Need help pls ILC

zohra

Thanks for reading my post. My mother just diagnosed with ILC. I did not understand her biopsy result. it shows ILC grade 2 involing 98% of the cores. ER + PR- HER-2 - KI 67 high . I need if any one can tell me what stage is her cancer... Also, is there any diet for her? What things she can eat and what things she has to avoid? She is going for ct scan and bone scan.Is liver function test important for her or not? Pls I really need advoice. Thanks

Moderators

zohra, until members post with their own experiences, here are some resources from the main Breastcancer.org site that can help you:

Your Diagnosis takes you, line by line, through what each item from the pathology result means.

Nutrition is an extensive section on the site that talks about healthy eating during and after treatment, and nutrition and risk reduction.

Tests for Staging ILC discusses some of the tests that may be done to determine stage.

Best wishes to your mother, and to you.

sgreenarch

Hi. Would like to help Zohra but need more info, if possible. Some questions:

-Has she had surgery yet or just a biopsy? Seems like just a bx since there's no mention of node involvement or size or location of tumor(s).

-if her Mom is a candidate for the oncotype test, that could be helpful to her.

-her oncs should be able to answer most of these questions.

-re diet; I now eat a mostly Plant based diet, organic when possible. Almost no alcohol. Try to exercise an hour a day.

Hope this is helpful.

zohra

Thanks sgreenrach for your reply.  She is going for bone scan and ct chest. She has not any surgery yet.Can you please tell me what is oncotype test ? Can she eat  suger and meat ? If you live in VA  DC or MD any good  oncologist for treatment.Thanks again for your help

Have a good weekend

Zohra

dlb823

Zohra, staging for breast cancer is based on the size of the lesion(s) and if any cancer cells have travelled to the lymph node(s) or anywhere else.  The biopsy report should give you an approximate size of the lesion they biopsied.  The actual size can only be determined from the surgical pathology.  An MRI or CatScan can predict with some accuracy if any of her nodes are involved, but only a sentinel node biopsy and/or axillary node dissection can answer the question definitively.  At this point, her breast surgeon might venture an educated guess based on the size of the lesion, and also if he/she anticipates additional involvement.  But it would still be somewhat of a guess.  The scans and surgery are really needed to accurately stage her bc.

Here are a couple of links that might be helpful to you:

http://www.cancer.gov/cancertopics/pdq/treatment/breast/Patient/page2   (explains staging)

http://cancercenters.cancer.gov/cancer_centers/map-cancer-centers.html  (a list of the top cancer centers in the US)

As far as diet, two of the very best books on cancer & nutrition are:  Anti-Cancer, A New Way Of Life, David Servan-Schreiber, MD, PhD; and Beating Cancer With Nutrition, Patrick Quillan, PhD, RD.  They're both well worth getting.

I'm so sorry your Mother is going through this, but she's fortunate to have your support, and I'm glad you've found bc.org.  (((Hugs))) to you both,   Deanna

Pawprint

Hi Zohra,



Oncotype test is done once the tumor is removed. The test on the tumor helps your oncologist decide on treatment. If oncotype score is low and estrogen is high most likely your mom will be put on medication in pill form to reduce estrogen levels. If oncotype score is high, she will probably respond better with chemotherapy. Stages of cancer is determined by size and lymph node involvement. Plant base diet is good choice, exercise also important. There Is a lot of good articles and forum posts on this site. Hugs to you and your mom.

itsjustme10

Don't follow any diet blindly becasue of something you read on-line.  Do your own research, and speak with your mom's doctors as to what, if anything, they want her to do.  No one here knows if she has any other under-lying medical conditions that might contra-indicate certain diets (like let's say she takes blood thinners - well those "plant base diets" are the absolute worst choice she could make, as the natural Vitamin K in green vegetables works against certain blood thinners, and could actually hurt her by making them not work as well, and allowing clots to form).

Probably the best thing she could do for herself, and assuming medical permission, would be some exercise every day.  That will not only help her get through treatment more easily, but also helps with future health.  Exercise could be something as simple as walking around the block or to the corner store every day.  It doesn't have to be a big process.

Just listen to the doctors -they know your mom, they know her medical history.  Ask any questions you have to them.  Even something as innocmous as her diet should be run by her medical team.  It never hurts to eat sensibly, and have all food groups within moderation, but before you concentrate on any one food group, always get medical advice. 

