Stage III lobular...is the treatment right?

SKBL

Hi everyone!

I saw an oncologist yesterday and he recommended Cytoxin and Taxotere every 3 weeks x 6.  He is considering Adriamycin, but said lobular cancer does not usually respond to that drug very well and is leaning against it. I would then have radiation for 5 or 6 weeks, hysterectomy (my choice), and he would put me on Tamoxifen or Arimidex for 5 years.  I am 55 and pre-menopausal. My Oncotype test score was 35.  We will have another meeting, but in the meantime, I will be getting a second opinion.  

Any opinions out there?  How does it sound?  I am healthy (otherwise) and strong....want to be around to see our young boy grow up! 

Thanks,

SKBL 

AnacortesGirl

Welcome to the boards!

Like Sherri I also had neoadjuvant chemo.  It was a trial and the first chemo regimen was taxol and sutent followed by AC.  Taxol is similiar to taxotere.  I had some response to the taxol and sutent but no response to the AC.  Because of the poor path report from surgery and the BRCA 2 mutation I am going to start on carboplatin next week.

Having said all that, I do not regret throwing the AC at the cancer.  I am a very healthy 51 but I did have to go on short term disability from Jan through Mar because of the SEs.  But now that I'm through with surgery my energy is back and I feel good.  My feeling is that now is the time to do what we can to eliminate the cancer from our systems.  We don't want to wait until we have mets.

I've been on the boards since last August and there have been other women with stage III ILC that have responded very strongly to the AC part of their AC->T chemo.  A second opinion is a very good idea.

And I haven't been on the boards for the last week because I returned to work.  It's wonderful to be useful and busy again!

Good luck with the onc visits.

amlg1

I too was dx with ILC,I did dense dose AC every 2 weeks.

after that Taxol and herceptin,and thats because I am HER2+(which is not common for ILC.)I was diagnosed at 62,and I did very good with my tx.I am still on herceptin.I feel good knowing I did the big guns.Do get a 2nd opinion.Good Luck!

negirly

I was mixed IDC/ILC and did 12x Taxol/herceptin then surgery and 4x A/C.  I continued herceptin for a year and now just take Tamoxifen.

Best of Luck,

Karyn

Dawnmrn1

Itoo had the TACX6, with no real SE, worked as an RN thru chemo and radiation, almost a year post chemo and I am doing well.I had bilateral mastectomies before chemo. I was a healthy 52yo with a 15 yo daughter when DX. It is tough but doable. I am now on tamoxifen, with a few joint problems, but I am doing well! Good Luck!!

Pure

I had 5fu, C, and A drug. I had it for 2 weeks on and then 3 weeks off followed by 12 weeks of taxol.Recent studies show that chemo longer is better then giving the taxol with the c and A drug. Also, adding 5fu just increases you chances...I also had zometa every 3 weeks with my taxol due to some promising results from a clinical trial.

flopsy

I also have ILC stage 3/a with 5/7 nodes.  I opted to have bilat mast because of this type of ca, after surg tissue showed atypical ductal and lobular cells in non ca breast.  My onc says made good choices because high risk.  I do not plan to do reconstruction but that could change. I am scheduled to start chemo with Adriamycin/Cytoxan on 6/30/10 with 4 doses over 8 wks time.  That will be followed by taxotere 4 doses for 12 wks.  I am supposed to have 6 wks rad after 5 mths chemo.  My onc is well respected and has 25 yrs experience with br ca.  He does say that there is no absolute miracle treatment but he is using his best knowledge for me.  I am a Rad Tech by profession and have specialized in Breast Imaging and Biopsy for 22 yrs.  I have always known that I was at high risk due to fam hx.  He has prescribed Emend(pricey), zofran, and decadron during my treatments.  I have heard a lot about taking claritin-d and aleve for neulasta sub qu after each tx if you have to have that also.  Keep me posted on your progress if you can and I will do the same.  Good luck and God bless,   gin2ca

karen1956

I had bilat, then TAC x 6 followed by rads, ooph and AI's....I'm 4+ years since Dx.....all the best to you.  Karen

Maire67

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LindaLou53

Hi SKBL,

Because I was given Adriamycin/Cytoxan and Taxol for my first breast cancer in 2000 (Stage 2 Invasive Ductal)  I could not be given Adriamycin a second time when diagnosed with my Stage 3c Lobular 5 years later.  So I was given Taxotere IV every 3 weeks for 6 rounds and also took oral Xeloda every day for 1 week on/ 1 week off during that time.  I have also been on Aromasin for over 4 years now.

Because of my high nodal involvement I went on IV Zometa initially every 3 months, then every 6 months. After completing 3 years on Zometa last year, I am now taking it annually.  I am almost 5 years out from dx and doing very well. Wish I could offer more insight regarding taking Adriamycin or not, but I am not aware of research stating Lobular does not respond as well to Adriamycin specifically.  There have been some articles stating that hormonally positive Lobular cancers in general are more impacted by Tamoxifen and the Aromatase Inhibitors than chemo, but in cases of large tumors and positive nodes chemo is still considered necessary treatment.

I am glad you are getting a second opinion so you can feel more comfortable with whatever decision you end up making.

MNLinda

I had 6X TAC at 3-week intervals, neoadjuvant.  I had read that lobular cancers don't usually respond as well as ductal to chemotherapy in general (don't know about Adriamycin in particular), so I wasn't expecting really great results from the chemo regimen.  But the path report showed I had excellent response.  My particular cancer type is a weird one - ILC, pleomorphic subtype - and I'm not sure whether there's any data about classic versus pleomorphic as far as response goes.  Also, of course I'll never know if it was one particular drug that made the difference, or if three together was the key.

I had two opinions at the outset.  Both recommended neoadjvant chemo for me.  One onc recommended AC plus T - four AC followed by 4 T at two week intervals (dose dense) - and the second proposed the TAC, describing his plan as slightly more aggressive.  I'm still not all that clear on the difference between the two plans, frankly.  Worked for me, though.

The chemo was followed by BMx and 33 radiation treatments, and I just started tamoxifen.  My onc says I am a candidate for bisphosphonates (Zometa), but wants to wait a couple of months to see "how the data settles" (what the consensus is on the best dosage and Tx schedule might be).

It sounds like the onc you talked to is being very thorough, since you have an Oncotype score.  A lot of doctors skip Oncotype DX testing if the cancer is stage III, since they already know from the staging that your risk of recurrence is significant.

My guess is that the treatment plan you get from your second opinion won't differ very drastically.  But you may find you have a better rapport with one or the other, and that's an important consideration too.  This is a doctor you're going to be seeing quite a bit of for a very long time.