Pleomorphic ILC

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  • cckim
    cckim Member Posts: 5
    edited June 2011

    Hi Fellow Pleomorphics.  I just found this site and am truly grateful for all the information.  I am 47 and was diagnosed in Oct, 2010 with PLC.  Had bilateral mastectomy Nov 1, 2010 - started AC X 4 and 12 weeks of Taxol.  Just recently finished Taxol.  Recently found out I have a BRCA 2 mutation and so now trying to decide on hysterectomy.  Anyone else with a BRCA 1 or 2 mutation?   

  • toomuch
    toomuch Member Posts: 901
    edited June 2011

    cckim-I did not have a BRCA mutation but I was diagnosed with PILC last July. I had my tubes and ovaries out in December after I finished AC/Taxol. I was in chemopause at the  time and have had almost no side effects. I haven't regretted my decision for a minute. Have you seen a gyn oncologist? I got opinions from 2 gyn oncs when making my decision and meeting with them really helped.

  • cckim
    cckim Member Posts: 5
    edited June 2011

    too much - thanks for responding.  Your diagnosis looks very similar to mine. I just had my first visit with a gyn-onc surgeon today.  She advised me to have a full hysterectomy due to the BRCA 2 mutation.  I am also in chemopause so I don't expect to have any additional side effects I haven't already experienced.  Are you now taking Tamoxifen or an aromatase inhibitor? My oncologist told me about the "SOFT Trial".  It is still ongoing but apparently will help answer the question if tamoxifen or an AI add any additional benefit for those who have had their ovaries removed.

  • sdisilvestri
    sdisilvestri Member Posts: 120
    edited June 2011

    Hi, I am Pleomorphic ILC but HER2+ which I understand is unusual for this.  I was also unusual in that I was Stage IV at first diagnosis with mets to liver and bones, but I am doing very well so far.  I understand that my particular combination of pathology does very well with Herceptin and so far I am finding that to be true.  Right now my liver is clean and has been for over a year, and my bones are "managed".  I am lucky that I have responded so well and hope I will continue to do so for a long time.

    I can't find anyone else on the Stage IV forum with this pathology, so I hope you don't mind me posting here!

  • amlg1
    amlg1 Member Posts: 596
    edited June 2011

    Suzanne,well I happen to be one of the unusual gals with ILC ER- PR- HER2+.When I first came on these board I had no idea that it was unusual.Usually ILC is ER+ PR+ HER-.I am the complete opposite.One of the members mentioned it to me,and I asked my onc.,and she did tell me it was unusual,when I asked her if she had any other patients withe the same,she said 1 other.Anna
    Diagnosis: 4/22/2009, ILC, 2cm, Stage IIIc, Grade 3, 31/34 nodes, ER-/PR-, HER2+

  • cckim
    cckim Member Posts: 5
    edited June 2011

    Suzanne, I am glad to hear you are doing well on Herceptin and glad you posted.  I pray for your continued success with this particular drug.  Do you also take Tamoxifen or an aromatase inhibitor such as Arimidex?

  • sdisilvestri
    sdisilvestri Member Posts: 120
    edited June 2011

    Thanks for the warm welcome!  

    So, Anna, did Herceptin work well for you too?  I hope so!

    cckim, I am on a clinical trial of T-DM1 so I cannot take anything else.  So far it has been my only treatment.  It is Herceptin chemically bonded with a chemo so it packs more punch than regular Herceptin with a side effect profile similar to that of Herceptin alone.  It has been a miracle drug for me. 

  • toomuch
    toomuch Member Posts: 901
    edited June 2011

    cckim-I am taking Arimidex and so far no bad side effects from it. I opted not to take Tamoxifen because I didn't want to worry about the uterine effect. My onc was comfortable with me taking either. What are you going to do?

  • cckim
    cckim Member Posts: 5
    edited June 2011

    toomuch - thanks for the info.  I have had an unusual turn of events.  I decided to take my post-op pathology report to a rad-onc at MD Anderson and it has now been recommended that I undergo radiation.  It's a long story but initially it was decided by a panel that I wouldn't need radiation. However my post-op report used words like "suspicious for lympho vascular invasion" and "extranodal extension" so I became a little worried bc I didn't understand it all. The rad-onc said a study that was recently published from Canada showed overall survival was better for those with 1-3 lymph nodes positive that had radiation vs those who didn't.  So here I go for radiation.  It seems to me that on one of your blogs you indicated you had gone through radiation.  Am I right?  I too would like to avoid Tamoxifen and take Arimidex for the same reason - uterine ca and blood clots.  If you had radiation, did you start Arimidex before radiation or did you wait until radiation was completed? 

