Pleomorphic ILC

Just checking in ...... Had a mid-treatment MRI last week.  Disappointing results - no additional shrinkage - the tumor is stable - no increase or decrease in size.  It's just the overachiever in me this is the first MRI were I haven't had a decrease in size.  Although after my taxol regimen by tumor had shrunk 90% in volume so I'm not sure what I was expecting.   Other than that I'm still just ticking off the weeks ..... only 8 more to go.....so far have found AC to be tolerable now that the nausea issue has been resolved.  It's all good.

Rover

Thank you for the info. we are of like minds. I am a nurse practitioner x 24 years who dared to ride the roller coaster of pathology journal articles on PLC (pleomorphic lobular Ca). And until I see my surgeon (from MSK) I prefer to read survivor stories. (..just got bx report 1 wk go).woops- the hubby woke up, time to either drug him or do something else to get him to sleep- read my profile- just wrote it. maybe I too, am delirious from lack of sleep, or all the love and prayers coming my way.

thank u. I just sent a personal to think positive. My path is 90%ER+, 50%pr+, and 0 HER2. The path journals say even though the stains show +, the cell type is not so responsive...The sono size was 2.5x1.9, again, may be wildly larger, as grows irregularly. I faxed my ins. cards with a letter to the surgeon asking her if she wanted an MRI (I wasn't going to do anything the asshole radiologist told me), and when my gyn suggested an MRI too, I called her office to confirm she got the letter and did NOT want me to get an MRI..i swear if she orders an MRI on Thurs, i will go somewhere else. I can already see she is very busy, and that's good, but I also need someone accessible (if only thru their staff) that I can count on not to cost me time and aggravation.

i am so scared.

Saw my oncol. yesterday and discussed the latest MRI results. Since there is already a 90% reduction he suspects there may be dead or scar tissue left that the MRI may be showing.  In his words "it's hard to kill something that's already dead."  Or the cancer cells may not be growing fast enough for the chemo to kill them and local control will take care of it.  Doesn't recommend any adjustments in treatment.  Guess I need to adjust my expectations, there might not be much left to reduce.  I'll have another MRI in 3 weeks.

Rover 

shell - Sorry you are joining us - but yes, this board will be very helpful. It's great that you had no positive nodes. That is very good news for you. ILC is rarely triple positive. If the her2 comes back positive, you may want to have the pathology reviewed at an additional lab...kind of like a second opinion. What made your drs think you had dcis and idc? Hang in there...good luck with your research and scheduling.

Hi Ladies,

I finally got my oncotype dx results (it's a long story) and I have a 15% chance of recurrence.  The Dr. didn't have the score with her when she called, but said she thinks it's 24, solidly in the grey area.  She says I will see a 4 to 7% reduction with chemo so that's what I'm going to do.  She seems in a hurry to start - it's been so long since surgery (Sept. 4th mastectomy) and it may be as soon as Friday.  I will meet with her and then start the chemo that same day.  I have no idea what she will choose for treatment.   I'm very nervous and it's hard to gear up this fast after waiting so long for news.  Any advice for helping me cope?  It's gonna be a long winter!

I am pleo ILC stage iib with a tumor 2+ cm and 2 nodes positive,.Had quadranytecomy - finished, adrimyacin, cytoxan and taxol followed by 35 radiation tx. Now on arimidex. Dx. 3/2007. Am 52 yrs old. Will have an MRI at my insistence, due to discomfort and heaviness of affected breast. I'm sure it's nothing!!??  Good luck to you!

I didn't fill out the DX correctly. It should show up now

 Here is a copy of that article I mentioned above... I apologize that I cut off the title and citation when I had copied for my files ....  I can find it if you wish...

Lobular Carcinoma
Invasive lobular carcinoma (ILC) is the second most commonly diagnosed histological type, comprising approximately 10-15% of all breast cancers. We have studied the molecular genetic profiles of ILC using microarray comparative genomic hybridisation (aCGH) and have identified genomic amplifications of 8p12-p11.2 (FGFR1) and 11q13 (CCND1) which are likely to be important in tumour development. We have also shown that the high grade, poor prognosis variant pleomorphic lobular carcinoma (PLC) has a similar aCGH profile to ILC with additional amplification of oncogenes such as ERBB2 (17q12) and c-MYC (8q24). The majority of ILC also exhibit loss or reduced E-cadherin expression and this is likely to be associated with the characteristic discohesive growth pattern of these tumours. Some diagnostic pathologists are now using E-cadherin positive staining to discount a diagnosis of ILC in favour of invasive ductal carcinoma (IDC). ILC and IDC have notable differences in their biology and clinical nature and so this has implications in the management strategy for a patient. We have demonstrated that ILCs with mutations in E-Cadherin can occasionally express the protein and we are currently studying cases of ILC morphology and mixed E-cadherin immunoreactivity to understand the role of E-cadherin in the biology of lobular lesions and evaluate the limitations of its use in clinical practice. Our lab is also extending these studies into lobular carcinoma arising within families with a hereditary predisposition.. There is strong evidence that lobular carcinoma in situ (LCIS) and ILC are associated with an inherited predisposition. They are both frequently multifocal and bilateral, a feature seen in many familial disorders, and a higher rates of ILC is found in familial BRCAx mutation carriers compared to sporadic controls. We are using the kConFab resource to study this association in high risk families. PLC may be part of the BRCA2 spectrum of tumours and we see molecular evidence to support this with loss of the BRCA2 genomic region by aCGH. We plan to study kConFab breast tumours to investigate the role of BRCA2 in this ILC variant.