Measuring ILC and using guidelines for staging

jojo9999

I have a question about measuring ILC. I seem to recall asking my MO in the past, and don't recall if he had a good answer (probably not!). ILC tends to grow in strings/streaks because the cells don't clump together. So imagine a 1 cm ILC tumor compared to a 1 cm IDC tumor. Wouldn't the ILC tumor be comprised of far fewer cells (less mass) than the IDC tumor? We often hear of women with very large ILC tumors 5+ cm, but wouldn't an IDC 5+ cm tumor have much larger mass, indicating much more cancer? Should ILC and IDC be using the same staging system based on measurement of the largest dimension? I realize that measuring the mass of the tumor may not be practical because of surrounding tissue, but simply measuring the longest dimension seems to be a very crude measurement of the amount of cancer.

Optimist52

jojo, I have often thought this myself and meant to ask my MO or BS about it. It's been a sort of comforting thought for myself with a 4cm tumour! I would love to know if there have been comparative prognostic studies of IDC and ILC with the same dimensions and other factors i.e. node involvement. Some studies seem to show a better prognosis for ILC. Of course it's often larger at diagnosis because of difficulty in screening for it. I had annual mammograms and ultrasounds for 12 years and they didn't pick up my second ILC.

JohnSmith

Good question jojo. Do you want to add this to the ILC Symposium "question" thread?

I'm curious about how metastatic tumor burden differs between ILC and IDC.
Without the sticky E-Cadherin protein, I assume metastatic spread physically manifests the same way as it does in the primary tumor. (i.e. diffuse growth that some have described as delicate fern fronds).
With that being said, I'm wondering if the visceral organ tumor burden of metastatic ILC (mILC) is less than metastatic IDC (mIDC), and if so, does this potentially translate into longer survival periods for mILC compared to mIDC?

hmh23

Lojo, I've added to the list of questions. It is definitely topical and many have posed the same question. Heather

hmh23

John, Good question...I have added to the list that I am sending out to the researchers. Heather