  • toomuch
    toomuch Member Posts: 901
    edited June 2011

    cckim-I had extracapsular extension too. One of my path reports indicated pleomorphic ILC the 2nd just referred to it as Grade II. Did anyone mention pleomorphic to you?

    My RO knew the preliminary results from the study that was just presented at ASCO last summer and yes, I did have radiation. I had 3 field radiation: breast, axillary and supraclavicular nodes. And I had anterior and posterior beams to the axillary nodes to fully cover the area where the extracapsular extension occurred. I have LE in my breast and mild LE in my chest and arm but I haven't regretted the radiation.

    I would strongly encourage you to ask your BS or RO for a referral to a lymphedema therapist now. There is some thought that early intervention with LE exercises and manual lymphatic drainage can help to keep LE mild. It's also good to have baseline measurements so that even mild LE can be diagnosed early. Ofcourse, many women have radiation and don't develop LE but being proactive can only help!  After chemo the radiation seemed easy. Although the daily trips did drag my spirits down a bit. I started the Arimidex a few days after I finished radiation. My RO said that I could start it during rads but my MO preferred that I wait.

    When do you have your simulation?

  • amlg1
    amlg1 Member Posts: 596
    edited June 2011

    Suzanne...So far everything is A-OK.I do have to go for Brain MRI and Pet scan the end of the month.

  • sdisilvestri
    sdisilvestri Member Posts: 120
    edited June 2011

    Good luck with those!  it's brain scan time for me too.  Fun, fun, fun!  Glad you are being checked out so thoroughly and I hope you get nothing but clean results.

  • suzieq60
    suzieq60 Member Posts: 6,059
    edited June 2011

    Suzanne - I'm another of the few triple positive lobular gals on here. I'm so sorry you weren't diagnosed before it had spread - it's the most sneaky bc out there. I'm pleased to hear you are doing ok so far. It's great you can be in that trial - I hope it kicks it's butt. 

    I just had a brain MRI the other day for a totally unrelated reason, and hopefully the results will be good.

    cckim - I didn't start my Arimidex until a month after rads. My onc wanted me to wait to get over the radiation before starting it.

    Sue

  • Sherry56
    Sherry56 Member Posts: 6
    edited June 2011

    I have been diagnosed with Pleomorphic Lobular cancer. I was told last week that  they were not sure the chemo & radiation will help. And if the cancer comes back there is nothing they can do for me and that I would have a short life expectancy. My tumor was a 2.5 cm and est/pro positive and HER2 neg.  So not sure  what to think or feel. My first chemo treatment made me really sick and was hospitalized and they were considering stopping but instead  will reduce my next dose to see if I can tolerate it on 6/29. I have never felt so empty inside. Sherry

  • Gitane
    Gitane Member Posts: 1,885
    edited June 2011

    Hi Sherry,  Welcome to this very exclusive little club, the PleoPals I call them.  I want to say right off that whoever is saying you have a "short life expectancy" is oh, so wrong.  Nobody knows that.  I remember my pathologist telling me that NOBODY can tell you YOUR prognosis.  The science just isn't there yet.  There are statistics, but they're old, out-of-date, and there is no way to compare yourself as an individual to a group, it's just not possible.  

    If you have a low mitotic count (yours is the lowest, 1), an intermediate size of tumor (2.5), intermediate grade tumor (grade 2), very little nodal involvement (1 node only), and you have ER+PR+ (good chance to respond to endocrine therapy)  you have a good prognosis, period.  Chemo will improve that even further.

    It seems you have been posting for a month, but I only saw this tonight.  I'm sorry I didn't respond sooner.  You are having feelings like mine.  I remember when I was diagnosed I felt doomed and empty.  I felt like everything was kind of unreal.  

    I was 57 also when I was diagnosed.  I was especially scared because nobody's case was like mine (pleomorphic lobular). The drugs they give us, the surgeries, the trauma, really take a huge toll physically and emotionally.  Depression is not at all unusual.  I hope you will take heart.  We have been where you are, we have had those thoughts, too.  I have Grade 2 pleomorphic BC just like you. Mine is Stage IIb/IIIa.  There are others, here, too, like us.  When I found them it really helped me not to feel alone.  

