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Topic: Pathology Report

Forum: ILC (Invasive Lobular Carcinoma) — Just diagnosed, in treatment, or finished treatment for ILC.

Posted on: Mar 7, 2008 06:49PM

needtotalk wrote:

Hi there.  When I had my biopsy in January, I was told I had ILC.  I had a lumpectomy last Tuesday and got the pathology report and now my surgeon said it looks like IDC with lobular characteristics.  Does this mean that it is pleomorphic?  She said it didn't make any difference - that it was not important.  Just wondering if anyone knows.  thanks and hugs to you all.

Dx 1/16/2008, IDC, 1cm, Stage I, Grade 1, 0/4 nodes, ER+/PR+, HER2-
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Mar 7, 2008 06:55PM wallycat wrote:

I'm not the smartest on this stuff...here is my 2 cents...

I = invasive

D = Ductal

L = Lobular

C = cancer...

so for her to say it has lobular "characteristics" is nuts...it was either found in the ducts of your mammary gland or the lobules....

I don't argue that IDC and ILC may be treated similarly and have similar outcomes, but the definition of the cancer is where it originates...and that can't be a characteristic, it is a location.

Best to you!! 

Dx 4/07 1 month before turning 50; ILC 1.8cm, ER+/PR+, HER2 neg., Stage 1, Grade 2, 0/5 nodes. Onco score 20, Bilateral Mast., tamoxifen 3-1/2 years, arimidex-completed 4/20/2012
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Mar 7, 2008 09:00PM LizM wrote:

I was also diagnosed mixed  IDC and ILC (IDLC).  My final pathology report stated infiltrating carcinoma with ductal and lobular features.  It is not all that uncommon.  My oncologist told me that both IDC and ILC are treated the same so it didn't make a difference in my treatment or prognosis. 

Dx 9/19/2005, IDC, 2cm, Stage II, Grade 1, 1/8 nodes, ER+/PR+, HER2-
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Mar 7, 2008 09:06PM LizM wrote:

IDC is in the ducts, ILC is in the lobules and IDLC is where the ducts and lobules meet.  Does that make sense?

Dx 9/19/2005, IDC, 2cm, Stage II, Grade 1, 1/8 nodes, ER+/PR+, HER2-
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Mar 7, 2008 09:12PM needtotalk wrote:

Absolutely.  Thank you for that information.  Yes, my surgeon said the same thing - that it didn't make any difference.  Wishing you the best ...

Dx 1/16/2008, IDC, 1cm, Stage I, Grade 1, 0/4 nodes, ER+/PR+, HER2-
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Mar 7, 2008 09:25PM shrink wrote:

I had the same dx - IDC with lobular features.  Treatment was the same.  I also had IBC diagnosed clinically.  Treatment is still the same considering the size. lymph node involvement and grade.

Dx 5/23/2007, IBC, 6cm+, Stage IIIC, Grade 3, 21/21 nodes, ER+/PR-, HER2-
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Mar 8, 2008 08:24AM matic22 wrote:

Hello ladies!

I have just wanted to say that actually this all is not true.Lobular cancer does not originate from lobules and ductal does not originate from ducts.They both originate in ductulo-lobular unit-in acinus, which is near the lobe-at the end of the duct,so actually even oncologists do not know well these things. Here in Slovenia we have a very good pathologist, who explained this to me.And why morphology is different in ductal and lobular it is because of different gene expression and not the origin.And I do not agree actually about prognosis either. If you have a look at the long term prognosis, then you will see there are different curves in long term survival ,but it depends on many characteristics.I believe this grade, size,nodes,and so on are totally irrelevant characteristics, because they are subjective, the most objective thing is gene microaray.I am sure and I believe so.This is why we see grade I tumours having high oncotype scores, on the other hand not all grade 3 tumours are high oncotype scored.Please be sure you are treated right before starting your treatment of breast cancer because you have to make sure everything is going to be done best for your individuum.Many oncologists are not so aware of some biologic profiles, unfortunately.They just say:well...type doesnotmatter, the size is the most important---well I think this is totally irrelevant and not true.

If that was true, all women with stage I would survive and all women with stage III would die...but it is absolutely not like that!!!!

And also about nodes...many survivors are worried about lymph node status, but please, keep in mind lymph node status is not the most important thing in breast cancer.It was believed in the past so,but many studies have shown it is not the key.

Have a look at genomic health link online and read about the study of oncotype mapping of women with 10 or more positive lymph node, and you will see the significant difference in survival with low,intermediate and high recurrence group.

Good luck and stay well;)

Matic

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Mar 8, 2008 12:02PM needtotalk wrote:

Hi there.  thanks for your response.  Yes, I believe there are so many factors involved, but I do not believe that grade, size and node involvement is irrelevant or subjective.  There is absolute data that supports early detection and grade as a better prognosis than late detection.  But I do believe that we are just getting started with all these other bio markers and it seems that everyone has a different 'recipe' that makes up their cancer and we all have to be very educated and proactive with regards to our own 'recipe' and not to paint ourselves with broad strokes.

