The most normal spread of ILC? % recurrence in other breast?
I hate the fact that ILC is so sneaky and am not getting any ILC specific info over here at all despite asking - what is the most typical kind of spread for ILC please? (not that I really want to know but I need to know what to look out for) .....
I was told I have 80% chance of cancer in my only breast as I´ve had it once and was stage 3.....is this true?
Its New Years DAy and all I can think about it how different it is to last year, I feel condemned to a life of cancer which for me is no life..........yet right now as far as I know I am well, but soooo tired all the time, did not have chemo, finished radiotherapy end of September, on letrozole for 6 months now, tired of feeling tired, and of not feeling like me anymore on any level....
Comments
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Hi,
You do sound tired-which is normal. I found that it took me a whle to really recover my energy from radiation... but it will come back, I promise. Have you tried to take the letrozole at night? that seemed to help me in the sleep and joint pain department--really changed how I felt.
As for your recurrence question--- I too have read that ILC can come back in the other breast. At each oncology appointment (every 6 months) I ask my oncologist about this (Dana Farber) and she says that it is very unlikely. I had a lumpectomy in 2008.
I think everyone has different information on this-- and it is hard to find out the "real"information in the breast cancer world, because it changes so frequently.
This may or may not be helpful, but I honestly found that it took me almost two years from the end of my treatment (lumpectomy, chemo and radiation) to feel like myself againg. The good news, is that I do feel like myself, better than myself and I don't think about breast cancer most days (just this week because I have an oncology appointment!). But once it is over, I don't think about it again until the next appointment. You will get there.... it is just still early for you.....
Here is hoping for a better year this year!!!
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How did you get that 80% number? It sounds very high.
As far as I know, 70% of distant recurrence is in the bones. Don't remember where I saw that, but it was in a medical article that I saw recently.
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80% was from the Radiotherapy Consultant and the Oncologist, both said the same thing.......
THanks Momine - that seems to make lobular more deadly than other cancers then? How do we tell if it is in the bones and differentiate it from hormone treatment induced damage or aches and pains?
I though lobular was a "better" cancer to have but am now realising just how sneaky and hard to detect it is in terms of spread.....
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Lily55, if you are concerned about aches in the bones talk to your Onc. I know mine wants to know any changes like bone pain that I might have. Did you have all the scans run at the time the cancer was found? I'm stage 1 ao no scans for me, but I do have the tumor markers done at each visit.
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No, why more deadly? I did NOT say that 70% of patients recur, I said that of those who DO recur, 70% of those recurrences are in the bones.
I am still confused about that 80% recurrence in the other breast. I remember much lower numbers for that. If it were 80%, the docs would be far more eager to do BMXs. I think there must have been some sort of crossed wires there.
What kind of follow-up care are you getting?
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Lily, Did you have chemo? I know my Dr. told me ILC is more likely than other BC's to affect both breasts, but not 80% of the time. As far as going to the bones I agree with Momine 70% of the time if it spreads outside of the breasts the bones is the most likely place. If you go to cancermath.net you can run your stats to get a good idea of your risks.
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THanks - I had bone scan done but did not have chemo..........I did check it with them to be sure I understood correctly and their exact words were I am 4 times more than the normal risk of getting it, normal risk is 20%, times 4 is 80%...
Sorry I misunderstood - so how many people do get recurrence then on average - anyone know? As its normally so hormone sensitive I thought those with lobular had better chances so long as we take the hormone blockers....
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This is what my cancermath report said....not very good.....T3, N2, pN2A IIIA
Shortens my life by 12.7 years but there is nearly 56% expected death rate from cancer by year 15...............with hormone therapy I gain 4 years apparently and if I had accepted chemo it would have been a 7% benefit over 15 years........for me with the additional risks that I have of chemo it was not worth it..........
