nuclear pleomorphism score??
My diagnosis is infiltrating lobular carcinoma, grade IIa, 4 cm tumor. The details give a nuclear pleomorphism score of 2. Does this mean I am pleomorphic?
Comments
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Rayhope,
Not necessarily-- Do you have a copy of your pathology report?? You need more info -- Nuclear grade is different than the subtype-- looking at my pathology report it was described as invasive lobular carcinoma, pleomorphic type--it then described the grade as a level two.
If it is Pleomorphic... ask your oncologist what this means... I personally received much shrugging of the shoulders as far as prognosis and difference from classic
Great news on no nodes-- How were you HER2+ tested... ICH?? Consider requesting the Oncotype dx notwithstanding the size of your tumour --- it also tests for Her2 now
Lobular tumours tend to be larger for a number of reasons here are 2--...1. harder to detect (which certainly happened in your case) and 2. the shape of the tumour tends to be ameoba like not a nice little oval -- so measurement actually is oversized.
Hang in there
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Path report states:
Tumor markers analyzed on VIAS:
The invasive tumor is positive for estrogen receptors.
The invasive tumor is positive for progesterone receptors.
The invasive tumor is positive (3+) for HER-2/NEU AMPLIFICATION
The breast surgeon mentioned the positive HER-2 as meaning cancer is more aggressive. That's really all I know at this time. Should have more info after appt with medical oncologist this Thursday.
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rayhope, I don't know that you have pleomorphic lobular unless it says "with pleomorphic features" or "with features of pleomorphic lobular carcinoma". Pleomorphic is a subtype of lobular. The nuclear pleomorphism is just that, part of the grading of the cells, not a cancer phenotype.
I have read some old studies where anyone with Grade 2 or 3 ILC was called pleomorphic lobular because classic lobular is usually grade 1.
A newer study I read recently is looking at genetics of lobular. They have divided it into "classical" and "other" and seem to feel that half of ILC cases fall into each category. Pleomorphic is within the "other" category. They are finding that the "other" type of ILC is more prevalent than they thought, but isn't always obviously pleomorphic, so not so easy to identify without gene testing. I think it's important to know this, because it could just be that the "other" category of ILC might benefit more from chemotherapy than the "classical". I hope they do more of this research; it could really help the ILC women make treatment decisions.
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"Ask and ye shall receive"!
http://m.oncologystat.com/index.html#snippet
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I can't find the link, can you repost?
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mattscot - I have actually wondered about the sizing of lobular tumors. Because they tend to spread out and be more flat, I wonder if you took my 9 CM tumor and balled it up like an IDC tumor what size it would be?
Not that it really makes any difference, but it is the size of my tumor that makes me a IIIA - not my two positive nodes.

Cyndi
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