I wish you well.  Take care. :)

Dx 1/16/2008, IDC, 1cm, Stage I, Grade 1, 0/4 nodes, ER+/PR+, HER2-
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Mar 8, 2008 12:06PM wallycat wrote:

Matic, thank you so much for your input, as always!!

I worry because my onco score was 20, even tho I was lobular with mitosis 0-1.  I and my onco were both surprised that it scored so high.  I know this is still low-intermediate, but who wouldn't want a 5 or 6 Embarassed .

I agree...sometimes we think we know all the answers and we try to do all the "right" things, but there are enough missing links/pieces that there is never a guarantee.

I always enjoy reading your posts Matic.

Dx 4/07 1 month before turning 50; ILC 1.8cm, ER+/PR+, HER2 neg., Stage 1, Grade 2, 0/5 nodes. Onco score 20, Bilateral Mast., tamoxifen 3-1/2 years, arimidex-completed 4/20/2012
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Mar 8, 2008 01:06PM matic22 wrote:

Dear wallycat!

I remember you well.

And I also remember your path report, I think you had 1,8cm tumour, ILC,grade I??I think I am right...

I am also surprised of your onco scores, but as I have said---nobody can know about genes,which are more expressed and how this expression influences the prognosis.

I think (believe!!) that grade of the oldest prognostic factors is much better prognostic character than size...I mean....I just can not say I agree with those who think size matters because look: The tumour arises from one cell(one breast cell) and it grows and grows,it is at 1 cm in size whatever like it is,(for example grade I). And it keeps growing but the gene material is the same no matter what size.Malignant cells can spread through the blood stream even when it is 5 mm in size, so please---try to understand why size is not so important...genes matters, because it depends on them whether those malignant cells that have spread will cause metastaic disease or not(never).This is an explanation of all this drama;)

Wallycat,your onco scores together with your great characteristics is low,I believe, and you have a really good prognosis tumour.You should be happy and proud of it and not worry about it any more.You will see-you will be doing great.

I am now sendind Mum"s tumour to oncotyping next week and I am really interested in those scores.So, it will help to determine about hormonal therapy or any other therapy beyond 5 years.

Kind regards and keep posting;)

MATIC

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Mar 8, 2008 02:20PM wallycat wrote:

Hi Matic!!

You are sweet!  I was a stage 1, grade 2 and two docs indicated that because of how they add up the characteristics, few lobulars end up grade 1....but I see many gals post grade 1 so I had my doubts about what they said.

I did have mitosis 0-1, which is some comfort.

It seems oncotypedx is trying to lower the chemo cut off to 25, so I would like to think I am a very low-intermediate at 20....

But I do agree with you that at some point, we have to believe we did everything correctly and as best we could with what we know about ourselves and what medicine has to offer.

As my kind oncologist said, before you had cancer, you had x-amount of risk.  Sure, you have a slightly elevated risk of recurrence, but NO ONE is immune from getting cancer, so everyone has some odds of getting it.  When I think of it like that....I don't feel so alone.


THANK YOU and I will be interested to hear what your mum's  score comes back with.

You will make a wonderful doctor!!

Dx 4/07 1 month before turning 50; ILC 1.8cm, ER+/PR+, HER2 neg., Stage 1, Grade 2, 0/5 nodes. Onco score 20, Bilateral Mast., tamoxifen 3-1/2 years, arimidex-completed 4/20/2012
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Mar 11, 2008 01:18AM - edited Mar 12, 2008 03:47PM by Gitane

I believe both ILC and IDC start in the TDLU (terminal duct lobular unit?) but I agree with Matic (Hi Matic!) that it seems to be the genes that are the most important. Scary for me because I have pleomorphic lobular with a median RS of 18.9, I don't know what my RS is. I was reading just last night the report that Matic mentioned in this conversation. The study indicates to me that genes are very important, although different gene tests are using different sets of genes. Most seem to be looking mainly at proliferation and apoptosis.

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Mar 11, 2008 10:20PM needtotalk wrote:

Sorry, but what is RS?

Dx 1/16/2008, IDC, 1cm, Stage I, Grade 1, 0/4 nodes, ER+/PR+, HER2-
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Mar 12, 2008 01:13AM - edited Mar 12, 2008 01:17AM by Gitane

RS is a recurrence score. It's the number you are given when you are tested by the Oncotype DX test. Reading back over this, this is way more information than you asked for and probably way more than you want or need right now. We just started talking and...... Anyway, your information looks very good so far with a small, grade one, node negative report on your ILC you are at very low risk. This is encouraging.



Sorry about all the deleted messages. My computer suddenly got very slow and I pressed "submit" a few times.
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Mar 12, 2008 01:13AM - edited Mar 12, 2008 01:15AM by Gitane

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Mar 12, 2008 01:13AM - edited Mar 12, 2008 01:14AM by Gitane

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Mar 12, 2008 01:14AM - edited Mar 12, 2008 01:16AM by Gitane

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