    I obsessed, I admit it, and didn't handle the emotions all that well.  But you know what???  Nobody handles it all that well.  We are all scared, we all have melt downs, it's normal, and we get through treatment.  We s-l-o-w-l-y get our life together when the storm of tests, surgeries, treatments, etc. finally slows down.  The experience changes us, but don't be afraid of that.  You can do this, you really can.

    I read that you were wondering what to eat.  I met with a fantastic nutritionist and if you want to know more about what she told me, just PM me and I'll share.  You may want to ask to meet with someone yourself as things are probably different by now.

    Let us help you if we can.  Above all, just let yourself be yourself.  Your world has been turned upside-down, so why pretend otherwise.  It's O.K. to feel lousy and say so, and feel good a few minutes later.  I remember thinking I must be going crazy sometimes.  

    I bet others will be along, soon.

    Hugs,  G. 

  • cathmg
    cathmg Member Posts: 278
    edited June 2011

    Hi Sherry,

    I don't have too much to add to what Gitane said so well about the process and feelings of going through bc, but want to extend a cyber  hello and support. It seems that there isn't too much agreement about the course of pleomorphic ILC, but a lot of our oncs are a lot more positive about prognosis than your doc. My onc said that er+ and no nodes were more important than the pleomorphic aspect, and here I am at almost 3 years. Whatever our docs say carries so much weight, no wonder you are feeling so down. Also, the chemo wreaks havoc with your body, mind, and emotions. I had a MAJOR depression during treatment. I think it was as bad as the cancer. Please talk with your doctor if you're showing any signs of worsening depression.

    Hope you had a good day,

    Catherine 

  • sueinfl
    sueinfl Member Posts: 258
    edited June 2011

    Sherry, I can't add much to what Gitane and Catherine have already said, but my six rounds of Taxotere, Cytoxan and Adriamycin beat my tumor down from 5cm to 2.5cm. I've opted to wait on radiation and Arimidex as fall back treatments in the case of recurrance. So far, so good. The chemo was tough and it took a lot of drugs the first 10 days after each round to get me through. Depression was just the status quo. We are here to keep you company through this and, I hope, the next 30 or so years...

  • JulieGeek
    JulieGeek Member Posts: 3
    edited June 2011

    I'm 42. I'm PILC Stage 2A, triple positive and BRCA2 positive. Nobody has mentioned any concerns about the ability of surgery and chemo to return me to health in a semi-permanent sort of way. I also have rheumatoid arthritis.

    I was diagnosed in 12/2010; I had a bilateral mastectomy in 1/2011. I started chemo in 2/2011; I finished 4 rounds of AC and I'm halfway through 12 weeks of Taxol and Herceptin. I'll continue Herceptin, have a salipingnoophorectmy (my new favorite word--ovaries and uterus) later this Fall and probably go on an aromitase inhibitor. I've been blessed in that chemo had not hit me very hard at all. The hair's gone, but that's about it. Nausea was successfully managed with dextramethasone and Kytril pre-chemo and phenergan post-chemo.

    I've maintained my mental state by working, finishing up my MBA, and staying active in my church.I trust my doctors and I follow their instructions (um, mostly) given my own condition. I am looking forward to getting back to my regularly scheduled life (my husband and I are planning our 20th anniversary trip to Ireland), my newly reconstructed truly *EPIC* boob job (I look great!), and menopause (I've been praying for it since I was 13). I pray, I do a lot of deep breathing, I meditate, and I give thanks.

    My mom who passed from ovarian cancer in August last year was taking antidepressants during her treatment and I thought it was a "Heck yeah!" idea. You do what you gotta to get through this. Make sure your doc knows--mine told me "The only side effect we can't fix is the one we don't know about."

    You're in my prayers, Sherry.

  • AnacortesGirl
    AnacortesGirl Member Posts: 1,758
    edited June 2011

    Sherry,

    I hope you come back and let us know how you are doing.  I've got to agree with everyone above, your doc was wrong on his (hers?) stats and even with the stats, each of us are an individual and our lives are what they are.   In other words, I'm willing to put big money out there that your life will be much longer than what that doc is saying.

    Even with my path report my onc is telling me 75%.  He's being generous but he also knows me as a person so he factors in my 'tude. 

    Please let us know how you are doing.  Chemo is rough.  Getting a cancer dx is really, really rough.  We understand.  We aren't your casual aquaintances saying "I'm sure you'll be OK".  We're the women who live this stuff daily.

