BC Standard of Care does not apply to ILC
My experience with my former GP Standard of Care for women with BC was totally useless. From what I have learned the past year is majority of women with ILC had normal mammo & US. I had the symptoms of ILC ( spots close to my nipple, postmenopausal, used HRT) but my GP just sent me for mammo & US & further recommendations depending on results, all normal for 2 years. His reaction when I showed him my spots was "nothing to worry about"( onco's basic description of ILC manifests itself on the nipple). If only he input my symptoms on diagnostic software, the tools would have given him ILC. A lot of ILC ladies tumors ( as huge as 10 cm) did not show on mammo.
Comments
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I agree that GPs need to be better educated about ILC.
Interesting your onc talked about ILC manifesting itself on the nipple, lrsreyes--mine was actually up against the chest wall. Also, I'm premenopausal, so I wouldn't fit into the scenario you described. I think there's such a wide range of presentation of bc in general that it's very difficult for the docs to be on top of it 100% of the time.
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My onco basic description of lobular cancer is a flat spider web like tumor close to the chestwall but it manifests itself on the nipple. She drew a picture & had 3 arrows which was exactly what I had 2 years before DX. There were 3 "age" spots, darker than my areola, 10-cent sized. After I spread the word on my lobular cancer, a lot of women were worried about moles close to their breast so an onco nurse practitioner said that if there are any abnormalities close to the nipple then it is something to be worried about.
What I mean by postmenopausal is higher probability.
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Same here -- post-memo, HRT, clean mammos & u/s's -- until a suspicious area (actually a bit of ductal) showed up. That ductal turned out to be small component of or adjacent to a larger lobular lesion -- plus I had 3 smaller lobular lesions (multicentric disease). In the beginning, I was incredulous and angry that my bc, which was already in 1 node, hadn't been detected sooner. But the more I read here, the more I am grateful that it was found when it was.
I don't know what the answer is re. educating docs, but I think there's a huge information gap, especially with GPs, PCPs, and OB/GYNs -- not only when it comes to lobular, but to the more rare forms of bc, such as IBC. If anyone has any ideas re. how to influence a change, it's something I also think about a lot, because the status quo is beyond disappointing. Deanna
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lrsreyes, thanks for the clarification on the nipple thing. I didn't have any skin changes around there, either, but that's interesting. I did, however, have a sore spot of skin near my cleavage that wouldn't heal for months and months. I went to see a dermatologist b/c I was afraid it was skin cancer, and she actually had the audacity to say I was just healing slower b/c I was getting old (I was 38 at the time). She did pause at one point in the exam and ask if I'd had a mammogram (I'd just had my screening mammo, which was misread as OK, but I didn't know it then), so somewhere in her mind she was linking skin issues with bc. After surgery, the spot healed up just fine, so I'm sure it was related.
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2.1 cm tumor way up on upper inner section of left breast, tucked between skin and chest wall. Premenopausal, no age spots or freckles or sore spots or abnormalities close to the nipple or anything on the surface of my breasts at all in my case. Just a lump that felt like perhaps part of a rib, up outside the area that was mammogrammed for seven years. BCP's, not HRT. I am not aware that there are diagnostic tools that would point to ILC...
I do think that there is some relationship between a weak immune system and cancer - whether your immune system is weak and it allows cancer to grow or whether cancer weakens your immune system isn't clear to me - so I could see how there might be things like sores that don't heal properly or other odd immune system things present in a woman who also has breast cancer. So perhaps that's what's up with your spots???
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Kleenex ~ I agree with you that many, if not all, of us share some sort of problem with our immune system, and I'd always thought of it as a breakdown or weakness that allowed bc to develop. But there was an interesting thread here recently that questioned if what we have are possibly overactive immune systems. That theory was based partly on the observation that quite a few of us have at one time or another had other autoimmune conditions. And I think someone actually cited some research that also pointed towards an overactive immune system. Sorry I can't be more specific, but I'm going to look for that research link and will post it if I can find it.
The "age" type spots might be explained that way, too -- basically, our immune systems had gone awry and were attacking our own bodies, and those spots (mine looked more like tiny birth marks) were areas that were damaged in the process. Deanna
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Like many of you, I had years and years of mamograms that showed nothing, except they all noted that I had dense breast tissue. I found a tiny dimple on my R breast 4 months after one of these-- in my case useless-- mammograms. Ultrasound showed a 5.5cm tumor! I'm taking responsibility for making the decision to take HRT, but I'm so angry that my gyn nurse seemed clueless about ILC and how hard it is to detect on dense breast tissues. Don't you think they would want to take a closer look at dense breasts after writing 8 yrs of RX for HRT?
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My breasts are NOT dense ... the radiologist told me my mammograms were very easy to read. It still missed the ILC as did the u/s. How come no one tells us that mammograms totally miss this type of cancer. Everyone thinks that if a mammogram says everything is ok, then it is ok......but it's not!!
