I am not sure exactly what they mean by the phrase "with ductal and lobular features".

For example, are they are saying it is a mixture of: (a) invasive ductal carcinoma and (b) invasive lobular carcinoma? If so, the National Comprehensive Cancer Center (NCCN) treatment guidelines (Version 3_2015) include this statement:

"Mixed lobular and ductal carcinoma as well as metaplastic carcinoma should be graded based on the ductal component and treated based on this grading. The metaplastic or mixed component does not alter prognosis."

That sounds good to me, but please don't hesitate to ask your doctors about this to be certain.

I note your comment about the "extensions". Do you know if they got clean margins? Even if it is true that the grade would be based on the ductal component, I would want to know if there may possibly be separate implications from the presence of a lobular component due to its growth patterns or other features. . . Again, please don't hesitate to ask your doctors about this.

Perhaps others with a mixed or lobular diagnosis and more informed than I am can shed some light for you.

BarredOwl

Bilateral mastectomy and SNB without reconstruction 9/2013

Dx Right: ER+PR+ DCIS (5+ cm) with IDC (1.5 mm) and micro-invasion < 1 mm; Grade 2 (IDC); 0/4 nodes.

Dx Left: ER+PR+ DCIS (5+ cm); Grade 2 (majority) and grade 3; isolated tumor cells in 1/1 nodes (pN0i+(sn)).

Stage IA IDC, 9/2013 BMX. Right: IDC (1.5 mm, grade 2) with DCIS (5+ cm), 0/4 nodes, pN0. Left: DCIS (5+ cm), 0/1 node, pN0(i+).
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Aug 8, 2015 02:45PM - edited Aug 8, 2015 02:47PM by wrmbrownie

thanks for the great info! And yes, they got clean margins.


Dx 1/8/2015, IDC, Left, 3cm, Stage IIIA, Grade 3, 9/19 nodes, ER+/PR+, HER2- (FISH) Chemotherapy 1/29/2015 Taxol (paclitaxel) Chemotherapy 4/23/2015 AC Surgery 7/28/2015 Lumpectomy: Left; Lymph node removal: Left Radiation Therapy 9/1/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 10/14/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 10/22/2019 Arimidex (anastrozole)
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Aug 17, 2015 01:41AM powerthruit wrote:

Hi wrmbrownie,

I have the exact dx. Mixed mammary carcinoma with ductal and lobular features. I am still not crystal clear on what IT is/was. And I will ask about it again!! ...and again. 😉 Best I can gather is on balance the large lobular component, sorta balanced out the ductal? I had a very large lobular component that I understand is quite difficult to see on a mammogram (which as an aside according to my MO has little to do with dense breasts). Mastectomy was in the cards for me for 2 reasons: Pre-MRI most of the tumor was right behind my nipple and they already knew from the mammo that it was at least 4cm. The MRI illuminated other abnormalities. It wasn't it until the final surgical path report that it turned out to be one huge tumor. Sounds similar to yours, but you ended up with the same size? I went in thinking 4cm and landed at 7.5. I have a great BS and she got clean margins. Yay!
Dx 5/2015, LCIS/IDC, Right, 6cm+, Stage IIB, Grade 2, 0/13 nodes, ER+/PR+, HER2- Surgery 6/4/2015 Lymph node removal: Right, Sentinel; Mastectomy: Right Chemotherapy 7/6/2015 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy Arimidex (anastrozole)
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Aug 17, 2015 11:34PM wrmbrownie wrote:

They thought it was aappropriately 2.5ish and it ended up being 3.2. Glad to know there is someone else in a similar boat, so to speak. I see radiology oncologist on the 25th and hope to get clarity.


