IBC and IDC

Lawgirl

What does this mean? My surgeon is recommending to my oncologists more chemo. He already knows I'm doing radiation. He said my pathology report was "favorable". I was so taken back by the recommendation for chemo I hardly remember the rest. They stopped my chemo before surgery (by two cycles) because the side effects were severe. I thought surgery removed the cancer....?

leisaparis

chemo is to clean up any loose cells that may have gotten away. More of an extra boost, just to make sure.

Lawgirl

Thanks just frustrated as I thought that's what rads are for. I have 36 of them ahead, then chemo I guess.

leisaparis

my original plan was chemo, surgery, radiation then chemo again. however they decided to do both chemos first. they have been doing studies and the farther away from the radiation they get the second set of chemo the less likely hood of me getting leukemia later. so I had chemo, chemo, surgery, radiation. now I'm on a trial drug for HER2+ patients. hope all this works. time will tell.

TooManyCocktails

I found this information when Googling IBC and IDC:

From Dr. Cristofanilli, here is his answer to the IDC and IBC question:

IBC is a clinical diagnosis, meaning that patients present with all
the features that we know (redness, swelling etc) and we recognize it
as such. When these patients go to biopsy then they have a
pathological dx. The cancer cells may look like "ductal invasive
type" or (less frequently) "lobular invasive". In summary, IBC is
usually an IDC type under the microscope...

Patti Bradfield, President

Inflammatory Breast Cancer Foundation.

The lady was wondering if her mother had  IBC or IDC.   The comment is at the bottom of the page.

http://www.breasttumors.org/invasive-ductal-carcinoma-or-inflammatory-breast-cancer.html

HollyinMich

TooManyCocktails - While the information you posted is correct it is also possible to have both IDC and IBC.  IBC alone presents without a lump.  I was unlucky (or lucky depending on how you look at it because it got me rushed in for a mammo and US) enough to have both IDC and IBC.  I had two IDC tumors as well as all the clinical manifestations of IBC.  My family doc originally thought I had an abcess and mastitis.  I knew better since I hadn't breastfed in over 7 years and pushed for the additional testing.

As for the original poster, you always, always follow the treatment protocols for IBC over IDC when you have both. 

TooManyCocktails

@HollyinMich, I found this topic very interesting because I always wondered if I had IBC?  In March of 2010, I got a really high fever over 105 degrees F.  I went to the ER and was hospitalized.  They could not find anything.  The next morning, my whole left breast was bright red and hard as a rock. I was 50 at the time and hadn't breast fed in over 20+ years and I'm post-menopausal.  The PCP drew blood cultures and they were all negative.  They kept me in the hospital and gave me high doses of Vancomycin IV even though I had negative blood cultures.  When I went home my breast was still swollen and red.  I made an appointment with my PCP.  She sent me in for a mammogram and ultrasound.  The mammogram said that I had dense breasts and that the left breast had edema and skin thickening.  The radiologist said that it was residuals of mastitis.

I continued to have problems with the breast even though the redness went away, I still had swelling, which was gradually going away; but my lymph nodes were starting to swell under my arm.  I went back to my PCP and asked her to check it out... Eventually, I get sent to a breast surgeon.  She can palpate a node under my arm as well as see it on ultrasound.  She said that it residuals of mastitis.  I asked her to biopsy it.  She refused.  She said if it hadn't went down in a month she'd look at it again.  That's all she did was look at it.  She still refused to do a biopsy.

The third time, I made another appointment with her because I had an even larger lump.  This time, she did biopsy it by FNA.  The path report said adenocarcinoma.  I had asked her point blank it it was IBC at the first visit and she said "no".  Since, I have two sisters that had/have breast cancer, I said that I wanted to get a bilateral mastectomy.  In November 2010, I had the surgery.  The path report said that I had 18 small tumors in my breast (.45mm to .5 cm) in all all quadrants of my breast and 41/41 positive lymph nodes all with macromets.   The largest lymph node was 3 cm, and had lymphovascular invasion, multiple nodes exhibited obliteration of nodal parenchyma by the tumor. The pathologist did not do a punch biopsy of my skin, even though, I did have a rash on my breast; so, the report said that I had no "dermal lymphatic invasion" the key terms that doctor want to see for a diagnosis of IBC.