That has not cheered me up....as its clear much much higher chance of dying from cancer than not
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Lily55, I sorry but I'm afraid what you're seeing is what cancermath says. But remember not everyone get it back. You had 7 nodes positive though. I know in my case chemo wa ssuggested for me, and I was node negative with a very small tumor.
There are many things you can do that isn't taken into account when Dr.s run these stats. I know my Onc. believes exercise is just as important as the meds. He encourages all his patients to take advantage of the free exercise classes the YMCA offeres cancer patients. The other peice is diet and suppliments.
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Lily, why did you not have chemo? Was that your choice? Also, are you possibly in the UK? Deanna
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Kira - thank you, yes I know and its 5 years out of date - I do the exercise, not always every day but I do it and did right from diagnosis (Zumba 3 to 4 times per week at least) and I plan to try and walk every day I do not do Zumba, I take supplements, have dropped nearly all dairy (apart from butter and a little drop of milk in tea) and am working on getting to the best diet, don´t eat meat anyway.......
I was told I needed chemo but I refused it as statistics were not enough of a benefit for me given my much higher risk of side effects and serious organ damage as a result of other health conditions and drug allergies/intolerances.
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Are you handling the Femara ok then? I can understand the other health issues. Sometimes we have to do what we feel is right at the time, and just not look back but rather look ahead!
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Lily, learning to live a new normal beyond bc takes time. For many of us, it took a good couple of years to get beyond the all encompassing daily fear you have now. It's a process you have to go through -- examining all the stats, etc. -- and I don't think anyone can short circuit it for you. But Kira is right. We can't second guess the decisions we've made about tx, and we just have to move forward, so that we don't continue to be victims.
One thing that helped me a lot is coming to the realization that if I worried all the time about a recurrence and it never happened, then I would have wasted all those days I should have been happy. And if, God forbid, it did happen, then I still would have wasted all those good days before it did. So my advice is to read whatever stats you still need to read and absorb about your situation, but also realize that either you will have a recurrence or you won't -- and all the stats in the world won't make a bit of difference either way.
IMO, the best things we can do post-tx is to strengthen our bodies to hopefully prevent a recurrence, or to deal with one if it happens, in which case it was probably genetic and unavoidable if we've done everything we can in the way of getting healthy and strong. (((Hugs))) Deanna
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Lily, I am so sorry you have a new normal.
I still remember the day I got the call that my biopsy was cancer. I don't think anyone touched by cancer is ever the same, but that does not mean you cannot have a full and meaningful life.
Give yourself time to grieve the loss of your old self. I too was dx in April (but in 2007). I remember thinking I would never make it to Thanksgiving. This april will be 6 years. It goes quickly.
I don't think any of us can totally let go of reading the research and checking the statistics. We all want the nugget of information that will give us reassurance and a promise for a long life.
Cancer is a crap shoot. If statistics were correct, and if doctors KNEW about cancer, then many of us would not be here.....eat right, exercise, have x-amount of kids, breast feed, less stress, blah, blah, blah. How many of us did it all right and are still here?? This goes to show that statistics can show a trend, but they cannot and should NOT define us! We are all individuals and how we respond and what our future holds is as unique as we are.
I have read about patients who were given months and are still alive and I have had friends who were told it was "all gone," only to find out that was not the case.
Intelligent discection of the information that continues to be produced can be helpful but even the worst of the worst statistics or reports should not be taken to heart. What if we are the ones that fall out of that range? That is what I tell myself. I should never have gotten it so maybe it will never come back

I do have days where the thought, worry and fear of it all comes woooshing back, but most of the time, I try and live my life as if I never had the diagnosis.
Life is short. No one is promised tomorrow. We are all going to die---it is just a matter of when and from what. When I look at it that way, I realize I am not really any more special or different from the next person.
Try to enjoy all the years ahead of you....and assume they will be long and beautiful.
Who knows, tomorrow may hold a cure!
