Pleomorphic ILC - Freaking Out
I was just diagnosed with Pleomorphic ILC - it's pretty large - have to have needle biopsy of 2 "suspicious" nodes that showed up on Breast MRI last week. Dr says they are small - whatever that means. Everything I read (which is probably way too much time on the Internet) leads me to believe that this Pleomorphic variety means I don't have too long left. Still waiting for my Oncotype test - Grade is 2, Estrogen & Progesterone highly positive - but another potion of the Biopsy (forget what it's called) is very high (40). Chest X-ray and bloodwork so far are normal. Dr says it is "Very very highly likely he can cure me" as he puts it - but after reading the negative Pleomorphic info - I'm really scared now. I know I need to buck up - most of the time I feel like that but right now i just want to run away somewhere and forget that this is happening. Sorry to whine - just need to vent. Thanks, guys -
Comments
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Racemom, I'm so sorry about the Pleomorphic ILC. It seems the BS is very positive. I don't know much about this kind of ILC, but as I understand it you're more than likely going to get a higher Oncotype number.
I'm sure someone will come along soon who will be able to give you more info. There is a group of ladies who have Pheomorphic ILC that are active on this board.
Don't be sorry you have every right to whine-vent.
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Don't freak out - pleomorphic ILC puts you in the same category as IDC. Grade 2 is good - I was grade 3 and HER2+ve. ILC is less invasive than IDC but the pleomorphic classification makes it the same as IDC. Being highly hormone receptive is good too, as you can take hormone treatment for it. I was 90 and 95%. Wait until you know if it's HER2+ve - likely you aren't, as we are a special very small group of ladies. If you are, then herceptin is there for that - I've only got 2 herceptin treatments to go.
Feel free to ask us anything we are all here for you.
Sue
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My onc told me the PILC is no worse than a Grade 3 IDC.
I'd freaked out when I'd read the PILC literature when first diagnosed as well, but most of it is old, and it's not clear if all PILC is highly aggressive or just the ones that are HER2+. And like Sue said, if you are HER2+, there's Herceptin for that, which wasn't available when most of the studies in the literature were done.
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Racemom,
I know just how you feel. I was diagnosed with Pleomorphic ILC in July. I also read too much and was totally freaked out. I sent my slides to Johns Hopkins for a 2nd opinion because the first pathologist didn't grade it. It came back Grade 2, no mention of pleomorphic and my Oncotype is 12. There are other pleos on the boards with low oncotypes too. My oncologist thinks that I had my 2 positive nodes because of the pleo status but once treatment started he told me not that it wasn't relavent. I saw an oncologist at Hopkins and asked why no mention of pleo on path report there and he said because we think that the grade, size of tumor, node status, and hormone status are all more important. So, take a deep breath and know that the hardest part is waiting for more information and a plan. We are here for you for information and support.
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Hi Racemom,
I'm sorry you are going through this nightmare called breastcancer. All your scared feelings are normal. You have found a good place for support in this site-I wish I had known about it when I was first diagnosed. There is a lot of scary (old) info on the net re. pleomorphic ILC-best to leave that alone.
There is a whole thread devoted to Pleomorphic Lobular-there are quite a few of us. Like too much said, the whole pathology picture is taken into account, not just the fact that the cells were pleomorphic.
I am 2 years out-hang in there, you will have a treatment plan in place soon and will be taking action to get rid of the cancer!
Cat
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I just recently read my pathology report again figuring now that I know more about cancer I'd understand it better. Imagine my surprise when I caught the word pleomorphic ILC. Yikes!!
Luckily I was seeing the Onco next day. (I've already gone through chemo and just finished Herception) I asked her about it and what were my chances of survival. She said don't worry about pleomorphic. Doesn't change your chance of survival. Everything's fine. Quit worrying. So that's what I'm going to do. Won't help anyway. One thing though---in my opinion, if you have an option of chemo or not...do chemo.
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Shelley - pleomorphic becomes irrelevant when you are special like you and I. The HER2+ve reading takes over everything else. Thank God for herceptin!!!
