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Topic: New member- Tubular/Lobular dx after lumpectomy- ILC and LCIS

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

Posted on: Jun 20, 2016 03:49PM

springlotusflower wrote:

Hi- I am new to this discussion forum. Anyone else have core biopsy result indicating invasive ductal carcinoma with lobular features; followed by pathology from lumpectomy indicating Invasive and in-situ tubular/lobular carcinoma? I am trying to determine why there were two different diagnoses from the biopsy to the lumpectomy; and also whether anyone else has experience with invasive and in-situ tubular/lobular carcinoma. I can't find a lot of information regarding treatment for tubulolobular. I have read that pure tubular has good outcome. I have been told by the breast surgeon that I'll need radiation. I have a medical oncologist appointment scheduled and was wondering if chemo would generally be recommended for this combination breast cancer. My tumor was grade 2 with 0/4 lymph node involvement. The pathology report indicated that the in-situ lobular carcinoma showed extensive involvement of terminal ducts with necrosis imparting ductal carcinoma in-situ-like features. This is all somewhat confusing and I want to be prepared when I talk to the M.O. I am thinking she will order an Oncotype DX test. Thanks for any input or suggestions. Have a great day!

Surgery 2/13/1996 Lumpectomy: Left Dx 2/14/1996, DCIS, Left, <1cm, Stage 0 Radiation Therapy 5/31/1996 Whole-breast: Breast Dx 9/10/2001, DCIS, Left, <1cm, Stage 0 Surgery 10/31/2001 Mastectomy: Left; Reconstruction (left): Nipple reconstruction, Nipple tattoo, Pedicled TRAM flap Dx 4/14/2016, IDC, Right, 1cm, ER+/PR+, HER2- Surgery 6/9/2016 Lumpectomy: Right; Lymph node removal: Right Dx 6/10/2016, LCIS/ILC/IDC: Tubular, Right, 1cm, Grade 2, 0/4 nodes, ER+/PR+, HER2- Radiation Therapy 8/22/2016 Whole-breast: Breast Hormonal Therapy 9/19/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jun 20, 2016 11:26PM Moderators wrote:

Hi Springlotusflower-

We'd like to welcome you to our community here at BCO. That does sound quite confusing! We'd recommend reading through and asking your question in both our IDC and ILC forums, we're sure one of our knowledgeable members can shed some light on what you're dealing with and what can be expected in terms of treatment.

The Mods

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Jun 23, 2016 12:25AM 614 wrote:

Dear SpringLotusFlower:  I was diagnosed with Pleomorphic Invasive Lobular Carcinoma, Bi-Focal Pleomorphic Lobular Carcinoma in Situ, and with Invasive Tubular Carcinoma.  I did not know about the Invasive Tubular Carcinoma and the second area of LCIS until after my pathology report came back.  It is common for the diagnosis to change after surgery.  Don't worry about that.  The prognosis for Invasive Tubular Carcinoma is very good.  The ILC and the LCIS is much more scary for me.  You will definitely need to have radiation since you were dx with ILC and you had a LX.  After rads, you should be fine.  Rads were not difficult for me.  I hope that you will be ok.  You have had so many bc dx over the years.  I am sending you hugs and prayers.  Good luck.

Hormone + Pleomorphic ILC, Pleomorphic LCIS,& Invasive Tubular Carcinoma for 1st BC DX. Hormone negative, Grade 3 DCIS for 2nd BC DX. History of dispersed ALH along with PASH, FEA, and focal atypia. Oncotype 14, Ki67: 21%. Dx Premenopausally. Dx 6/25/2014, ILC, Left, 1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Dx 6/25/2014, LCIS, Left, 1cm, Grade 2, 0/2 nodes, ER+/PR+, HER2- Dx 7/22/2014, IDC: Tubular, Left, <1cm, Stage IA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Dx 7/22/2014, LCIS, Left, 4cm, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 7/22/2014 Lumpectomy: Left; Lymph node removal: Left, Sentinel; Prophylactic ovary removal Radiation Therapy 9/7/2014 Whole-breast: Breast Hormonal Therapy 10/5/2014 Arimidex (anastrozole), Zoladex (goserelin)
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Jun 23, 2016 01:40PM springlotusflower wrote:

Dear Moderators-

Thanks for the support and additional information on where I can post my situation!