My BS said I had IDC and she said I definitely did not have IBC. About two months ago, I changed oncologists because the one I had just didn't answer all my questions and I kept having complications with the chemo. The new oncologist says that I do indeed have IBC that IBC can be made by a clinical presentation of the symptoms with tests as well!

I've already had the mastectomy/ies. I should of had chemo first!

I wanted to ask you ladies what your path reports said so that I could get a better handle on this.

Thanks

ibcmets

Toomanycocktails,

I was diagnosed with both IDC & IBC.  My local medical facility was familiar with it and my report right after mamo & ultrasound said suspicious of inflammatory & idc.  My surgeon biopsied and confirmed a week later.  I felt a tumor on top of my breast that was also red and looked like I had a bug bite.

Terri

TooManyCocktails

ibcmets, did your pathology report say that you dermal lymphatic invasion or just IDC?  Was your IBC diagnosed by clinical manifestations only?

HollyinMich

Hmmm, weird, there was a thread where several of us had posted our pathology reports and I can find it in a search but when I click on the link it redirects me to the main forum page.  It was called IBC Pathology-Diagnosis & Mastectomy.

My report did note dermal lymphatic invasion but it also only referred to it as IDC.  A large majority of IBC diagnosises are made by clinical presentation only.  Punch biopsy, which is most commonly used in IBC that presents without a lump, are not always accurate because of the way it grows and can throw false negative results.  When a paitient presents with symptoms of IBC without a lump they should be referred for MRI and PET to help with the diagnosis.  Because I had a rather large palpable IDC tumor that was fairly close to the skin I had a surgical biopsy and they removed a section along with skin that was directly above it.  I did not have a punch biopsy.

I'm going to PM a moderator to see what happened to that thread.  Definitely something that could be useful for a question like this. 

TooManyCocktails

Thanks Holly for the information and help.

HollyinMich

No problem!  The moderators are looking into the problem of the missing thread.  Hopefully they can get it restored.

ibcmets

Toomanycocktails,

My pathology report came out after the biopsy with invasive dermal lymphatic invasion & idc.  My oncologist had me do an MRI, Pet scan & bone scan to diagnosis and confirm later.  I started chemo within 2 weeks as chemo is the first treatment with ibc.

Terri

HollyinMich

Terri, do you remember the other thread I referanced above IBC Pathology-Diagnosis & Mastectomy, where we all began posting our pathology reports?  I've been in touch with the moderators to try and figure out why it had disappeared and Judith was asking who started the thread.  My memory is fuzzy but I recall that you were involved in that thread as well.  Any ideas?

ibcmets

 Holly,

I will search to see if I can find it or we may be able to find some help on pathology report on some other sites.  I believe they have explanations on Susan Komen's site.

I'll let you know if I find something.

Terri

ibcmets

Holly,

I found some basic explanations of pathology reports under symptoms & diagnosis from the very top of Breast cancer.org.  On the left side, you can check pathology reports and find info that way.  I'm not sure if this is detailed.

Terri

HollyinMich

Thank you, Terri.  I did find that link as well.  The thread I was referring to showed how different (yet in many ways similar) our pathology reports were.  Some of the women had punch biopsies, surigical biopsies as well as clinical only diagnosis.  It was interesting to see how we had all ended up with the IBC diagnosis and the path that led there.  I was hoping it would be useful to Toomanycocktails in her journey to find answers.  The mods have the IT dept seeing if it's possible to restore.  From the looks of another thread they are currently busy playing babysitter again over in the Alt/Holistic thread.

mrsnjband

My skin punch biobsy was negative but the tumor biospy was postive.  I don't know if it the tumor biopsy indicated IBC or not, I never saw the report.  I didn't know to do such things back then. NJ