Topic: Actress Rita Wilson's experience with breast cancer

Forum: Acknowledging and honoring our Community — Share accomplishments, milestones, goals of community members, family members or yourself.

Posted on: May 7, 2015 11:49AM - edited May 7, 2015 11:51AM by larkspur

Posted on: May 7, 2015 11:49AM - edited May 7, 2015 11:51AM by larkspur

larkspur wrote:

This article appeared in the New York Times this week:

http://www.nytimes.com/2015/05/07/theater/rita-wil...

(I hope this link works!)

I was surprised to read that although Ms. Wilson had a double mastectomy, she didn't have chemo or radiation. I suspect that information isn't accurate. Anyway, kudos to her for going public with her situation.

Dx 1/5/2015, DCIS, Stage 0, Grade 1, ER+/PR+, HER2- Dx 2/10/2015, IDC, Right, <1cm, Stage IA, Grade 1, 0/1 nodes, ER+/PR+, HER2- Surgery 2/11/2015 Lumpectomy; Lumpectomy (Right); Lymph node removal; Lymph node removal (Right): Sentinel Radiation Therapy 4/13/2015 Whole breast: Breast Hormonal Therapy 6/11/2015 Femara (letrozole) Hormonal Therapy
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Oct 6, 2016 02:56PM - edited Oct 6, 2016 02:57PM by beesie.is.out-of-office

LAstar, you've hit on what I've considered for 11 years to be one of the biggest mysteries.

It's pretty much agreed that something in the range of 90% of all cases of IDC develop from DCIS, and it's very common to find small amounts of DCIS in the pathology of women diagnosed with IDC (often it's listed as an incidental finding on the pathology report and is never even discussed with or mentioned to the patient). Similarly, women who have large amounts of DCIS, particularly if it is high grade, are at significant risk (as high as 40%, from some reports I've read) to be found to also have a very tiny area of IDC (often just a microinvasion or something just a bit larger).

So why is it that:

- in some cases, a tiny amount of DCIS initially develops but then almost immediately evolves to become IDC and the cancer develops from that point forward as IDC

whereas

- in other cases, DCIS develops and continues to spread through the ductal system as DCIS, but somewhere in the middle of all that DCIS, a tiny area of IDC develops - but doesn't continue to spread as IDC.

I think that there must be something biologically different between these two very common development patterns of breast cancer, even though both include DCIS and IDC, and both almost certainly started as DCIS. In one case, the patient might end up with 1.8cm of IDC and 2mm of DCIS, whereas in the other case, she might end up with 7+cm of DCIS and 1mm of IDC (as in my case).

I have bookmarked dozens of studies that look at different theories of what biological/molecular factors might cause some cases of DCIS to evolve to become invasive cancer, while other cases of DCIS don't ever develop beyond DCIS, but I have never seen any study that attempts to explain these two different patterns of DCIS to IDC development.

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Oct 6, 2016 05:13PM lastar wrote:

I knew you'd have a great answer, Beesie. We just need a few million in grant money and we could get to the bottom of this.

This sounds crazy, but I wonder if the DCIS spreads because it is looking for something that will help it make the change to IDC.

Dx 3/5/2012, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR- Surgery 4/6/2012 Lumpectomy; Lumpectomy (Left) Surgery 5/4/2012 Lumpectomy; Lumpectomy (Left) Surgery 6/19/2012 Mastectomy; Mastectomy (Left); Prophylactic mastectomy; Prophylactic mastectomy (Right); Reconstruction (Left): translation missing: en.treatments.surgery.surgery_types.short_options.left_reconstruction_flap-reconstruction_sgap-flap-hip-flap; Reconstruction (Right): translation missing: en.treatments.surgery.surgery_types.short_options.right_reconstruction_flap-reconstruction_sgap-flap-hip-flap Surgery 10/5/2012 Reconstruction (Left): translation missing: en.treatments.surgery.surgery_types.short_options.left_reconstruction_flap-reconstruction_sgap-flap-hip-flap; Reconstruction (Right): translation missing: en.treatments.surgery.surgery_types.short_options.right_reconstruction_flap-reconstruction_sgap-flap-hip-flap Surgery 1/26/2015 Reconstruction (Left): DIEP flap
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Oct 6, 2016 08:55PM beesie.is.out-of-office wrote:

"This sounds crazy, but I wonder if the DCIS spreads because it is looking for something that will help it make the change to IDC."

Not crazy at all. Quite interesting, in fact.

Any ideas on where we can find a few million dollars?

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Oct 7, 2016 12:18AM - edited Jan 8, 2017 12:16PM by JohnSmith

Fwiw, according to this link, Rita was originally diagnosed with LCIS (Lobular Carcinoma In Situ) years ago. New biopsies in 2015 confirmed PLCIS (Pleomorphic Lobular Carcinoma In Situ) and additional opinions upstaged the PLCIS to PILC (Pleomorphic Invasive Lobular Carcinoma). Pleomorphic has the potential to be more aggressive, although it sounds like she may have caught it early, either Stage I or II.

In terms of surgery, many women opt for a double mastectomy (BMX) since getting "clear margins" in Lobular is often very challenging for surgeons. This is due to the lack of the sticky cell-to-cell adhesion protein, Ecadherin, which results in diffuse growth. (At the genetic level, Lobular cancer cells lost the ability to make this E-cadherin protein. Without this protein, the ILC cells can spread in a discohesive pattern).

Wife was Age 45 at Dx 4/2014. BMX Surgery 6/2014 revealed: ILC, Stage 2 (Multifocal ILC, largest lesion 2.2 cm), Grade 2, ER+/PR+ (95%), HER2-, Ki-67 5-10%, Oncotype 11; Variant in the ATM gene Dx 4/8/2014, ILC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2-, Surgery 6/26/2014 Mastectomy; Reconstruction (left); Reconstruction (right)
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Feb 10, 2020 07:30AM - edited Feb 10, 2020 07:33AM by lacelace

do you have side effects from the hormone therapy? Why did you switch. Is your dr saying 5 years. Mine is now saying 10 @amyfrommi

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