ILC 40s Node Negative - Did I make the right decisions?
Diagnosed last April at 43 with ILC. Right sided mastectomy, sentinel biopsy. I was stage 2a, and tumor was 3cm. My margins were clear, but margin was smaller then they would have liked. Node Negative thank god. I will be having preventative Mx in two weeks on other side. I chose not to do Chemo initially with support my oncologist. My chance of recurrence is low. I know nothing is guaranteed, but I still worry sometimes that even with a low chance of recurrence, it might happen. I know I just have to take care of myself and live my life. I am mostly at peace with the no Chemo decision.
Did other node negative ILC ladies choose no Chemo? Did you have narrowly clean margins? Did you have preventative mastectomies? Okay, I know this is a lot of questions, so please humor me! Thanks for your input.
Butterflylady (Sharon)
Comments
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Hi Sharon, - did you have the Oncotype testing done? What was your score? I can understand all of your questions (been there!) about your choices, but, at this point, it may be better to just move on, since you're past the point of opting for chemo. (not sure if you had radiation).
One question- with your preventative mastectomy next week, are they going to do a SNB? The reason I ask is because a sister of a close friend of mine had a double mastectomy (preventative on one side) and they only did a SNB on the side they knew had BC. After surgery, and too late for a SNB, it was found that the "good" side had cancer, also. It really messed with her head. -
Similar situation: Oncotype score 25 Mammaprint low risk -- but borderline so tests left me with no clear guidance. BMX with dirty margins on cancer side. no LVI and no lymph node involvement. Mitotic score 1 -- pretty common with ILC I understand So no chemo -- rads for the dirty margin and now on aromasin.
Did I make all the right choices? Time will tell. As my onc said when I told her I had decided against chemo -- "It is all a crap shoot anyway. " I was not offended or horrified at her comment -- from reading these boards it is pretty clear she is right. There is just no certainty for anyone.
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Hi
I think you have to make the best decision you can at the time with the info you have. I actually had chemo (my oncotype was in the gray area, so I decided to take chemo). I had no nodes and pretty clear margins at my lumpectomy. I am heading into year 5-- was on lupron/femara-now just femara---- feel great....
I feel like I made the right decisions for me, but I know people with the exact same diagnosis who made different decisions--- no right or wrong--just what is right for you.
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I had ILC Stage 1 Grade II and an ONC score of 13. My MO said definitely no chemo. Because I had a BMX no rads either. I also choose not to do Tamoxifen. I was 49 at the time. One year anniversary this February. As time goes by, I am more confident with my decision and try not to second guess everything I did. Wishing you the best.
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Thank you Ladies for sharing...Yes, I did take the Oncotype test and my Oncotype was 14, I was put on Tamoxifen and I had 5 weeks of rads. My Onc told me that Tamoxifen is a pretty powerful med. It's supposed to drop me another 5% in recurrence risk. If I wasn't on Tamoxifen, I think I would be really worried. For the most part, I do feel good about my decision, but I do have my moments. Yes, with cancer there are no guarantees. Each of us makes the best decisions we can with what we know. That's all we can do. I feel very thankful, live my life and try to not worry the best I can. But I do have my moments.
Momof3boys...for my March 20th surgery, I will not be having a SNB. Your close friends's sister...I'm so sorry that happened to her. Initially last May I had an MRI on both sides and they checked nodes on both sides. On right side they removed the brest and 4 nodes, but nodes were negative. Left side they do not seem to have an issue. I recently had a Mammo in Dec. on left side as a pre-surgery check and no abnormal calcifications were found, which was an indicator on the other side. I just pray there is not something miniscule lurking in the left nodes like your story.
