Has anyone not had a mastcetomy with Ivasive Lobular?

Annie51
Annie51 Member Posts: 22

I am in the UK I have had a Lumpectomy and I was told it was ILC at 15mm with the MRI it showed 57mm and in reality it was 80mm , but the core was 15mm and the remaining amount was with some ILC and extensive LCIS I had clear margins of 2mm on avg and in some places 10mm clear.

Has anyone refused a mastecomey and just gone with Chemo and Drugs ?

Thanks Annie

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Comments

  • HensonChi
    HensonChi Member Posts: 357
    edited June 2009

    Hi,

     I had a lumpectomy and my tumor was 1.2 centimeters.  The surgeon got clean margins the first time in.  I got two opinions and decided to go with the lumpectomy. I don't regret it..... 

  • Survivor07
    Survivor07 Member Posts: 71
    edited June 2009

    I had a complete mastectomy.  My mass was 12 x 8 cm.  Pretty big.  I'm lucky though; I trust my doctors and go with whatever they say. I figure they know more than me.  And the sooner I had that cr*p out of my body, the better.

  • Annie51
    Annie51 Member Posts: 22
    edited June 2009

    Thanks Henson Chi,

    How long ago did that happen to you ? Did you do all the other therapies?

  • Rabbit_fan
    Rabbit_fan Member Posts: 166
    edited June 2009

    Hi Annie,

    I had a lumpectomy for ILC in May 2009.  The first opinion I got was that double mastectomy was my only option.  I got three more opinions that all said that lumpectomy was reasonable for me. 

    My tumor was pretty small, and I think maybe that plus the fact that it was found by a screening mammo somehow made me feel like I didn't need to go the most drastic route.  The biopsy report also showed no lymph or vascular invasion and I had an MRI that was clear for anything other than the original tumor. 

    I didn't have the experience like a lot of others seem to where they can tell something is wrong and none of the scans show it.  If I had, I think I probably would have felt a lot differently.  Since it was so out of the blue I didn't have that feeling that diagnostic tools had failed me and I needed to get rid of my breasts asap.  I decided that for me I would do the lumpectomy and if there is a recurrence I can have a mastectomy then - I guess I had more fear of the effects of the mastectomy than of recurrence. 

    I brought up the issue that ILC is oftentimes missed by imaging, and the doctors who said I could do lumpectomy all said things like "you'll be followed very closely - if you have a recurrence we'll find it."  Maybe I'm naive for believing them, but since I was given the option of lumpectomy I took it - I was very afraid of double mastectomy and lymphedema.  I didn't want to risk both arms if I didn't have to.  If all of the docs had said no to lumpectomy I wouldn't have done it, but for me the vote was 3-1 that it was reasonable.

  • Kleenex
    Kleenex Member Posts: 764
    edited June 2009

    I had an ILC tumor (with a touch of LCIS connected to it) of 2.1 cm, and I opted to start with a lumpectomy. We got "okay" margins - the tumor was very close to the chest wall and skin due to it's high-up location - and so I did not need more surgery. I had an Oncotype score of 11, so I was not offered chemo. I had radiation (I probably would've ended up with radiation even with a mastectomy), and I'm on Tamoxifen. I feel that the lumpectomy and radiation most likely took care of my originally identified cancer, and the Tamoxifen allegedly will help keep it from spreading or coming back.

    If you have clear margins, why are you considering a mastectomy? You can always have more surgery later.

  • fortunate1
    fortunate1 Member Posts: 644
    edited June 2009

    A dear friend had a lumpectomy for ILC, chemo, rads and AI's. She was in her 50's. She just reached her 5 year anniversary.

    I had an ILC tumor, 1.2 cm, mast, no chemo, no rads, and Femara at age 61. Age can make a difference with early stage BC treatment. I wanted a lumpectomy, but was urged toward a mastectomy because the tumor was in the cleavage area and would leave a large "defect". An MRI and a PT/CAT scan showed no other involvement besides the tumor. A double was also suggested by the surgeons, but my oncologist said there was no medical reason to do so, thus a single mast. was my choice. 

    Are your doctors suggesting a mastectomy? Or are you wondering if you've done enough? 

  • IllinoisNancy
    IllinoisNancy Member Posts: 722
    edited June 2009

    Hi,

    I was dx with Invasive pleomorphic  ILC in October of 06.  I had a lumpectomy, radiation and now I'm on Tamoxifen for 5 years.  My Onctotypedx was 9 so chemo wasn't necessary.  My tumor was ER+, PR-, HER-.  Good luck with your treatments!