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I've been reading a lot about ILC and I haven't seen one article talking about these spots? Do you know where I can find some information about this?
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Hi Everyone,
Mine showed up in a mammogrm and ultrasound. I wonder why mine did and so many of you with ILC had mammograms that missed your tumors. My breast had become dense over the area but my doctor did not feel the tumor during my physical exam 2 weeks prior to the mammogram. It was difficult to feel because it was like a flat ridge just above the nipple. I'm really puzzled as to why mine showed up. I'm not complaining because it was found at Stage 1. I'm sorry so many of you weren't so lucky.
Roseann
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Hi everyone,
Mine ILC luckily formed a lump, which I found. Maybe the lump was the "ductile features" they found in there at surgery. Nothing ever showed up on a mammogram but dense breasts and no one ever told me that dense breasts were a problem. The tumor was found with ultrasound. I took HRT for way more than a decade. It seemed the logical doctor approved thing to do after a hysterectomy at 35. I also have an autoimmune disease, rheumatoid arthritis, kept in check with methotrexate. Are we forming a pattern yet?
All in all, I feel incredibly lucky to have found it at such an early stage, but kind of at a loss as to what to do to protect myself and my remaining breast now. My onc says that mammos are still the best thing we've got, and MRIs every two years. Not reassuring.
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how about mri every year instead of every 2 years. .... i agree ... not reassuring at all.
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No kidding!
Onc says they give too many false positives. That's not too reassuring either, but perhaps better than missing BC. I'm going in for my 'one year later' mammo and a ultrasound on a palpable lymph node in a few weeks. I will be watching to see if they are extra vigilant with me.
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I have of late been scaring friends with the information that "dense" breasts is a risk factor - that it's not just a statement of the condition of the tissue and that you may not sag as much but instead it may mean "we can't see a thing in here."
fortunate1 - good luck on your "one year later" mammo. I had my first follow-up mammo way too early - February after finishing radiation in Nov - and have since had a second one. They are VERY thorough, which is about as reassuring as things are going to get. The radiology techs mentioned that they almost never see anything in the first follow-ups - if things "come back," it's year two or three, and if not then, usually not until about 10 years out. Sort of reassuring on the EARLY end of things...I figure I'll push for an MRI at about year 2.
I think the best we can do, given that we really don't know a lot about what CAUSES this beast, is just to enjoy life as much as we can and treat our bodies well. Eat less crap (easier said than done for me!), exercise, etc.
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Ah yes, eat less crap and exercise more. The elusive goal. I will achieve it, really, I will. And I also will continue to scare my friends into self exams. My dense perky remaining breast is small and easy to examine, no where to hide.
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I have reading a lot of posts that Femara is better than chemo for ILC. One lady ( stage IV bone mets, entire spine & ribs covered with black stuff) posted that after 6 months of monthly Zometa & arimidex her scans showed NED. When I posted this under the Zometa thread, one lady(stage IV) said that it was the anti-hormonals not the Zometa.
Fortunate1- I see you are taking Femara. I am seeking advise because a friend of mine has LCIS(urged her to get MRI on other breast ) , simple mX for DCIS, taking Tamox , had ovarian issues.
I think Femara would give her better protection.
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Irsreyes- My ONC likes Femara. But he didn't tell me why. I'm menopausal, but I know that some take another AI first and then Femara. I hear of so many different treatments. I trust him.
You were good to your friend.
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Thanks for the reply. I will urge her again to take Femara because I read in the Tamoxifen thread that it can cause cysts in the ovary.
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I'm post menopausal and take Arimidex. No one has mentioned Femara. I'm not sure what my oncologist will do from here because my bone density test showed some issues with my left hip. They can't tell for sure because I have some arthritis in that area and it can give a false read for bone loss. Because I have TMJ, they are afraid to give me meds for bone loss as they can cause degeneration of the jaw bone. I may end up on alternative treatments as my only choice as I am 59 and don't want to spend my elder years as a hunch back. I started a thread about this and there are several others in the same position.
Rosann
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rreynolds1,
I wrote a couple of days ago because my diagnosis is almost exactly like yours and I am 58. My doctor has me on Femara and I have no SEs. I also have osteopenia, but am now taking 5,000 IU of VD and 1500 calcium. That's supposed to help.
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Iriseyes----the AIs (femara / aromasin / arimidex) are used for after an invasive bc-----they aren't approved for use with LCIS; only tamoxifen (pre or post meno) and evista (only post menopausal) are used preventatively for high risk. Only tamox for DCIS (I'm not sure if they use evista for DCIS or not). Have her talk with her doctor and see what is the best option for her. (I had ruptured ovarian cysts while on tamox, but it is a very uncommon occurence--a yearly transvaginal ultrasound to monitor both the uterine lining and the ovaries is a good practice.)
anne
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anne,
Thanks for the info. I have urged her to change her diet & sent her a list that the ladies in the "natural" group has compiled such as juicing, turmeric, green tea, vit D, more veggies & less animal fat etc.
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