37 yrs old, ILC: MRI, Chemo or Surgery first??

oaklandmama

God bless you all and hope you are all doing well. My basic story: One month ago, I found a lump in right breast during a self exam, had it mammoed and core biopsied. Came back ductal carcinoma with lobular features. The area that lit up was 3 cm but calcifications spread out over 6 cm. My dr said that 'with lobular features' at my age (37) could mean that there could be pure ILC and that it would not show up on the mammo so she is giving me some different treatment options. I am overwhelmed with all the terminology and choices and need your feedback ladies...1) get lumpectomy this Wednesday and wait a few months to start chemo then do recommended Genetic testing (I have family history) during chemo to see if I need a 2mx and radiation after chemo (2mx is recommended at my age for BRAC positive)2) Start Chemo now to shrink lump and kill other potential cells that have spread, do genetic testing during chemo to see what kind of surgery I need. then do surgery and radiation according to genetic results.3) have MRI now and find out if ILC has spread and to where. Then decide if chemo or surgery first. They say MRI results take a while to get back.One big question- what is the difference between an what an MRI and a sentinal node biopsy can do for you? I know this is a lot - help me!! I have a meeting with my doctors on Tuesday (day after tomorrow today is sunday 11/6) and there is an option for me to do surgery on Wed. Im hesitant because if the cancer is aggressive, which they say can be true for younger patients,  I will have to wait a whole other 6-8 weeks to begin chemo (to let the surgery heal, right?) during which time Im afraid of mets.Let me know what you all think. trying to stay positive and believe that my higher power is working for me but this is all happening so very fast and my kids (2 and 3 yrs old) are sensing something is wrong with mommy and my husband who is wonderful is shit scared (scuse the lang). feels like the world is caving in around me at times but at others I feel I will be fine and can be strong..- need more info...which is why I am here.God bless 

youngsurvivorsister

Hello, I will try to answer one of your questions, "One big question- what is the difference between an what an MRI and a sentinal node biopsy can do for you? "

MRIs are very sensitive and can show the spread of the tumor and cancer cells, most likely they will inject a contrast agent and image its flow, this will help them image angiogensis, ie growth of blood vessels and rate of blood flow, that way they detect even small pockets of malignancies, something that does not show up on ultrasounds. Sentinel node biopsy just shows if the sentinel node is positive or not.

Wish you luck, hope you find a treatment option that works for you...

momof2greatkids

Hi Oaklandmama - I am from the Bay Area but now live in Indiana!

I have a similar DX - ILC but it had spread to armpit by time of DX. I was freaking out over the options (was asked to be in a clinical trial and only had a few days to decide) and desperately wanted immediate BMX, but onc ended up recommending 18 weeks of chemo, then bmx will be in Dec, then rads. Still have decided if I will get recon or not.Luckily, I found this wonderful site and it helped so much!!

Anyhow, MOST important is to know what type your cancer is, especially to know if it is HER2+ or not. Personally (and in retrospect, which really says a lot) I would not have anything done until all the information is in - tumor type (again is it her2+ or-; and what your ER/PR status is); then I had PET scan, bone scan, brain MRI, and MRI's of both breasts. Also, do you have "dense" breasts? (ILC is more common in dense-breasted women.)  I do and this was a factor for me in deciding on the BMX - ILC in dense breasts is VERY hard to detect on mammograms. I have not had a sentinel node biopsy. Tomorrow is my 5th chemo, one more to go then surgery. 

Once you know the info re her2, er/pr, you will be able to find out a lot more. If you that info now, please post it.

 God Bless you as you begin this journey and I look forward to talking again soon!