There should be several large cancer centers with excellent reputations in the area in which you love.  This thread, where Northern VA ladies talk might be a good starting point to meet some local women who could have medical recommendations for you..

http://community.breastcancer.org/forum/6/topic/709375

Good luck!!

mary625

I'm in Northern Virginia and would recommend the Lombardi Cancer Center at Georgetown University Hospital. I see Dr. Robert Warren and Dr. Elizabeth Feldman there. I would highly recommend them. I chose not to have treatment in Virginia except for radiation. I would highly recommend my rads onc in Virginia, Dr. Stella Hetelekidis. Other than that, good choices would be Johns Hopkins in Baltimore and possibly Virginia Hospital Center in Arlington. Those were my 2nd and 3rd choices. I have been very, very happy with my care at Georgetown!

zohra

Thanks for your help full advices.I really apptreciate it. GOD bless all of you.Hopefully , all of you had a great weekend.

 Here is some more information about her reports . Any information will be help full.

Right breast 4.0 cm at 10 o, clock , core biopsy .

1 - Invasive Lobural Carcinoma, grade 2 involing 98% of the core.

(Tubules 3, Nuclei2 . Mitosis 1 total score 6/9

2- Lobular Carcinoma in Situ ,Focal , Minimal

ER + PR- HER-2 - KI 67 high.

MRI Result

Comparison

Right breast , there is spiculated rapidly enchancinh mass seen withen the right upper outer quadrant measuring 9.6 x 6.1 x 5.8 cm.This mass invades the underlying pectoral musculature and there are spicules arising from this mass extending to the skin with overlying skin thickening in the right upper outer quadrant , There is an abnormal round lymph node within the right axilla which measure 1.0x0.8. this node does not demonstrate any normal fatty hilum. A secand larger right axillary node is seen measuring 2.0x 1.3 cm however this node contain fatty hilum.

Left breast  , multiple enhancing foci indentified throughtout the left breast however there are no facally suspicious  mass is seen within the left breast .Mildly prominent round left axillary nodes are seen which demonstrate loss of normal fatty hilum . A represenative node measure 1.0x 0.9 cm.

No abnormal interenal mommary nodes indentified. No aggressive appearing bony lesions indentified.

Impression

highliy suspicious  rapidly enhancing 9.6 cm mass within the right upper outer quadrant with chest wall invasion and possible extenion to the skin with overlying skin thickening. Recommand correlation with pathology results.

2.Bilateral abnormal axillary nodes. Recommand second look axillary ultra sound with guided biopsy of any abnormal nodes if this has not allready been performed , as clinically indicated .(no biopsy clips  are noted within the axillary regions and there are no post biopsy changes noted around thses  axillary nodes)

Right breast birads category 06 - known biopsy proven malignancy

Left breast birads category 02 - benign finding.

I need if any one can tell me what stage is her cancer and what cancer she has ?

ILC or LCIS?

She is going for bone scan and CT chest , Abdomen Pelvis

More information would be help full.

Thanks again

Zohra

Lily55

Hi Zohra - I am not a medic but can tell you that your Mum does NOT have LCIS, she definitely has an invasive or infiltrating cancer, stage and grade as yet unknown as you do need pathology analysis for that but from what you say I would guess a Stage 3 grade 2 at least......but please do not take this as gospel.....

I say it is not in situ as the info you give above says it is in the chest wall so I think it is ILC.....but you often get ductal cancers alongisde these so hard though it is for definite info you do need to wait for the pathology report......

Trisha-Anne

Hi Zohra

Your Mum has ILC, but there is a small part of it that is LCIS.  That's quite common - the ILC is the invasive part and the bit that matters.  A lot of wome have both invasive as well as in situ cancers.

You wont know the stage of your Mum's cancer until after her bone scan and CT scan.  If they are clear and show no metastases (that it hasn't gone to other parts of her body) then after surgery she will be staged. Once surgery is done, then an accurate size of the tumour can be made as well as if any lymph nodes are affected.  It sounds like she has a large tumour that has started to invade the chest wall so I would be surprised if her stage was lower than a IIb or perhaps III depending on lymph nodes.

As to diet - Itsjustme gave you good advice.  Your Mum needs to discuss it with her medical team before starting on anything.  They know what other medical conditions she may have.  I don't believe that diet really makes too much of a difference when it comes to breast cancer.  I have my own vegetable garden and have eaten plenty of fresh veggies and fruit most of my life.  Never been one for fast food or junk food, but I still got cancer.  I do think that eating healthy food is good for your overall health though, and still do eat very healthy. 