Hugs, Sharon
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Hi Butterfly! My diagnosis was very much like yours-Stage lla,grade 1,Er+,Pr+,Her-clean margins,clean nodes. I did not have chemo,and I'll share what my Rad.oncologist told me:The question should NEVER be "don't you want to do everything you can?" More appropriately,you should ask if you NEED this. He said by the logic of the first question, my surgeon should have taken both breasts, my uterus and both ovaries(LOL), and said I was right about refusing chemo,since I didn't need it. Remember, medical oncologists make ALL of thier money from selling chemo drugs to patients at a big markup. This creates a conflict of interest that made me wary from the start. If you're nervous, try talking with one of your OTHER doctors. I was glad I did! Bless you, and best wishes in your quest for your truth.
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Hi Butterfly,
I had bilateral prophylactic MX last May b/c of history of very dense breasts, multiple cysts, LCIS and a host of other things (including extreme stress and pain that was constant for 12 years) - thought I'd get the BPMX and no Tamoxifen for me. Sentinel node negative.
Pathology found ILC 3mm in the area where the LCIS had been. I'm on Tamoxifen. On Tuesday my MO told me that I'm basically a very healthy 40-something (eat well, exercise, and try to avoid undue stress) who listened to her body ... So barring any issues with endometrium, uterus, or ovaries... I hope I'm good to go.
I haven't told many of my family about this. 1) didn't want to burden them and 2) didn't think they'd understand or be supportive.
I'm happy with the choices that I've made thus far. The new boobies look a lot like the old boobies (L is LOOKS bigger than R) and the scar tissues are beginning to smooth out - DH likes them and refuses to call them "foobies" he says they're our boobies.
Good luck!
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Hi Butterfly,
I had a BMX, mostly because of suspicious micro calcification in left breast, but also because my 3 Dr opinions recommended it. I had SNB on both sides 2/5 nodes on right had micro mets (just a few cells) so not enough to be node positive. My Oncotype was 18. One Onc said no chemo just Tamoxifen & the 2nd Onc (who I still see) recommended chemo but due to other health issues said Tamoxifen for now.
Most of what I've read said Tamoxifen & AI's are best for ILC that is Er/Pr+ & am praying that is true for me.
I feel good about my decision & am about 18 months since surgery.
I will keep you in my thoughts & prayers for a successful surgery & recovery. Let us know how you are doing.
Hugs & good night all. -
trying to figure all this out for my Mom,
she will not be getting chemo either- much like butterfly- she is well- you can see sig below

and her new RO said SAME thing pretty much! We really like him. he said "do the known risk factors/side effects outweigh the possible benefits?" when we asked about chemo- he rec only the radiation and hormone therapy.
but, no chemo, she doesn't actually have a MO yet- but one we met at a multidisciplinary clinic said that her oncotype would be low she guessed and that her 5.2cm ILC didn't warrant it.
she is starting radiation for 33treatments, begin next wk.
**WHEN does she start the hormone therapy??? she wants to start but the MO didn't mention till I mentioned/asked about it and we never got a clear answer except yes she should do HT.
oh, gotta go! hugs to all!
I am making an appt with the actual MO that we were hoping to see, just to see what he says. My mom wants to start the HT femara, and wants to start it like yesterday!!
*she is continuing to heal nicely from her BMX, though is noting some skin breakdown at surgical site...
Hugs to all
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well I was node negative but am in the middle of chemo right now.. why ..because my tumour was 6cm and I had 3 other areas in the same breast. The oncotype we did but didnt consider as I would have been excluded on all the trials that evaluated it given my tumour size and multi focal. Also my big tumour was 1mm from chest wall so chemo and rads are necessary for me even with mx.
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I wanted to share that I had my left sided mastectomy on March 20th and all went well. Implants to be placed in August and then all done!
I still have moments when I get scared, but the further I get out from initial diagnosis, the better I feel about my decision. I think I did the right think with the specifics of my ILC, my Oncotype results, the 2nd opinion from UCSF and just my own gut feeling. It does get easier over time, when you know that did all you could for yourself with the information that you had available to you and your decisions were yours and yours alone! It is your life!
Thank you for your responses and caring support!

-Sharon
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