  • cckim
    cckim Member Posts: 5
    edited June 2011

    toomuch - hello.  I had my simulation done last week on the 16th.  I will actually begin radiation on Monday the 27th.  I have seen an LE therapist and have received a sleeve and exercises.  I do worry about pneumonitis.  Have you experienced this?  I am also concerned about my implant as I had immediate reconstruction following BLM.  Are you aware of anyone that received or is receiving radiation with implants?  I will have intermammary radiation in addition to supraclavicular and whole breast radiation.  Oh and yes my pathology report did indicate PILC.

    susieq58.  Thanks for your info.  I guess I will be waiting until after radiation to start hormonal therapy.  I understand the reasoning is to be able to determine which treatment is causing side effects occuring, if any.

    Sherry56 - I truly hope you receive encouragement from this site as I have.  There are quite a few of us with PILC.  Like others I have been told that the pleomorphic designation is not as important as the er/pr receptor status plus the node status.  I am a clinical pharmacist in a University setting and I spoke to the oncology pharmacists who confirmed the pleomorphic status is not a signifcant factor in prognosis.  I pray that you will tolerate your next chemo treatment.  I had trouble with a normal dose of Taxol and so we lowered the dose by 25% and I did fine.  I also want you to know that like you I have many days of feeling empty, lonely and scared but that is normal and we will get through this. Gitane is absolutely correct in saying no one can tell you what your prognosis is.  Hugs and prayers, Christina

  • toomuch
    toomuch Member Posts: 901
    edited June 2011

    Sherry - I am just seeing your post for the first time and I am so glad that some other pleo ladies have chimed in. When I first got my path report and saw pleomorphic ILC, I was freaked out. My oncologist told me that the pleo part wasn't as important as the size, grade, oncotype and number of nodes. I was skeptical so I sent my tumor to one of the top 3 cancer centers in the country and went for a 2nd opinion. My path report there didn't even mention pleomorphic. When I asked the oncologist there why, he reittereated that they didn't think that the pleo part was important. None of the 3 oncologists that I saw gave me a gloom and doom opinion. In fact, all three were optomistic.

    I see that you are from Iowa and it may be difficult for you to get a second opinion but if it's possible for you to travel for one, I would highly recommend it even now that you've started chemo.

    We've all had days filled with dispair but the journey really does get easier. I'm now almost a year out from diagnosis and I feel good. I don't know that I'll ever be able to put cancer behind me but the diagnosis doesn't consume me anymore. I'm enjoying my family and my job and I'm loving life!

    I hope that your next chemo round is easier then the last. Please check back in and let us know how you're doing.

  • toomuch
    toomuch Member Posts: 901
    edited June 2011

    cckim-I do not know anyone who had radiation with implants in place. I do know women who have had radiation with the expanders in place though. I had considered having a mastectomy with expander placement before my radiation and my RO told me that she had some women do fine after radiation with implants. She felt that upper extremity exercise to increase blood flow to the area during radiation was important in preventing complications. She suggested that I swim or kick box. I wore my sleeve to my radiation treatments and exercised daily throughout treatment. I did not develop limited range of motion in my arm so I think that the exercise helped.

    I hope that the radiation is easy for you. Moisturize a lot. It definitely helps prevent skin breakdown!

  • suzieq60
    suzieq60 Member Posts: 6,059
    edited June 2011

    cckim - the theory my onc told me was they like to give you a month to recover between treatments. So, rads were a month after chemo, and arimidex was a month after rads.

    Sherry - I'm another of the rare triple positive ILC girls on here - there a only a few - welcome.

    Sue

  • ChrissyG-Australia
    ChrissyG-Australia Member Posts: 9
    edited July 2011

    Hello everyone, I have been reading for a while and decided to 'jump in here'.  Last year in October 2010 I was diagnosed with PILC Multifocal Stage 3 Grade 3. I am ER+/PR+ and HER2+ - I didnt realise how 'unusal' this was, until now.  I have completed Chemo - TCH - 6 sessions - three weekly - and 25 sessions of radiation.  My burn is recovering nicely :)  I had a mastectomy in November and no reconstruction. Was advised against it until after radiation.    I am on Herceptin until about Xmas time but have refused to take Femara.  I live alone, (have friends and family) but I need to be able to work to survive and I want some quality of life now.  The side effects of this drug are too bad for me to even contemplate,  so I have been to see a cancer nutritionist/dietition and hopefully I can keep it at bay this way.  My Cancer markers are 'clear' whatever that means.  My Oncologist is not too 'forthcoming' with information - its like pulling teeth and I am a private patient !!  It seems to me that they dont want you to ask questions, just do as you are told.  Had enough of that when  I was married !!  Anyone else out there not taking the oestrogen blockers ? It was hard to make this choice, but I think its the right thing for me to do.  My oncologist did tell me that he has had others say 'no' and they are still alive, albeit for only a few years so far.

