Lack Of Updated Clinical Trials and Info

luv_gardening

Here's a large retrospective review of the effects of adjuvant chemo in IDC and ILC. Published 2012, over 23,000 patients, 3685 had lobular cancer.

Effect of adjuvant chemotherapy in postmenopausal patients with invasive ductal versus lobular breast cancer

And here's the full PDF version, no login required.

"Conclusion Adjuvant chemotherapy seems to confer no additional beneficial effects in postmenopausal patients with pure or mixed type
lobular breast cancer receiving hormonal therapy."

I found an analysis questioning the above study but now I can't find it.  Maybe it was withdrawn, or I'm not looking in the right place.  I don't like to be in any way biased as the truth is too important.

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This much smaller study published 2011 with 299 patients, (only 79 tumors were considered pure lobular carcinoma or mixed)), concluded chemotherapy was worthwhile despite the small results. 

Is adjuvant chemotherapy useful in lobular breast cancer patients?

Conclusion: "Even if a complete pathological response was very rare, this suggests that lobular tumors are not completely chemoresistant. This limited chemosensitivity could be enough to decrease the relapse rate in the adjuvant setting."     

This suggests... could be enough... limited chemosensitivity... let everyone weigh up the risks and make their own personal decision.  We just don't have enough proof one way or the other at present.

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And here's a reason why chemo may not work as well on Lobular.:

The poor responsiveness of infiltrating lobular breast carcinomas to neoadjuvant chemotherapy can be explained by their biological profile.

luv_gardening

Here's a more recent meta-analysis of neo-adjuvant chemo dated Nov 2013.

Response to neoadjuvant chemotherapy in ductal compared to lobular carcinoma of the breast: a meta-analysis of published trials including 1,764 lobular breast cancer.

TaniaE

Age, Year of Diagnosis:   44, 2013

Nationality:  Australian

Current Age:  45

Children/Ages:  2 - Aged 20 and 16.

Drinker/Smoker/Caffiene Status: Rarely, non-smoker, 2 cups of coffee and 2 cups of tea daily

Diagnosis, Grade, Stage (if known):  ILC 3 cm, 2/17 lymph nodes, Grade 2, Stage 2

Surgery: Lumpectomy, node clearance left side 

PR/ER and HER2 Status: ER/PR+ HER2-

Treatment: AC x 4

Metastasis: No

Reoccurrance (with dates):  No

Birth Control: Yes on the pill for 20 years for heavy periods, took a break to have children. My onc says it made no difference but I believe differently

Other Medical History (only if you want to share):  Gallbladder removed in December 1998

mary625

So I had neoadjuvant chemo with ILC.  Is the Nov 2013 study saying that neoadjuvant is the best choice?  

Can't undo it now, of course.

luv_gardening

Mary, the study says the response by IDC was better than the response by ILC, but that means nothing to any individual as none of us know how we as an individual benefit till after the fact.  In the case of a tumour where a clear margin would be difficult for the surgeon, then Neo-adjuvant is the best treatment.  For others there is no knowing if there was a benefit.  We can't see if any microscopic tumours are forming or if they were destroyed.
We need a way to find out if cancer is hibernating silently or just too small to find, or if it's gone completely, then we will know whether to use the big guns or wave goodbye to our oncologist and know we're cured.

toomuch

Torridon - I hope that your doctor finds a treatment that will keep you stable or get you back to NED. This disease is so unpredictable...of course, you feel sad. ((((hugs))))