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Thanks for the support from everyone. Well, I went in yesterday for the needle biopsy of the 2 suspicious lymph nodes that showed on the MRI last week and after the technician AND the radiologist took the ultrasound they both concluded that all the lymph glands they could see looked normal! So I didn't have to have the biopsy and they sent the report to my Doctor that the lymph nodes looked normal! That was definitely an answer to prayer. Then later in the day my Doctors office called to say that the HER results came in inconclusive but my Doctor said that's leaning toward positive. They are going to do more testing - results in a few days. Also, still waiting for the Oncotype test. I also found out that the MRI speculated my mass as 9 centimeters! I'm holding on to the "all lymph nodes look normal" statement. I've listed all the info I have so far below - looking for the miracle that I won't have to have chemo.
Diagnosis: 10/25/10,Pleomorphic ILC,Grade 2, ER+ PR+
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Racemom,
I just sent you a private message.
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Racemom, for what it's worth, my preop MRI showed my tumor at 4.8cm, when in reality it was 2.7cm. So maybe your 9cm will turn out to be smaller as well.
Good news on the nodes!
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racemom, Great news about those nodes looking normal on MRI. This is such a drawn out process, with lots of ups and downs. Hang in there. G.
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racemom, Good news the nodes look normal. Hang in there, everything takes so long. Good luck with the onco test.
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Thanks for the support everyone - I'll let you know when I get more test results. Take care -
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Glad to see a lot of quick responses on the pleomorphic dx and how those studies out there are old. I went through the exact same fears when I found out that I was grade 3 and pleomorphic. But my onc also told me that the other factors drive the treatment and are more pertinent to the prognosis.
Clear lymph nodes is HUGE! Congratulations on that and I hope you continue to get encouraging news. Waiting is lousy but knowing exactly what you have to deal with makes it all worth it. Hang in there.
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Thanks for everyone's encouragement - just talked to Dr's office and they did a second stain on my HER2 test and the results are negative. I feel very thankful for that - now we just wait for the Oncotype score. I'm sending positive thoughts for each of you -
Diagnosis: 10/25/10,Pleomorphic ILC,Grade 2,ER+,PR+,HER2-
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racemom, glad your HER2 test cme back negative. Keep us updated on the onco score.
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I will, Kira - thanks and take care
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Great news!!!!
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racemom - My preop MRI showed tumour 2.5cm. Post op path report said 1.2cm for the main mass extending to 2cm with extensive LCIS 95% outside to 2.5cm. So the original 2.5cm measurement included the LCIS and my invasive tumour size was officially 2cm.
The details of your grade score will have a bearing on chemo decision too. Eg my onc explained that even though my cancer cells were abnormal and so got the pleomorphic description (and a score of 2 which eventually bumped my Elston/Ellis up to Grade 2), the main factor for him when making decisions about chemo was the mitotic score (how fast the cells were dividing). Mine was only 1 so it was not fast growing and he said chemo would not be very effective for me as it targets fast growing cells. I chose to go straight onto Hormone Therapy as my cells were very strongly ER90%/PR80% + which meant most of them used estrogen or progesteron as fuel to grow. The HT drugs either block the estrogen from getting to any rogue cells or by stopping the body from producing estrogen. The theory is that over 5 years any cells 'hiding' anywhere will shrivel and die when they are starved of estrogen.
And great news about no nodes and HER2-.
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I don't have to have chemo!! My onco score was 19 (12% chance of reoccurrence) - Dr doesn't feel I need it now. I'm waiting for them to let me know when my masectomy is - now I can worry about that! Then radiation and hormones. But I am very grateful for no chemo. Raeinnz - my miotic score was 1 also - guess we have that in common. . . . .! I'll post my masectomy date when I find out - you guys are great for support and advice. Thanks.
Diagnosis: 10/25/10,Pleomorphic ILC,Grade 2,ER+PR+,HER2-
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Congratulations on not needing chemo. I hope the hormones and radiation kick it in the butt and it never returns:)
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racemom - yahoo!!! no chemo. I had bmx with recon - let me know if I can help with any info.
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racemon, congrats in not needing chemo.
