Invasive Ductal Carcinoma with "Lobular Features"?

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Anonymous
Anonymous Member Posts: 1,376
edited June 2014 in Stage III Breast Cancer


This has been on my mind alot lately. I know we all get insecure and worried on and off thru this process. But it seems that the longer I go NED I get more worried. Does that sound crazy or what? My mind keeps going back to my original diagnosis where my pathology report stated that I had Invasive Ductal Carcinoma with "Lobular Features", which confuses me a little. I wish I knew more, and I totally forgot to ask my onc last visit. So I tried researching IDC with Lobular features and found that IDC-L had a higher frequency of nodal metastases (51 vs. 34 %; p < 0.0001) and a worse 5-year disease-free survival than IDC (hazard ratio = 0.454; p = 0.0004). ILC and IDC-L had similar clinicopathologic features and outcomes.


Now something else to worry about. I was wondering if anyone else here has IDC-L.

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  • dlb823
    dlb823 Member Posts: 9,430
    edited October 2013


    My biopsy path report used the term IDC with lobular features, but the pathology from my surgery showed side-by-side IDC and ILC lesions. So it was actually IDC and ILC. But more importantly, my first surgeon also missed 3 tiny additional ILC lesions that a second opinion medical team later found, necessitating a mx (detailed on my bio page). I don't know, but I can't help but wonder if the reported worse outcomes could be due to situations like mine, where smaller additional lesions are initially missed.


    Was the "IDC with lobular features" from your biopsy path or surgery path? Did you have an MRI prior to surgery? A mx? Deanna

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  • Momine
    Momine Member Posts: 7,859
    edited October 2013


    Deanna, I just read your bio page, and I completely agree about getting a 2nd and 3rd opinion and finding docs who are actual experts on this particular beast.


    The doc who operated me was the 2nd surgeon I saw. When I told him what the first surgeon had proposed, he blanched and told me that had I gone that route, he was certain I would not live even 5 years. At the time I thought he was just being overly dramatic. I have since gotten to know the guy and now know that he doesn't say things lightly, nor does he over-dramatize. He really meant it.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited October 2013


    Deanna, The lobular features are stated on my Surgical Patholoy Report following the mastecomy. Wow! I'm reading this report for the first time in quite awhile and I'm seeing "lobular features" "lobular neoplasia" (LN2/atypcial lobular hyperplasia) "invasive carcinoma with mixed lobular differnentiation I'm not seeing "invasive ductal carcinoma" only "invasive carinoma with mixed ductal and lobular features 5.2 cm"

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  • weesa
    weesa Member Posts: 707
    edited October 2013


    Funny that you recently hauled out your path reports and reread them. I did the same thing recently, and it has been an eye opener for me. First I had two lumpectomies and a surgical biopsy which stated that I had ductal carcinoma. When they did not get clean margins I had a mastectomy, and lobular cancer was discovered underneath the ductal, which had never been suspected. If I had gotten clean margins on the lumpectomies I shudder to think what the lobular would have done.Anyway my final path report from the mastectomy mentioned both lobular neoplasia and lobular hyperplasia which I believe are not true breast cancers but are pre-cancers. Hopefully somebody can come along with more information.

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  • mary625
    mary625 Member Posts: 1,056
    edited October 2013


    My surgical path showed ILC with both LCIS and DCIS. I saw a very prominent oncologist last week, and he said this is very common. No further explanation.

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  • Momine
    Momine Member Posts: 7,859
    edited October 2013


    Weesa, my MX path (from the supposedly healthy breast) also had the neoplasia and hyperplasia as well as outright LCIS. I looked at my surgeon and said that my guess was that breast would have had me back in his office within the year if we hadn't lopped it off. He looked down again at the path and just nodded. None of it had showed on any of the scans etc, and I had every available form of imaging done on that breast, except for a PET scan.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited October 2013


    Weesa, - Yeah it's funny how you can take a second look at the path report after being more educated here on this fourm, and see things that weren't noticed at all when we were first diagnosed in in mind numbing shock of it all. So now my question is what is IDC-L. Is this Invasive ductal carninima with lobular features or is it a combination of IDC & ILC?


    Momine - Now I know specifically that I will be talking with my onc. Also, just to ask anyone, how long should followups last with the BS. I haven't followed up with my BS in well over six months. I also haven't seen my Rad Onc since then either. I only do follow ups with my Onc and family docs.

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