    Chrissy.

  • suzieq60
    suzieq60 Member Posts: 6,059
    edited July 2011

    Hi Chrissy - where are you in Oz? I'm in Brisbane. My onc was wonderful - he does actually listen to me and answers everything I ask. Sorry you are another one of the rare lot like me. How high were your hormone receptors? That would be the indicator of whether it's worth taking arimidex or tamoxifen. I was 90% and 95% - so it's a no brainer for me. Also, how old are you - ie have you been through menopause already? Arimidex is Ok to take - like taking the bc pill everyday.

    Anyway - welcome. There are some very lovely ladies on this board.

    Sue

  • ChrissyG-Australia
    ChrissyG-Australia Member Posts: 9
    edited July 2011

    Hi Sue, I live in Hervey Bay (QLD) and I have just turned 56 - Wooohooo ! Well, anyway, at least I'm still alive.  I think my receptors were 100/80 but not sure about that, my doctors are very vague and just dont like questions.  I am seeing the breast surgeon on 21 July at Greenslopes Hospital and I want some more answers.  I dont like being 'patted' on the head and told to 'just get on with my life'

    chrissy

    PS yes been through menopause started at 41 finished about 50 - hysterectomy at 45 - but still have my ovaries.  They dont want to take them out, say they are not 'working' anyway.

  • suzieq60
    suzieq60 Member Posts: 6,059
    edited July 2011

    I'm 58 - just turned 57 when diagnosed. Where did you have your chemo and who is your oncologist? If your receptors were that high, then you would really benefit from taking Arimidex, if you are post menopausal. Keep asking your questions!!!

  • ChrissyG-Australia
    ChrissyG-Australia Member Posts: 9
    edited July 2011

    Do you have any side effects from the Arimidex ? My main concern with Femara is Osteoporosis and loosing my hair - again - and these side effects can be PERMANENT.  There are heaps of other side effects.

     Originally my oncologist was a Dr Albert Gan - in Western Australia.  I went to WA and stayed with my sister as I live alone and there is no private hospital offering oncology in Hervey Bay.  He was okay but really hated me asking questions.  When I finished Chemo (five months later) I flew back to Brisbane and then onto Hervey Bay.  Two weeks later I was back in Brisbane (May just gone) for my radiation at Wesley. Premion Cancer Care.  This was okay, although I did get a rather nasty burn, but its healing okay.

    Dr Keith Horwood took over my oncology at Greenslopes (my original diagnosis, breast surgeon and surgery where performed there in October last year) for the last couple of months.  Now I have decided to stop all the travel and just let myself be 'at home' whatever that means.  Not sure where home is anymore.  Tomorrow I will be having Herceptin number 10 or 11 (not sure) at the Hervey Bay Hospital.  I will be a public patient for the first time through this whole thing.  Hopefully this goes okay.  I will be seeing another oncologist (visiting) by the name of Doctor Alison Hadley.  I hope she is nice and I can talk to her.  Maybe she will finally answer all my questions.

    Chrissy

  • suzieq60
    suzieq60 Member Posts: 6,059
    edited July 2011

    Hi Chrissy - sorry - had to go and watch the Amazing Race - I just love it!!!

    You really are at a disadvantage for treatment up there - lucky you can have your herceptin locally at least. I went to Premion at Chermside for rads. Did you have Marie Burke as your rad onc? My oncologist is David Grimes here in Brisbane - he treated my husband for bowel cancer years ago, so it was good to already know someone good.

    I have arthritis anyway, but am not really suffering more from taking Arimidex. I also have Zometa infusions to protect my bones. No hair loss at all, in fact it's thicker since finishing the herceptin last December. I didn't think hair loss was an SE of the hormone drugs.

    Good luck with the new oncologist!!!

    Sue

  • hmh23
    hmh23 Member Posts: 306
    edited July 2011

    Sherry56;  Get a new Oncologist!!!!  I can't believe he/she said that to you. Sorry you were so sick after chemo.  Ask your onc for additional pre meds and take your anti-nausea drugs as soon as your get home from treatment.  Dream of Wellness!!!!  Heather

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