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Finally got my surgery date - not until December 8! Geez, that's 7 weeks since my biopsy! I know they keep telling us that it's been in your body for years and a few weeks won't make a difference, but I keep thinking that the quicker we get it out of there, the less likely it is to move to my nodes. I'm having a right breast masectomy, no reconstruction and a Sentinel Node Biopsy. The day before they inject my breast with some kind of dye. I'm scared but holding up well since it's 3 weeks away. How bad is post masectomy discomfort? I'm not a wimp, but I don't want to take anything stronger than ibruprofen any longer than I have to. I'm determined to feel good before Christmas!! I still feel kind of like I'm watching a TV movie and everything isn't real - I guess because I haven't had to have chemo so nothings really been done yet except tests.
You ladies are a wealth of info and I'm so glad I found this site. Take care-
Diagnosis: 10/25/10,Pleomorphic ILC,6+cm,Grade 2,ER+PR+,HER2-,Onco 19
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I remember well the feeling of walking around knowing I had cancer in breast and just wanting it out. It sucks.
I had neoadjuvant chemo and was pretty worn down by the time my surgery date came around. The cancer side was a modified radical which meant the lymph nodes were removed but the right was just a total mast and they didn't touch the nodes. So my experience is probably different than yours will be.
However, surgery wasn't that bad. I did take the pain meds (oxycodone) on a regular schedule for the first 3-4 days and then I was able to cut back. But I still took them for a total of two weeks. I'm guessing you'll be able to less than that if it's a single with no nodes. Do what feels right. I needed them to be able to move freely without pain (specially the left arm) and the sooner you can get moving the better. The first week was amazing how quickly I started feeling better. The second week wasn't as dramatic but still felt stronger everyday. But the third week I felt like I was stalled out in the healing. My surgeon told me that the chemo was going to slow down the healing process and I think that's what happened.
I'm going to guess that you'll feel pretty good the third week. Hopefully someone with a closer situation chimes in.
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Thanks for the info, AnacortesGirl - I'm ready just to get this done! Hope you're doing well.
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I saw your post and it so reminded me of myself seven years ago that I felt I had to respond. I was dx with lobular pleomorphic seven years ago this week. Lymph node involvement, her2 negative, 2.5 cm. I totally freaked out when I read all the data as well. The truth is though that after the chemo, radiation and lumpectomy, I am still here. I was 44 then, now 51. I don't know what the future holds but I do know that the data on the studies are ancient and not based in modern medical reality. Women with more positive lymph nodes than I are doing great many years out. Just hand tight, do your treatment and I know that years from now you too will be writing a post like this to another finding themselves in this same position.
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MJAfromMass - thanks for the post. My surgeon was 'very concerned' when my pathology came back pleomorphic. Because it is rare and we are such a small number of patients in NZ he had not come across it before and sent me off to see 'the best BC onc in the country'. Needless to say I was pertified by the time I got there expecting the worst news. Onc however assured me it made no difference at my stage and grade and said I had about the best prognosis BC there was. What a relief. Glad to hear you are doing well 7 years out.
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MJAfromMass - thanks so much for your post, I really need all the reassurance I can get! It helps alot to read success stories - we all need that. Well, 11 days until my surgery and I've strained my shoulder and lower back some (probably lifting my grandson too much). I'm now trying to baby it so I'll feel ok by the time surgery is here. I certainly don't need to have pain in my shoulder and back going into surgery. I know that they tell you not to take any aspirin or painkillers 2 weeks before surgery - but I hope it won't hurt to take a couple of ibruprofen a day for the next 2 or 3 days for the strain and muscle spasms. Good timing, huh?!
Take care, girls - hope everyone had a great Thanksgiving!
Diagnosis: 10/25/10,Pleomorphic ILC,6+cm,Grade 2,ER+,PR+,HER2-,Onco 19
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Racemom - sorry to hear about your strained back and neck. Just keep your eyes on the prize - believe me, there is light at the end. The fact you are not her2 positive makes your pronosis the same as the average, garden variety grade 2 ductal. The pleomorphic does not hurt you. I will tell you though, that I have read that the women with pleomorphic and her2 positive have the BEST responses to herceptin of any type of breast cancer. Truly remarkable. Keep your chin up!
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