Dx 1/8/2015, IDC, Left, 3cm, Stage IIIA, Grade 3, 9/19 nodes, ER+/PR+, HER2- (FISH) Chemotherapy 1/29/2015 Taxol (paclitaxel) Chemotherapy 4/23/2015 AC Surgery 7/28/2015 Lumpectomy: Left; Lymph node removal: Left Radiation Therapy 9/1/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 10/14/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 10/22/2019 Arimidex (anastrozole)
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Aug 19, 2015 12:07AM caligirl3 wrote:

Hello ladies,

I too was diagnosed with mammary carcinoma mixed ductal with lobular features. i was told it is treated as ductal carcinoma. I also had a large area of pleomorphic LCIS, with a bit of dcis thrown in! It made me really nervous at first to have so many different things going on in the same area, but from everything I have read and according to my Onc, it does not change prognosis.

Mammary Ca(mixed Ductal and Lobular) Oncotype Dx. 6 Dx 12/10/2014, Right, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- (FISH) Surgery 12/10/2014 Mastectomy: Left, Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Hormonal Therapy 1/12/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 9/29/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Aug 28, 2015 02:00PM cbm wrote:

I had a mixed tumor in 2008, including IDC, ILC, DCIS, and LCIS. It was 2A, Grade2, triple positive, and I had a bilateral mx plus AC/TH, and later I was in a Neratinib trial. My oncologist said it's usually treated as ductal, though it seemed to have a little of everything.

Though one node was involved and was actually larger than the 1.9 cm tumor, I later obtained an Oncotype dx, on which I scored only a 9.

At the time, most of my references said it was not all that unusual and did not have a worse prognosis than a more streamlined presentation. However, I haven't run across many since I've been dropping in here.

Peace,

Cathy


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Aug 28, 2015 11:06PM mrskirby wrote:

I too have Invasive Ductal Cancer and Invasive Lobular Cancer, Stage II, and I opted for DMX on August 19, 2015 a day I won't forget. My path report found another lobular tumor and DC In situ and LC In situ. I think I am typing this correct. I am wondering about theraphy? I know I will have something? My worry is chemo? Then side effects?

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Aug 29, 2015 02:32AM Meow13 wrote:

i had 2 tumors one idc and one ilc pathology says with 95 percent confidence that tumors were totally separate occurrences.

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Nov 2, 2015 11:43PM Merymete wrote:

I was just diagnosed with this, glad to find others here. Just beginning my journey through this

Dx 10/27/2015, IDC, Left, <1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 1/18/2016 Lumpectomy: Left Radiation Therapy 1/18/2016 Surgery 1/18/2016 Lumpectomy: Left; Lymph node removal: Sentinel; Reconstruction (left); Reconstruction (right) Hormonal Therapy 3/24/2016 Femara (letrozole)
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Nov 19, 2015 11:18PM Girl53 wrote:

Have been on boards since summer, and posting mainly to ILC threads, but just noticed something on my path report that had escaped my attention.

In one spot on report, it says "infiltrating lobular carcinoma" (weakly positive for e-cadherin); in other spot it says "invasive mammary carcinoma with lobular features" (which I understand as being mixed ductal and lobular cancer). Have read that e-cadherin status is often used by pathologists to distinguish between ILC and IDC.

Do I need to ask my MO about this? Thanks, ladies.

Dx 9/3/2015 ALH and LCIS; dx 9/14/15 ILC 2mm, ER+, PR-, HER2-, grade 1; SNB 11/19/2015, 0/2 nodes; fam history but BRCA neg;completed rads 2/17/16; started Arimidex 3/25/17 and stopped 9/23/17; started Aromasin 3/25/17 and stopped April 19.
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Jan 2, 2016 07:18PM lscrivy wrote:

My 78 yr old mother was diagnosed with invasive mammary carcinoma on Dec 23 ... Merry Christmas ! Her report also says weakly positive for e-cadherin staining, but mainly lobular features. She has one nodule that is nearly 7cm at the 10:00 position as well as a 5mm lymph node at approx the same position. She has not yet had surgery. We are seeking centers that specialize in older adults to help us make the best decision for treatment. She is in relatively good health now -- she has COPD but is still pretty active. We have an appt at MD Anderson on Jan 11. We are also considering the Moffit Cancer Center in FL. We would really appreciate suggestions for any other experts, regardless of location. Thank you so much in advance.

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