Pleomorphic

minuet
minuet Member Posts: 25
edited June 2014 in ILC (Invasive Lobular Carcinoma)
Hi...just found this board. Was diagnosed about 2 years ago at age 40 with ILC and LCIS, multifocal grade 2. In some other post there was mention of pleomorphic ILC.
How is it determined if it is pleomorphic? Just by grade?
I understand classical is grade 1 so anything higher is pleomorphic?
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  • nash
    nash Member Posts: 2,600
    edited July 2007
    I have both pleomorphic ILC (grade 2)and pleomorphic LCIS. As far as I understand it, pleomorphic doesn't have to do with grade. Rather, it's a subtype of lobular cancer, named b/c of the cell shape (pleomorphic is a general term that means large and round, I think). Some research suggests that pleomorphic lobular cells behave more aggressively than classical lobular cells.

    My oncologist said that many pathology labs do not identify the subtype of lobular cancer, and my surgeon said the subtype is more of an issue for the LCIS than for the ILC (as far as the pleoporphic LCIS being a more aggressive marker for future bc than the classical LCIS).

    Hope that helps!
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  • snicklefritz
    snicklefritz Member Posts: 66
    edited July 2007

    Hi Morden: I can tell you that I had an invasive lobular which was classified as pleomorphic. There are several subtypes: Classical (less aggressive), alveolar, solid, tubular (not aggressive), and then pleomorphic which are said to be the most aggressive due to the structure of the cells within the tumor. Pleomorphics are usually grade 2 or 3 and in rare cases, her/2 positive. I was spooked by what I read about the cases involving pleomorphic tumors but I now know that they are no more aggressive than the average ductal carcinoma of grade 2 or 3. Please don't fret over the subtype because in the end, it is not dispositive. That's pretty much all I know but if you google it, lots of info will come up for you. Best wishes, Mary Jane

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  • dobie
    dobie Member Posts: 424
    edited August 2007

    On my initial biopsy the Dx was DCIS but after my lumpectomy pleomorphic lobulatr cancer in situ (PLCIS) was found with PLICS in the margins along with a small 2mm area of ILC with clear margins of 4 mm. In the past they beleive that many who were dx with DCIS may actually have had PLCIS since they look and behave similarly. I have also seen PLICS referred to as ductal lobular cancer in situ. My case went to tumor board last week and the debate is what to do about the PLICS in the margin. Apparently this is an emerging area in BC pathology and there is not a consenses yet whether this needs to be treated like DCIS with excision or in my case re-excision or treat like classic LCIS which they generally just watch. They just don't have enough info yet on this beast (Another gray area of BC research and treatment). I will at least have to have sentinel node biopsy and radiation because of the ILC. As for the rest, I am waiting to get a MRI to r/o any occult lesions in both breasts and I will go from there. Let me know if anyone digs up anymore info regarding this pleomorphic stuff. "Pleomorphic" was right in the dx part of my pathology report. Another clue is that these cells are E-cadherin negative. I don't think you have to dig for it. A mystery to me on my pathology report is the statement under comments- "There is no carcinoma seen in deeper level, therefore, Her2neu immunostain will not be performed." I will ask next time I get the chance but does anyone have a clue what this means?

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  • moonie
    moonie Member Posts: 194
    edited August 2007
    Hm....I don't really 'get' that....
    It sounds like they are saying they aren't doing the test to determine Her2 status. Since you had an ILC tumor--even tho it was small, it seems to me they should have done the Her2 test. They did on mine...tho I guess my largest one was 5mm. Maybe they didn't have enough tissue to test it or something?
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