    Take care,

    Nancy

  • nash
    nash Member Posts: 2,600
    edited June 2009

    I had a lumpectomy for a 2.7cm pleomorphic ILC tumor that was right up to the chest wall, clean margins, extensive pleomorphic LCIS left in the breast that extended into the pectoralis muscle. Oncotype 18, did chemo and rads, am now on Tamoxifen and Zometa.

    Remember, the adjuvant therapy the doctor recommends for you is not based on the surgery you chose. Mast=lump+rads, so having a mast doesn't mean you get to skip chemo and rads if the biology of the tumor/size of the tumor/your age, etc., warrants it.

  • LoriL
    LoriL Member Posts: 185
    edited June 2009

    I was planning on doing just a lumpectomy, but the mass (that I found myself) did not show up on either mammogram or breast MRI. So, I felt like I really wouldn't be able to trust the "close followup with mammogram and MRI" that they planned. If my mass would have been seen on mammography, I would have felt pretty comfortable with lumpectomy.

    My margins were technically clear, but came as close to 1-2 mm on 2 sides. So, I'll be starting rads this week and then Tamoxifen after that. My Oncotype Dx score was 16, so chemo would not be any further benefit for me. 

  • dlb823
    dlb823 Member Posts: 9,430
    edited June 2009

    Annie ~  Did you have an MRI?  I initially had a lumpectomy for a mixed ductal/lobular lesion.  But when the pathology from that came back with some oddities, I went for a second opinion, and the second  MRI I had (a month later; my first MRI had "obscured" areas that no one worried about) found 2 tiny lobular lesions.  I had a mastectomy, and the pathology from that found one more very tiny lesion (5mm) in a piece of breast tissue my BS trimmed at the last minute mostly for cosmetic results.  So, I actually had 4 lesions when my original BS only took out 1!  

    My concern re. lumpectomy is how carefully has your breast has been examined for other possible tiny lesions.  I know we like to think that chemo and/or rads will get anything that might be left behind, but someone made the point to me that after surgery the blood supply to your breast is somewhat compromised, so there may be areas the chemo doesn't reach.

    Just some food for thought from my own experience --   Deanna

  • amlg1
    amlg1 Member Posts: 596
    edited June 2009

    I had a lumpectomy margins clear.My breast surgeon recommmended the lumpec.I was for a mast. but she didn't see a need for it.Glad I did what  I did.Many positve nodes,Just started Chemo.

  • HensonChi
    HensonChi Member Posts: 357
    edited June 2009

    It has been a year and a half.  I had TCH chemo and radiation.  I just finished the herceptin two weeks ago and am feeling better every day!  Hope all goes well with you.  My hair is growing fine, and my fingernails are coming along!  It gets easier as time goes by!

  • HensonChi
    HensonChi Member Posts: 357
    edited June 2009

    By the way....they took out anything that looked like it could turn into something in the other breast so actually although there was no cancer there...I had a double lumpectomy!  With the radiation my scars are even going away!

  • Anonymous
    Anonymous Member Posts: 1,376
    edited June 2009

    annie--my mom had ILC many years ago. She had lumpectomy, radiation and tamoxifen, and is doing very well after 22 years without a recurrence.

    Anne

  • sakura73
    sakura73 Member Posts: 467
    edited July 2009

    I had a lumpectomy followed by a reexcision when the intial lumpectomy revealed multiple small foci which had not shown up on MRI and which meant no clear margins. Before the reexcision I asked the surgeon if I should just have a mastectomy. She said we should try for clean margins first. On reexcision we got them so I still have my breast and am very very glad I do.

  • Annie51
    Annie51 Member Posts: 22
    edited July 2009

    Thanks for the input. Now I am confused with them all , should you have chemo then surgery or the other way round ?

    What hell is this trying to decide

  • Annie51
    Annie51 Member Posts: 22
    edited July 2009

    Hi I didi have an MRI it should some areas on the other breast but there was nothing after tehy took biopsys

    The other area was clear

  • Rabbit_fan
    Rabbit_fan Member Posts: 166
    edited July 2009

    Maybe someone who had a tumor similar to your size will chime in on when they had chemo.  I know I've seen quite a few posts where people have had chemo to shrink the size of the tumor before surgery.  I don't know if that was so they could try to have clean margins on a lumpectomy, if it was necessary to get clean margins on a mastectomy, or if it is just standard to try to reduce the size of a large tumor before surgery. 

    Anyone who has gone through this and knows the answer?

