Oncoplasty for ILC

ILC_in_2014
ILC_in_2014 Member Posts: 6
edited August 2014 in ILC (Invasive Lobular Carcinoma)

I was just diagnosed with ILC. I have three tumors in my left breast, of which, two were biopsied. This is because 2 were right next to each other. One was atypical and the other was ILC (the one next to the 3rd which was not biopsed). I had a breast MRI which showed two suspicious areas on my right breast. Today, the sonogram could not find them, so I have to have a MRI core biopsy on my right breast on Thursday.

I thought when I was diagnosed, that as middle aged woman with large sagging breasts that a diep would be a great option, as my stomach has benefited from my lack of exercise. But I had a 2nd BS opinion and my PS said I should go for oncoplasty. I am wondering if I am rolling the dice with ILC because as my BS said, it is the sneaky cancer, and there may be more in there than what the imaging shows. Should I just go for the DMX or should I try for the oncoplasty. I guess ultimately it is my BS's call, but I just thought I would ask if there are any ILC people out there who have had it, or people with ILC who think I should just go for the DMX...

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Comments

  • Meow13
    Meow13 Member Posts: 4,859
    edited July 2014

    I never heard of this before. If I had the lumpectomy option I wanted to know what could be done plastic surgery wise. All the PS I saw said nothing. I wonder if you have to have large breasts?

    I had the mastectomy and 4 months later DIEP. Love the DIEP and flat stomach. I really needed to get rid of the extra skin on my stomach after I went from 183 to 123lbs. Now on AIs my weight is back up.

    By the way I had one tumor ILC and one IDC.

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  • Momine
    Momine Member Posts: 7,859
    edited July 2014

    What is oncoplasty?

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  • ILC_in_2014
    ILC_in_2014 Member Posts: 6
    edited July 2014

    Oncoplastic surgery is where they take all of the cancer out and a plastic surgeon resections your breast (you can get a lift and reduction as well) all in the same surgery.

    http://breastcasym.org/evolution-oncoplastic-breast-surgery-history-options-and-limitations

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  • Momine
    Momine Member Posts: 7,859
    edited July 2014

    Oh, ok, thanks! So basically a large lumpectomy, with a plastic surgeon "fixing up" the breast.

    My main concern would be the ILC sneakiness, but it is so personal how you weigh the pro/con there. My breasts had always been tender and painful, and after child birth, they were also soft and larger than I liked. It was not difficult for me to let them go. 

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  • Ridley
    Ridley Member Posts: 634
    edited July 2014


    ILC --  good luck with your decision.  Given you have a choice between lumpectomy and oncoplasty or mastectomy and recon, I would encourage you to consider all of the factors both physical and emotional (e.g. how will you deal with future screening, how important is maintaining your own breasts).  Lots of pros and cons on each side depending on what's important to you.  You noted in your message that this is your breast surgeon's call, but I think its really your call and you should ensure you are very comfortable with the choice.

    There are lots of messages on the board about lumpectomy vs mastectomy that you might want to search and read through.

    fyi -- I ended up with mastectomy recommended for one side and I did the other side as well (there was dcis there, but I could have had a lumpectomy).  I had diep recon.  I'm not quite finished, but I'm very happy with the results so far.

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  • vlnrph
    vlnrph Member Posts: 1,632
    edited July 2014

    It can be more difficult to get clean margins due to the way ILC grows. If another excision is required, would the oncoplasty need to be modified also? I assume you would get radiation too. Lots of factors to consider: follow-up mammograms in the future, etc.

    My decision for mastectomy came from also having a ductal tumor in a separate quadrant, making two lumpectomies impractical. Since the sentinel node appeared clean during surgery, I had immediate DIEP. After completion of pathology, micrometastases were found which led to chemo because rads would have been detrimental to the reconstructed tissue. 

    Insurance allowed a couple years worth of annual MRIs but is now getting fussy about paying for them...

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  • ILC_in_2014
    ILC_in_2014 Member Posts: 6
    edited July 2014

    I just had biopsy MRI guided biopsy yesterday for two lesions on my right breast, I already had my left breast biopsied and know one of three on left is invasive lobular cancer and the second is abnormal, the 3rd was not biopsied, but is adjacent to the cancerous one. My surgeon said she would do a partial mastectomy with a wire something, and that the plastic surgeon would do the reduction and lift and reshaping. If the pathology comes back with clear margins and a good sentinel node test, then I will be just doing radiation for 5 to 6 weeks and go onto tamoxifen. If the pathology comes back with not good margins then I think I will just have a double mastectomy shortly thereafter and do reconstruction later.

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  • rivercaralee
    rivercaralee Member Posts: 29
    edited July 2014

    Hi VA,

    I went for the total bilateral mastectomies.  I had extremely dense breasts, my ILC (which did form a 1.6 cm lump) was missed on several mammograms.  No law at the time in my state of Hawaii to mention the density as a risk factor (that has changed as of this year).  They were large and saggy, and I don't miss them too much!  I was highly intolerant of MRI which would have been the only way to see a recurrence, and MRI is not the eyes of G-d, by any means!  I love my new smaller prosthesis (no reconstruction for me), I can wear so many different styles.  My husband misses them more than I do!  I fidget way less with my silicone prostheses than I did with my actual breasts.  Just put em on and forget about them!

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  • MsSnowWhite
    MsSnowWhite Member Posts: 3
    edited August 2014


    You're right it is a sneaky one ILC.  When I did my ultrasound they found a barbell looking one which could be a bigger one or it could be two stuck together?  a week later through another ultrasound from my first PS there was another one found. So now it's 3 altogether. She said they tend to hide and due to dense tissue it can easily be missed. I decided to do the DMX get it out all of it so there's no surprises later. I want my life back so I can enjoy the rest of the year. My boobs are size D so there would be additional scars from the breast lift and reduction so I thought lets start from a fresh canvas and this time around I get to pick how big I want to be and better shape with the silicone implants.  That's me making lemonade when given a bag of lemons. 

    SW

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