Good luck to both of you

Trish

zohra

Thanks for your replies.
Mary my mother dont have insuarnce. I talked Lombardi. They cant help . I applied mediciad for her then she can do her treatment in Lombardi. But it will take little time to get medicaid. Virginia hospital center in Arlington is ready to help us no cast. She allready started her treatment in FairFax hospital. and talk with surgen just one time.But we can change any time. What do you suggest us ? Thanks

zohra

Thanks for your replies.
Mary my mother dont have insuarnce. I talked Lombardi. They cant help . I applied mediciad for her then she can do her treatment in Lombardi. But it will take little time to get medicaid. Virginia hospital center in Arlington is ready to help us no cast. She allready started her treatment in FairFax hospital. and talk with surgen just one time.But we can change any time. What do you suggest us ? Thanks

dlb823

Zohra, I'm not sure about Virginia, but in many states women without insurance can qualify for breast cancer screening and then be referred for treatment through this program:  http://www.cdc.gov/cancer/nbccedp/

You might want to contact them and see where they refer clients in your area, and if they can give you any help or direction.     Deanna

mary625

Zohra--I feel that your mother will do well at either Fairfax or Arlington Hospital Center. Dr. Cocilovo is a great surgeon at Fairfax who went there from Georgetown. There are 3 great surgeons at Arlington. I do not know anything about oncologists at either.



If you don't have the possibility of going to Georgetown, I think either of these will be good. The reasons I went to Georgetown were several. Primarily, I was upset with the Inova System (owns Fairfax Hospital) that I felt missed my cancer for years on mammogram. I've since learned that is fairly common.



Please also know that there is an excellent resource very near Fairfax Hospital called Life With Cancer Center. I would recommend calling there asap. The services are all free, except for individual massage. They can help guide you to free services like counseling, talking with oncology nurses, classes, support groups, etc. Who knows what else they have there...it's really impressive. Also, there are great patient navigators in the Fairfax/Inova system.



I would go with where you both feel most comfortable and what is as convenient as possible, as you will be spending a lot of time there. In many ways, Georgetown was more convenient to me so that my husband could go to his office while I was in treatment, and I felt 100% comfortable there with all treatment modalities under one roof.

zohra

Thanks Mary for your kindness. I think I have to pay only for medicine. Are the medicine are very expensive? Do I have to go for secand opinion?

Thanks again

mary625

Zohra--I think you should ask whether they mean prescriptions only and if that includes chemotherapy or not.  Since I'm not a doctor I cannot say what medicines your mother will have to have, but I would assume that she is going to be recommended for chemo based on what you've said above.  I had insurance, but I noticed that my chemo was not billed as a prescription for which I would have had some sort of co-pay.  I would say it was billed as a treatment.  If that's the case for your mother, that will obviously be a tremendous help.  There is also a drug that is often used with chemo called Neulasta which is quite expensive.  Again, I did not notice any co-pay for that.  However, the Neulasta manufacturer has some sort of program for making it available at low cost for those who cannot pay.  The hospital should be able to give you a brochure on that.  If not, let me know and I'll find the website. 

Now, for actual prescriptions, there are many involved with chemo and/or surgery, but not a one of them was name brand--they were all generic which makes it lower cost.  Even many of the medicines she may need after treatment like Tamoxifen and Aromatase Inhibitors are now available in generic but they are still costly.

What I would do right now if I were you is call the people at Life With Cancer.  703-698-2526 www.lifewithcancer.org There are social workers and oncology nurses available there who may be able to hook you up with resources or if they can't, they probably know where to send you.  Also the American Cancer Society's location in Vienna is a good resource, at the very least for a free wig if needed.  They may also be able to set you up with some resources.

Regarding a second opinion, it's a very nice-to-have, but not required. 

zohra

Thanks Mary for all helpfull information.

zohra

Hello , my mother done with bone scan and ct chest.It was clear. Cancer did not spread in her body only right side breast and lymph nodes. Also , they found some lymph node in left breast.How we know how much cancer spread in lymph nodes..What will be treatment ?  Please , need more information about lymph nodes.

Thanks

Zohra

kathleen1966

Zohra.  Soo sorry to hear about your mom but glad she has you!  It's good news that the cancer hasn't been shown to spread in her body at this time. I believe, she is most certainly a stage IIIc with the stats that you gave, especially with the chest wall invasion. They usually do chemo first for locally advanced, larger cancers.  Normally you would know more about the lymph nodes at surgery, but as you will likely have chemo first, this will be different for your mom. Although there seems to be a good number of nodes that are positive, it is still treatable at this stage. Lymph nodes usually mean that there is a higher probability of microscopic cancer cells being through-out the body and this means chemo will used to treat the cancer. The larger amount of positive nodes, the higher the likelihood of these microscopic cells being in the body. Has you mother had any of the tumor markers done?  15-3 or CA 125?  If tumors give off this marker, these may be elevated. They usually are not elevated when the cancer is not advanced so they are not always reliable. I'm sorry about your mom.  I hope she has great success with her treatment and that you are able to get insurance to pay for it. There is hope. There are a lot of programs for women with breast cancer and no insurance.  I hope you ask to talk to the social worker at the hospital to be directed where to go.