multiple diagnoses

cbm

multiple diagnoses

cbm

Hi, I had both ductal and lobular features in my invasive mixed tumor.  I couldn't choose both on the menu and didn't concern myself at the time.  I'm wondering now if anyone else has or had such a tumor--Susan Love's book references it without much comment. 

C

KathyNSW

I had ILC and DCIS in the one breast

Take care Kathy

Angel10

Hi C!

I had invasive ductal and "tubulolobular" CA in the same tumor.  Found contradictory info on the tubulolobular aspect. Some lit said it was more invasive than tubular and lobular, some said the exact opposite. I did a bilateral mx so got rid of it all!  Take that you mixed bag of goodies!

Good luck to yu!

God Bless!

Angel 10

dreaming

I had 2 tumors one ductal found when I had a biopsy and during the mastectomy  a tubular invasive cancer was found, it was larger.

Insun

I have mixed invasive ductal and lobular carcinoma. What is that translate into in terms if treatment and prognosis?

OhhKay

Insun - I also have mixed invasive ductal and lobular carcinoma. My surgeon said they typically treat it like IDC, but i would also like to hear more info from someone with the same mixed type. I was Dx 1/17 and awaiting BMX later this month. I just turned 40.

((Hugs))

-K

mripp

I have Dx of left DCIS and LCIS from path report after Lx of the DCIS site. Had clear margins and SNB was negative 0/3. Anyone else? Freaked that LCIS may be elsewhere in breasts and will it mean recurrence down the road? I'm currently doing 33 rad tx now.

leaf

Almost everything about LCIS is controversial. Plain classic LCIS is normally multifocal (meaning it is found in multiple places in the breast) and is often (not always) bilateral. They know this because prior to about 1990, they routinely did bilateral mastectomies on women with LCIS.  So I wouldn't be immensely surprised if you have multiple spots of LCIS in one or both breasts.   Since LCIS (unlike most DCIS) is often not detected with  breast imaging, you can't know for sure if you don't have other spots of LCIS without having bilateral mastectomies.  Now-a-days, classic LCIS is normally treated with a) possible excision with surveillance, b) possible excision with surveillance with antihormonals or c) bilateral mastectomies, usually for women with a significant family history or history of chest radiation treatment.

However, LCIS is normally not considered as serious as DCIS.  There is a PLCIS diagnosis, which has features of both classic LCIS and DCIS.  There isn't a lot of information about PLCIS, because it was first described in the mid-1990s.  But most people consider PLCIS to be potentially more aggressive than classic LCIS, and some want to treat PLCIS like DCIS.

Assuming you have classic LCIS (and not a variant LCIS), they normally consider classic LCIS as a 'nonobligate precursor'.  This means infrequently LCIS may itself become invasive, but the majority of time it just sits there and never becomes anything else.    Unlike DCIS, sometimes when LCIS patients go on to get invasive breast cancer, the LCIS patient get breast cancer not at the site of the previously known LCIS, but at a different location.

reniebeanie

Hello,

My 50 yo mom had clear and bloody discharge from her left breast, and went in for a mammogram, then a 3D ultrasound, but nothing was seen until she had an MRI. They saw 3 2cm masses, and performed a biopsy that came back with secretory-like findings. Originally, her doctor said it was stage 1, grade 2 and triple neg. He said she had a very good outlook and wouldn't need chemo or radiation, only a lumpectomy. Then he came back and said she would need chemo, and came back again 2 weeks later saying she wouldn't. She just had a double mastectomy 2 days ago. After the surgery, her surgeon came out and said they got all of the cancer and that her outlook with secretory was good. The pathology report just came back today saying that she had 2 tumors in the left breast. One was 0.6 cm and the other was 6 cm. The report says the pathologist found DCIS, cribriform and micro papillary, and secretory types. It also says she is stage 3, and her doctor says she will need radiation or chemo. What I don't understand is how 5 months ago there was nothing on a mammogram, she only had 2 cm masses, was stage 1, and wasn't going to need chemo. Now she has a 6 cm mass, is stage 3 and probably needs chemo. How could they have missed a 6 cm mass? How did it take her doctors 5 months to figure out what was wrong with her? I feel like they have no idea what they are doing, and I need to find her a doctor that has treated invasive secretory carcinoma before. I'll take her anywhere. I don't care if we have to travel to the other side of the country. Any suggestions?

dtad

Hi everyone. I have both ILC and IDC in the same breast and are the same size. The ILC was only found on a pre op MRI. So if it wasn't for the IDC the ILC would have never been found. I was originally scheduled for a lumpectomy but after the ILC was found I opted for a BMX. Lesson learned.....always have a pre op MRI before any treatment decisions are made. Especially if you have dense breasts. Also my doc at a major NYC teaching hospital said they would both be treated the same way. Good luck to all