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Thank you - I would cope a lot better if I had a reconstruction as I am soooo miserable like this lop sided and really sore and limited.........and it reminds me every day, in fact the physical side at present reminds me constantly......prior to rads I was feeling a lot better and able to forget about it much easier...........
I have only done these statistics now, not addicted to them as they are only based on standard treatments and we are all individual and I see cancer as a systemic disease so my system is down to me........ and I would make the same decision again as I know that was right for me.
I wish I could take Femara, only get the generic version and every month its a different brand so I never get in to a rhythm of the drug - I get REALLY cold shivers though and then when i am really cold I can get so hot I need to strip off........is this typical? I find if i do Zumba regularly I get less joint pain.
I do feel I am grieving and I don´t like the new me at all, I feel I have totally lost who I was.........
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Lily55, Your feelings of grieving are very normal. It's over 2 years for me now, and I will say that first year was very hard for me. I will never be the person I was before, but in many ways I like the new me much more than the old me.
As far as the hot flashes we all have them. One minute I'm so hot and dripping all over, and then comes the cold feeling. I also found the Femara symptoms changed with each one of the generics sent.
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Generic versions of medicine should be fine.
Tamoxifen is a generic. I had anastrazole, which is a generic for arimidex ($400/month vs. $60/3-months).
Many gals here are generic. The cold-flash/hot-flash means your estrogen is dropping...good thing.
I often wondered if I should have switched the AI's versus sticking to just one.
Julia Child had a mastectomy (left breast) and nothing more...no chemo, no rads, no drugs (none available at the time)....she died a month shy of 94.
Even IF you should get a recurrence in the other breast, that is considered either a primary or a local recurrence and your suvival does not change.
Give yourself permission to grieve and then time to heal....
I did yoga years before dx and I swear it helped me through the ordeal. I was on no pain meds even immediately after surgery (my surgeon was very upset that I was not taking anything)....but I grieved and felt lost. There are days when I look down and miss the breasts I had (I had beautiful D-cups that were very sexually responsive)...and then I try not to let it define me.
My husband is kind and thoughtful and he even said I looked less matronally and younger!!
You will look back in a year and feel differently...2 years, even more different....give yourself the time.
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I don 't know what is normal for all with ILC as we allreact to everything so differently. Was originally dx in 2002 with ILC in the left breast - (luckily, easily detected by mammo. and Uultrasoundnd so went with a mastectomy,immediate TRAM reconstruction and CMF chemotherapy. I had two oncologiists tell me I was originally"cured". huh? When did it happen that cancer is cured?? After chemotherapy, onto 3 years of tamox.,2 years of Femara. After being seen monthly, that time extended to once annually. Fast forward to 2010. Hmmm, something not feeling right - couldn't eat much at all (early satiety) soon I go for a CT where the lights blazed brightly throughout bones, peritoneum and of all weird places the most involved for me - the stomach. My limited knowledge of ILC is that popular areas prefer recurrance in the lower abdominal areas, certainly not true for everyone. Later scans reveal that my best scans are from MRI's as now my cancer shows up as in sheets rather a lump. My MO told me last week that she felt popular was slower growing but harder to see on scans.
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I still think something is majorly off with that 80%, but not sure what they told you. I suspect that they were telling you that you had 4X the normal chance of contralateral recurrence, not 4X the risk of BC generally. Where are you?
Here is what I found:
"Patients should continue to have regular breast physical examinations and mammography to detect either recurrence in the ipsilateral breast in those patients treated with breast-conserving surgery or a second primary cancer in the contralateral breast.[27] The risk of a primary breast cancer in the contralateral breast is approximately 1% per year.[28,29] Patient age younger than 55 years at the time of diagnosis or lobular tumor histology appear to increase this risk to 1.5%.[30] The development of a contralateral breast cancer is associated with an increased risk of distant recurrence.[31,32]" http://www.cancer.gov/cancertopics/pdq/treatment/breast/healthprofessional/page1#Section_8
So even if you are 4X the normal risk because of lack of chemo or whatever, that would make your risk 6%, not 80. That is a fair difference

Also, going by your stats in your siggy, I get different numbers out of cancermath, but not sure where the difference is. As far as I can see you would have gained major advantage from chemo, theoretically anyway.