Surgery 2/13/1996 Lumpectomy: Left Dx 2/14/1996, DCIS, Left, <1cm, Stage 0 Radiation Therapy 5/31/1996 Whole-breast: Breast Dx 9/10/2001, DCIS, Left, <1cm, Stage 0 Surgery 10/31/2001 Mastectomy: Left; Reconstruction (left): Nipple reconstruction, Nipple tattoo, Pedicled TRAM flap Dx 4/14/2016, IDC, Right, 1cm, ER+/PR+, HER2- Surgery 6/9/2016 Lumpectomy: Right; Lymph node removal: Right Dx 6/10/2016, LCIS/ILC/IDC: Tubular, Right, 1cm, Grade 2, 0/4 nodes, ER+/PR+, HER2- Radiation Therapy 8/22/2016 Whole-breast: Breast Hormonal Therapy 9/19/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jun 23, 2016 01:56PM springlotusflower wrote:

Dear 614-

Thanks so much for sharing your background and for the encouragement. It's good to know that it's common for pathology results to change from the biopsy to lumpectomy. I just met with the medical oncologist. Since there's a lobular component to my invasive and non-invasive tubulolobular results; and my cells were grade 2; they are ordering an Oncotype DX test to determine if I would benefit from chemo prior to radiation. I am pre-menopausal with estrogen &, progesterone + results, so I guess the Oncotype DX results will be the deciding factor. I meet with the medical oncologist in a month to go over results. As you likely know, such a long waiting process for everything! If I don't need chemo, then on to radiation! Glad you got through radiation okay. Hugs and prayers to you, too, for continued good health!!

Surgery 2/13/1996 Lumpectomy: Left Dx 2/14/1996, DCIS, Left, <1cm, Stage 0 Radiation Therapy 5/31/1996 Whole-breast: Breast Dx 9/10/2001, DCIS, Left, <1cm, Stage 0 Surgery 10/31/2001 Mastectomy: Left; Reconstruction (left): Nipple reconstruction, Nipple tattoo, Pedicled TRAM flap Dx 4/14/2016, IDC, Right, 1cm, ER+/PR+, HER2- Surgery 6/9/2016 Lumpectomy: Right; Lymph node removal: Right Dx 6/10/2016, LCIS/ILC/IDC: Tubular, Right, 1cm, Grade 2, 0/4 nodes, ER+/PR+, HER2- Radiation Therapy 8/22/2016 Whole-breast: Breast Hormonal Therapy 9/19/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jun 23, 2016 03:15PM Moderators wrote:

We're so happy we could help, Springlotusflower! Please keep us all posted on your Oncotype DX results and what you decide. We're all here for you!

--The Mods

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Jun 24, 2016 11:04AM 614 wrote:

Dear SpringLotusFlower:  The waiting and worrying is stressful and AWFUL!  Have you considered genetic testing?  The waiting for genetic testing was long too but it was worth having the test (if you are a candidate).  The oncotype test determined whether I needed to have chemo.  My doctors thought that my results would show that I would be in the "grey area" because of the pleomorphic nature, but the results of my oncotype showed a low score.  I wish you the best of luck.  The whole experience is harrowing. I would expect that you will be taking tamoxifen after your tx is finished since you are pre-menopausal.  I was diagnosed pre-menopausally too but I was medically induced into menopause so that I could take an Aromatase Inhibitor.  (I could not metabolize tamoxifen.)  My MO informed me that AI's work slightly better for Lobular Carcinoma than Tamoxifen does.

I just looked at your signature.  You have really "been through the wringer".  You were dx very young the first time.  I am sorry that you are having a second round of bc.  Hugs!! 

Hormone + Pleomorphic ILC, Pleomorphic LCIS,& Invasive Tubular Carcinoma for 1st BC DX. Hormone negative, Grade 3 DCIS for 2nd BC DX. History of dispersed ALH along with PASH, FEA, and focal atypia. Oncotype 14, Ki67: 21%. Dx Premenopausally. Dx 6/25/2014, ILC, Left, 1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Dx 6/25/2014, LCIS, Left, 1cm, Grade 2, 0/2 nodes, ER+/PR+, HER2- Dx 7/22/2014, IDC: Tubular, Left, <1cm, Stage IA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Dx 7/22/2014, LCIS, Left, 4cm, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 7/22/2014 Lumpectomy: Left; Lymph node removal: Left, Sentinel; Prophylactic ovary removal Radiation Therapy 9/7/2014 Whole-breast: Breast Hormonal Therapy 10/5/2014 Arimidex (anastrozole), Zoladex (goserelin)
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Aug 18, 2016 11:37PM - edited Aug 18, 2016 11:39PM by springlotusflower

My Oncotype DX score was 20 and chemo was not recommended. I start 4 weeks of radiation on 8/22/16. I previously had it on the other side, in 1996, so I have an idea of what to expect. I also posted on the fall 2016 radiation topic. I'll start Tamoxifen after radiation.Glad to have a plan in place...