  • MRSROCKYTOP55
    MRSROCKYTOP55 Member Posts: 403
    edited July 2009

    I actually had two tumors, one was ILC and one was IDC.  I live in Costa Rica and the care here is very good.  The doctor decided that since my breast was large enough they could get by with a quadrantectomy.  They just removed the quadrant and then I am having chemo, Herceptin and radiation.  They said that research has shown that the outcome and prognosis is the same.  I hope this helps you.  Kathy

  • Seabee
    Seabee Member Posts: 557
    edited July 2009

    My tumor was officially 2.2 cm, but that was only the dominant part. The MRI showed it as extending up to 6 cm in some directions, so MRI was used to guide the surgery, which was successful after one reexcision. Luckily I have large breasts and the tumor was in the lower outside quadrant and concentrated in the same area, so it was possible to get clear margins and good cosmetic results.

    If ILC or LCIS is in more than one part of the breast, then mastectomy is more likely to be recommended.

  • CjPA
    CjPA Member Posts: 16
    edited July 2009

    I'm having a double mast on 7/20.  I decided to do a this after the BS explained to me how lobular grows in the breast.  She said lobular is like the roots of a tree, long and thin. It can may it hard to get clear margins. My MRI says the area is about 4.2cm, but she said you never know till you get in there of what the size will really be.  I also didn't want to have to do radiation (i'm really fair n). Thought this would be best for me, since I was worried about getting it all.

    My other factor is getting mast was I know of three women that did lumpectomy and with in three years they all had to go back and have a mast.  I hope this helps

  • Annie51
    Annie51 Member Posts: 22
    edited July 2009

    I have had clear margins now going for a quad and then if needed the full thing in the same year , I am having Chemo and rads and Tamoxifen ..

    It has helped but I know I shoudl go for the full thing but they cannot say if it is further and in the surgeons mind they have cut it out already

    thanks and good luck prayers are with you

  • Survivor07
    Survivor07 Member Posts: 71
    edited July 2009

    I had chemo first to shrink the mass (12 x 8 cm). Then I had the mastectomy. 

  • dutchgirl1
    dutchgirl1 Member Posts: 9
    edited July 2009

    Yes in 2003 had 2.5cm Ilc had a lumpectomy chemo 4 ac then radiation for 5weeks   5years of   Arimidex    and Iam still neds

  • Annie51
    Annie51 Member Posts: 22
    edited July 2009

    Hi

    Did anyone have chemo After the Lumpectomy then full Mastectomy  ?

    I am confused the doctors are saying it does not matter but the surgeon want s to get on with surgery and the Onocolgist wants to do Chemo ?

    It woudl be easier not to have surgery 1st but am I risking myself ?

    Thanks for all the help and support

    Annie

  • Annie51
    Annie51 Member Posts: 22
    edited July 2009

    Hi They are recommending everything chemo rads and drugs Tamoxifen, which I am already on pre surgery or Chemo

    . I think the option of a quad gives me 9% higher risk of getting Cancer again Even though I have clear Margins it is a big Risk . I have to decide now Surgery or Chemo 1st that is my big question and I need to decide within the next week.

    It is all doing my head in

    Annie

  • Annie51
    Annie51 Member Posts: 22
    edited July 2009

    Hi They are recommending everything chemo rads and drugs Tamoxifen, which I am already on pre surgery or Chemo

    . I think the option of a quad gives me 9% higher risk of getting Cancer again Even though I have clear Margins it is a big Risk . I have to decide now Surgery or Chemo 1st that is my big question and I need to decide within the next week.

    It is all doing my head in

    Annie

  • JannaC
    JannaC Member Posts: 30
    edited July 2009

    I was diagnosed with invasive lobular cancer, LCIS and hyperplasia in Feb, 2009.  I had a lumpectomy and then a reincision for a clean margin.  .9mm, stage 1, grade 2 with an oncotype of 19.  That's what threw me.  Just over the medium range.  My oncologist said it was my choice to do chemo or not, but she recommended against it.  So I didn't do it and am taking Femara now, but second guessing the chemo part since my number was 19.  I also had 5 weeds of radiation.  Scary.  Will it come back?  $64,000 question.  r27784y

  • LizziesNuNu
    LizziesNuNu Member Posts: 56
    edited July 2009

    I was diagnosed last Thursday with ILC, stage 1. I saw my surgeon yesterday ( 7-16-09), she said I was at stage 2 because I have very thick breast tissue. The tumor is 1.6cm. She is recommending mastectomy with reconstruction. I understand with our type it can move to the other breast. She also said our's is an aggresive form. I am encouraged by what I'm reading here, but am even more confused. I want to get treatment started, but no one will help me make the decision. I am scheduled for an MRI on both breast next Monday. So...just wait and see? I'm getting mixed messages from my family, they all think they know more than my surgeon. Anybody got any advice?

  • LizziesNuNu
    LizziesNuNu Member Posts: 56
    edited July 2009

    That helps a lot.

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