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Feb 14, 2018 01:32AM
Feb 14, 2018 02:30PM
If you're sure the surgeon said "lobular," referring to a cancer (which certainly fits with the radiation), then the acronym would be "ILC" for "invasive lobular carcinoma." It's definitely possible to have both ILC and LCIS. It's also possible (and not uncommon) to have LCIS with invasive ductal carcinoma (IDC), so just knowing that you had "cancer" and LCIS doesn't mean for sure that your cancer was ILC.
The "in situ" part of LCIS does not mean that the cancer has not spread to the lymph nodes. "in situ" is a term used for precancerous cells in all types of body parts, and what it means in plain English is that the cells have become very abnormal, so abnormal that they look a lot like cancer, but they haven't yet gained the ability to leave the structure where they started growing. They can't metastasize (cancer in lymph nodes is technically a metastasis) because they can't - by definition - leave where they have started. "Ductal" "in situ" cancer cells are stuck in the ducts, and "Lobular" "in situ" cancer cells are stuck in the lobules. On one of the links I posted above, there's a picture showing LCIS cells just stuffing a breast lobule - but that's it, they're stuck there and unless they mutate and become even more abnormal, they won't get out and cause serious harm. In situ disease can definitely create lumps by stuffing things tremendously full of abnormal cells, but they can't go outside their own breast structures.
When cells become so abnormal that they start being able to push into other tissues, for example "lobular" cells that mutate so they can push through the wall of the lobule, they are no longer considered "in situ" and are considered "invasive" cancer cells. This has to do with a fundamental change in the abormal cells, like a fish suddenly mutating to have lungs and wiggling up on sand. It's not a result of them just reaching some critical mass and bursting out. Being "invasive" also does not have to do with size. It can be "invasive" and remain in only a tiny area of the breast. Many women with ductal carcinoma in situ (DCIS), have HUGE tumors because the cells can spread quite far through all the ducts, but that does not make it "invasive" cancer. My own DCIS was pretty much my entire right breast. On the other hand, there are women with invasive ductal carcinoma (IDC) whose cancer is so small it's less than 1cm. Whether it is "invasive" is a determination made on a microscopic level looking at the tumor itself. They do not even have to examine a lymph node to determine that the cancer is "invasive." Lots and lots of women on these boards have diagnoses of ILC or IDC (invasive ductal carcinoma), but their cancer did not spread to the lymph nodes. Cancer does not have to spread to lymph nodes to be considered "invasive."
So, in summary:
- "in situ" means in the particular tissue structure where it started
- "invasive" means that the cells can push through the boundaries of the structure where they started
- lymph node status is a separate thing, it doesn't have anything to do with determining whether disease is "invasive"*
I hope I explained that reasonably. Do you have your pathology report? Knowing your own diagnosis for sure is definitely useful as you navigate through all this.
*The exception would be if the pathologist has only seen "in situ" disease in the main tumor, but there is cancer in a lymph node. That's rare, but it's not impossible. Pathologists cannot examine every single bit of the original tumor, so if the part that turned invasive just didn't happen to be put on a slide they may not have seen it