Surgery 2/13/1996 Lumpectomy: Left Dx 2/14/1996, DCIS, Left, <1cm, Stage 0 Radiation Therapy 5/31/1996 Whole-breast: Breast Dx 9/10/2001, DCIS, Left, <1cm, Stage 0 Surgery 10/31/2001 Mastectomy: Left; Reconstruction (left): Nipple reconstruction, Nipple tattoo, Pedicled TRAM flap Dx 4/14/2016, IDC, Right, 1cm, ER+/PR+, HER2- Surgery 6/9/2016 Lumpectomy: Right; Lymph node removal: Right Dx 6/10/2016, LCIS/ILC/IDC: Tubular, Right, 1cm, Grade 2, 0/4 nodes, ER+/PR+, HER2- Radiation Therapy 8/22/2016 Whole-breast: Breast Hormonal Therapy 9/19/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Aug 20, 2016 07:38PM 614 wrote:


Dear Spring Lotus Flower:

I have been too busy to login during the last few weeks.  I am glad that all you need to have is radiation and that you have a plan in place.  Good luck next week.

 

Sincerely,

614

Hormone + Pleomorphic ILC, Pleomorphic LCIS,& Invasive Tubular Carcinoma for 1st BC DX. Hormone negative, Grade 3 DCIS for 2nd BC DX. History of dispersed ALH along with PASH, FEA, and focal atypia. Oncotype 14, Ki67: 21%. Dx Premenopausally. Dx 6/25/2014, ILC, Left, 1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Dx 6/25/2014, LCIS, Left, 1cm, Grade 2, 0/2 nodes, ER+/PR+, HER2- Dx 7/22/2014, IDC: Tubular, Left, <1cm, Stage IA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Dx 7/22/2014, LCIS, Left, 4cm, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 7/22/2014 Lumpectomy: Left; Lymph node removal: Left, Sentinel; Prophylactic ovary removal Radiation Therapy 9/7/2014 Whole-breast: Breast Hormonal Therapy 10/5/2014 Arimidex (anastrozole), Zoladex (goserelin)
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Aug 20, 2016 10:54PM springlotusflower wrote:

Thanks, 614, and hope you are doing well. 🙂

SpringLotusFlower

Surgery 2/13/1996 Lumpectomy: Left Dx 2/14/1996, DCIS, Left, <1cm, Stage 0 Radiation Therapy 5/31/1996 Whole-breast: Breast Dx 9/10/2001, DCIS, Left, <1cm, Stage 0 Surgery 10/31/2001 Mastectomy: Left; Reconstruction (left): Nipple reconstruction, Nipple tattoo, Pedicled TRAM flap Dx 4/14/2016, IDC, Right, 1cm, ER+/PR+, HER2- Surgery 6/9/2016 Lumpectomy: Right; Lymph node removal: Right Dx 6/10/2016, LCIS/ILC/IDC: Tubular, Right, 1cm, Grade 2, 0/4 nodes, ER+/PR+, HER2- Radiation Therapy 8/22/2016 Whole-breast: Breast Hormonal Therapy 9/19/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Aug 21, 2016 12:25AM 614 wrote:


Thanks.  I love your name.  The story behind the lotus flower is interesting.  Lotus flowers are beautiful.

Hormone + Pleomorphic ILC, Pleomorphic LCIS,& Invasive Tubular Carcinoma for 1st BC DX. Hormone negative, Grade 3 DCIS for 2nd BC DX. History of dispersed ALH along with PASH, FEA, and focal atypia. Oncotype 14, Ki67: 21%. Dx Premenopausally. Dx 6/25/2014, ILC, Left, 1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Dx 6/25/2014, LCIS, Left, 1cm, Grade 2, 0/2 nodes, ER+/PR+, HER2- Dx 7/22/2014, IDC: Tubular, Left, <1cm, Stage IA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Dx 7/22/2014, LCIS, Left, 4cm, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 7/22/2014 Lumpectomy: Left; Lymph node removal: Left, Sentinel; Prophylactic ovary removal Radiation Therapy 9/7/2014 Whole-breast: Breast Hormonal Therapy 10/5/2014 Arimidex (anastrozole), Zoladex (goserelin)

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