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Some up to date research on ILC confirming the abdominal site as mets recurrence more prevalent in ILC
http://cancerres.aacrjournals.org/cgi/content/short/72/24_MeetingAbstracts/P3-07-11?rss=1
and new figures in one study on the contralateral recurrence risk
http://www.docguide.com/invasive-lobular-breast-cancer-does-not-boost-risk-contralateral-disease -
Some data on outcome comparison between ILC and IDC
http://foodforbreastcancer.com/news/lobular-breast-cancer-has-less-favorable-prognosis-than-expected -
Apart from cancermath you may like this tool, too, it's not as detailed but it may serve as a comparison.
http://www.predict.nhs.uk/predict.shtml -
Lilly, I was thinking about you today, hoping you're feeling a bit more optomistic than the day you started this thread. I don't recall if it was mentioned above, but one thing that might be reassuring to you is something my BS now does (I had both IDC & ILC), which are bi-yearly breast MRI's. Of course, none of us ever wants to contemplate a contralateral bc, but with regular MRI's, if they do happen, they can be picked up extremely early, which should be reassuring to you if your BS will order MRIs for you with some regularity.
Just wanted to share this thought, which I hope might ease your mind a bit. (((Hugs))) Deanna
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Hi Deanna
THank you, I do feel a little bit better but nothing has changed....I have asked for yearly MRI´s but they have refused........I am going to pay for a thermograph but cannot pay for an MRI privately.....I hope the oncologist will change his mind soon as I KNOW I need regular MRI to check for spread or contra lateral disease.........
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Hi, Lily! Hmmm... if you're not happy with your planned followup, is there a possibility you could find a new oncologist? Just because you're finished with your active tx doesn't mean you have to keep an onc whose follow up protocol leaves you uncomfortable or worried. Just an idea... Deanna
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Hi Deanna - Part of my depression is because I do not trust the Onc and have tried but am not entitled to change at all, have to stick with the one part time oncologist allocated to my area.....only way of changing that is to move house and get under a different hospital - not so easy to do but my house is up for sale!!
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Wow, that's horrible. Are you in the US? If so, there are laws and procedures that should give you access to what you're not getting. I'm not up on them, but others on BCO have successfully fought insurance companies for access to out-of-network providers, and I'll be glad to help you find that info.
And something else you said above has also been on my mind... "I would cope a lot better if I had a reconstruction as I am soooo miserable like this..."
Is that decision irrevocable for some reason? Deanna
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Lily, I was diagnosed stage 3 ILC in 2004. At the time, my onc told me ILC can be bilateral in about 30% of cases. Because I was so advanced at dx I chose to have a bilateral mastectomy and sure enough I had areas of LCIS throughout the "good" breast that were not detected by mammo, ultrasound or breast MRI. My breast surgeon and onc both told me I made the right decision.
This is a very hard journey. I am sorry you are dealing with doctors you don't trust.
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NoMoreMeh, that was my situation as well.
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Deanna, the downside to universal healthcare is that there is usually just one treatment option available for each disease stage/situation. The refusal to do elective BMX, for example, is fairly common, since standard of care says that it does not confer advantage, medically speaking. It is like being insured by a really hard-assed HMO in the US basically.
In Denmark (Lily is from Spain, but I am Danish) there is private insurance and hospitals, but the private system is not very built up and typically does elective and/or non-emergency procedures like boob jobs and knee replacements. If you need cancer treatment, your only option is the public system and there is exactly one cancer center for the entire country.
Here in Greece (where I live), the public system is currently in disarray, but there is far more choice and flexibility even within the public system and also an extensive and fully fledged parallel private system (in which I was treated).
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