ShareTheLight

Hi dtad! Your post was from quite a few months ago so hopefully you'll see this. My cancer seems to have very similar characteristics as yours except mine is Grade 1. I'm only 40 and my initial diagnosis was IDC also with a 1cm tumor. My lumpectomy and SLNB was done last Wed and thought my nodes came back clear, my margins did not so I am scheduled to go back just to take out a greater margin next week. My surgeon said something to me about it now being ILC. Did you have two separate tumors? I only had the one so I'm confused as to where the ILC came from now. I meet with her Tue to get all the details as I wasn't processing the info over the phone. She did say that if margins do not come out clear once again, then at that point we will do an MRI and talk about more radical options. What are your thoughts on that? Did any of your nodes test positive? Did your surgeon recommend such radical surgery or was that your idea? Any regrets on your decision at this point? Hope you've recovered well. I welcome input from anyone else with similar backgrounds. Thanks in advance! (P.S. my ILC dx info in signature line is preliminary as I have no real info on it yet other than being told that it was found.)

nem126

My tumor has "mixed ductal and lobular features." At least that's what the biopsy said. I should get my post surgery pathology this week. A little nervous but looking forward to having more info about my treatment plan.

ShareTheLight

Hi nem126! So you knew after your initial biopsy about the mix? See, that's what I'm curious about. Why didn't that appear in my biopsy? I wish you the best in regards to your results. Keep us posted! If your surgery was on the 11th though it seems like you should have already received them. I didn't want to wait till my post-op so I had surgeon call me with results 7 days later. I'm not too patient. A little nervousness is natural but you're very young so stay focused on the positive. This too shall pass, right? Have my appt tomorrow so I'm putting together my list of questions now. Hope you're having a smooth recovery!

leftduetostupidmods

Late to the discussion here.

ShareTheLight - the biopsy only samples a tiny fragment of the tumor. My own biopsy only showed DCIS, so I went under the knife knowing I was a stage 0 - still had chosen to have BMX because 1. the tumor was like 7 cm in the right breast and 2. I didn't want to deal with something bad later down the road.

The post-mastectomy pathology though showed what you can see in my signature: both LCIS and DCIS and a mix of three invasive - something that even my breast cancer surgeon, who is in the top 20 in the country had only encountered a couple times in all his experience. The IDC and cribriform (which is actually a form of IDC) were in a mass of ILC. All in the same tumor. Think about it this way: imagine a grape. You have the central stem, the little stems dividing from it, with the grapes at the end. The breast is about the same way, only that the grape itself would kind of envelop the little stem. The grapes are the lobules, the stems are the ducts, with the main stem ending at the nipple. It's like the "grapes" produce the milk, the stems carry it to the nipple. I hope I described an easy to visualize picture. Now, most common of all is the cancer of the duct - of the stems, respectively. No matter of where it is, if it is contain within the grape itself or the stem, it's "in situ". If it starts spreading and spills out of the grape or the stem, it's invasive. Think of it this way: like a mold/fungus starting to grow inside the stem or inside the grape. If you figure out it's there in time, you can break off the part that has the fungus and that's it. If not, the fungus will grow and penetrate through the casing of the grape or of the stem and start growing outwards. That is the invasive breast cancer, and if it starts growing from the grape, it's lobular, if it starts growing from the stem, it's ductal. Now it's very possible that you still have some remaining in the stem/grape - that's the DCIS/LCIS part. You might have a lot of the fungus that grew out of the grape itself grow so much as to envelop half of the whole grape cluster, and the fungus from the stem only grew enough to envelop the stem or only in small clusters here and there. That was the case of my tumor - it was a multifocal (that means more than one cluster) IDC, multifocal cribriform, in a "sea" of ILC, but there still were some LCIS and DCIS cells here and there. So yes, you can have several types of breast cancer in the same tumor.

ShareTheLight

@seachain Thx for your time in explaining all that as it does make sense! I think I've gotten off very easy compared to you and many others. They did an MRI and didn't see any ither lesions or suspicious areas so 2nd surgery last week got everything. Yay! Now just waiting to meet with MO to talk treatment options but with my oncotype score being a 12, chemo does not seem to be part of the pkg which I'm thankful for. All the best to you.

2FUN

great description I had small IDC removed with lumpectomy, but pathology found DCIS throughout the rest of the sample. So while waiting for MX I was dx with endometrial cancer. Had hysterectomy with alergy complecations. Also noticed a growth on kidney. And thyroid. My urologist said she isn't surprised that all of these growths are happening. Due to endocrine changes as I am early/mid 50s.

thebrave5

2Fun,

Can you explain about the growths and the fact that your urologist isn't surprised? When my PET scan was done because of recurrence, my thyroid lit up, they weren't concerned about anything and though it was more than likely an infection. Found a nodule which is highly normal in people but since they don't consider me normal they did a biopsy on that as well and I'm waiting for the results. The did find I have a thyroiditis-type, Hiroshima...still researching.

2FUN

my urologist feels that all of these cancers can be grouped into a syndrome. All of them are related to hormonal disregulation: breast, endometrial, thyroid. I had on side of my thyroid removed 14 yrs ago due to nodules. A biopsy will reveal benign or malignancy, except if you have what I had, which was Hurthle cells. They need to be looked at in th ed context of the thyroid gland. Mine was benign. I will be getting my biopsy done a few weeks after my MX. Urologist said even if it is malignant they do not always treat with surgery these days. I really don't need a 4th cancer! Good luck to you, and I wouldn't be too stresed.