Newly Diagnosed - Lobular & Ductal features (???)

skipper8

I'm new, 57 years old & don't know how to make "posts" on message boards! Just found you guys, and I'm hoping you can help!!!
I had a clear mammogram in April, but it noted dense breasts. About 3 wks ago I felt a lump, then mammo (clear), ultrasound and needle biopsy. Biopsy results: infiltrating mammary carcinoma.
The tumor is Grade 1, ER+/PR+ and HER 2 negative, 1.8m x 1.6cm. The path report says it has "lobular and focal ductal features," and "rare ductal elements as well as areas of single file pattern." The 1st surgeon said it felt "much bigger" than 1.8x1.6, and said to seriously consider a mastectomy 'cause of the "nature of lobular cancer," worried about getting clear margins, and the big lump/small breast issue. The second surgeon felt it, and said it was approx. 2 cm x 1.5 cm, and that their path lab's diagnosis was "invasive ductal carcinoma." They said not to worry about the lobular feature, as the treatment is the same as ductal, and said they could do a lumpectomy w/ radiation.
Scheduling a bilateral MRI today. Do you think it will show enough additional info that will "tip the scales" in favor of either a lumpectomy or a mastectomy? I'm really confused!
In case I can't figure out how to post again, thank you!

LizM

Hi Skipper, I can only tell you my story and how I came to my decision. I was also diagnosed with mammary carcinoma with ductal and lobular features, grade 1 in Fall 2005. My mammorgram was also clear but the ultrasound picked up a 1.4 cm mass. There was no lump but there was a thickened area that I had been told previously by many doctors was fibrosystic dense breast tissue. There was some question as to whether there was another smaller area of 3 mm but My breast surgeon told me he thought he could get all of the cancer with a lumpectomy. However, I chose to remove both of my breasts and have reconstruction because my breast cancer was hard to find and I did not trust imaging on my dense breasts. After my bi-lateral my good breast also showed atypical lobular hyperplasia (ALH) and my cancer breast showed mixed IDC, ILC, DCIS, LCIS and ALH. My tumor turned out to be 2.1 cm, ER/PR ++ her2 neg and I had one positive lymph node, stage II. I have tried to get information on IDLC but haven't been able to find too much. My oncologist told me they are both treated the same and have the same prognosis but there is some research showing that lobular may be less aggressive than ductal. Where that puts us with mixed I don't know. Having grade 1 is good and having estrogen and progesterone positive and her2 negative breast cancer are also a good prognostic factors as you will be given hormone therapy after treatment. I know that these decisions are very hard to make. My advice to you is go with your gut/inner voice whatever you want to call it and never look back. My gut has served me very well during all of my treatment. Hang in there. Liz