HealingWell
Search Close Search
☰

2mm Lobular Carcinoma found after breast reduction

Support Forums
>
Breast Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 8/29/2013 12:53 AM (GMT 0)
So I'm the husband here and a near 4 year veteran of the Prostate Cancer side of Healing Well.

12 Years ago my wife had a lumpectomy on the RIGHT breast followed by 5 years of tamoxifen.

On August 1st, 2013 she had breast reduction surgery and upon examination of the removed tissue they found a tiny 2mm lobular carcinoma in the LEFT breast.

The surgeon who did the lumpectomy 12 years ago said this 2mm finding, would never show up on a mammogram and is suggesting an MRI in 3-4 months after the swelling goes down and most likely radiation and or some newer drugs or tamoxifen. Her attitude is the reduction was a great thing and very well may have cured my wife of cancer a second time. She feels there is no rush to consider a mastectomy at this time, and if need be it's something we can always consider later.

Now we have the Plastic surgeon who did an amazing job on the reduction and was WONDERFUL in every way. He reached out to a breast cancer specialist is his hospital (different from the 12 year ago Dr./Hospital) and his colleague there seems to be pushing very hard for a double mastectomy. We meet with her tomorrow but in a phone consultation she and the plastic surgeon had with my wife they are very much of the mind you've found cancer twice, no more fooling around.

My wife is going to do the genetic testing for BRCA, but I'm wondering where all the folks on the Breast Cancer side of HW feel about next steps.

1) Assuming the MRI finds nothing do we go with radiation & medication?

or

2) Do we strongly consider the double mastectomy sooner than later?

How difficult might a mastectomy be 5 -10 years down the road if we did radiation & meds now and later discovered we had to do surgery?

Thanks,

Mike (the husband).
Posted 8/29/2013 11:57 PM (GMT 0)
Come on Folks. 24 hours and not a single reply ?????

So we went to see Doctor #2 today and she states:

"If you were my sister i'd be telling you to get a double mastectomy and reconstruction."

Her thinking is my wife had cancer in the Right breast 12 years ago and now cancer in the Left breast makes her a ticking time bomb.

The pathology states " .... microscopic focus of INVASIVE Lobular carcinoma measuring 2mm..."

My wife had an MRI today but the surgeons feeling is since the reconstruction we have no way of knowing where the cancer came from and if there is more.

At this writing my wife is 80% sure she is going to have the double mastectomy.

We'd love to hear from others if this thinking resonates with your experiences.

Thanks,

Mike (the husband)
Posted 9/3/2013 1:44 AM (GMT 0)
Hi Mike.. Sorry for being one of the silent majority about your query. At first reading I thought that you were dealing with very technical terms until I did some readings online. I'm waiting for my biopsy results as of this date. If I were your wife, I would opt for a double mastectomy at this time. I was thinking that if I get a malignant diagnosis myself (two suspicious lesions were found on my right breast, one 1 cm and the other 8 mm) I would opt for a unilateral mastectomy. I'm 51 years old.

I'm hoping that everything would be fine and that you would both be able to make the soundest informed decision there is. Keep in touched!
Posted 10/29/2013 4:11 PM (GMT 0)
UPDATE >>>>

On 10/8/13 My wife had the double mastectomy.

The pathology results determined that the 2mm cancer found in the breast reduction was the only active cancer. However in the remaining breast tissue they did find:
LCIS (Lobular Carcinoma in situ) &
DCIS (Ductal carcinoma in situ).

LCIS indicates that you have an increased risk of developing breast cancer.
Women with LCIS have an increased risk of developing invasive breast cancer in either breast.

DCIS is the presence of abnormal cells inside a milk duct in the breast.
DCIS is considered the earliest form of breast cancer.
DCIS is noninvasive, meaning it hasn't spread out of the milk duct to invade other parts of the breast.
While DCIS isn't life-threatening, it does require treatment to prevent the condition from becoming invasive.

End of the day the doctors felt the pathology results from the mastectomy confirmed and validated that we did make the correct choice with the double mastectomy.

There was no lymph node invasion and no need for any further treatment.
Yesterday she has had the last 2 of her 4 drains removed and has begun having her tissue expanders filled for the reconstruction that we hope to have done in early 2014.

I must admit that my wife is much stronger than I had imagined. She's doing great and has an amazing outlook under the circumstances. She says she does still have her dark moment when she's alone and looking at herself in the mirror but I'm doing all I can to love and support her, and even after just one day of tissue expansion she's starting to have some definition in that area and it looks better already.

The mastectomy was necessary and as you can imagine a very low point for her and the entire family.
We're hoping we can now get on with living cancer free and looking forward to the reconstruction, a surgery she's excited to have.

Thanks for letting us share.

Mike ( the husband).
Posted 10/29/2013 6:02 PM (GMT 0)
Hi Mike,
My husband is also a Mike and has had prostate cancer 5 years. He has PSA's every 6 months and gets a biopsy every year. So far, so good. It's still there but is not growing. No surgery planned.

I got diagnosed with DCIS breast cancer July 18th and had a double mastectomy with immediate reconstruction August 23rd. Prior to surgery I had 2 mammograms and an MRI with contrast to make sure there was no cancer in the other breast. None was found but I wanted the bilateral MX anyway. Imagine my surprise when the pathology report showed cancer in the "good side" too! It was a different kind, LCIS, but more concerning because of the link to other kinds of cancer. I've since learned that LCIS is harder to diagnose in dense breasts but it still amazes me they missed it completely. Unfortunately I've talked to many more women lately who've had the same experience.

The oncologist said I had made the right decision and that no chemo or rads or hormone therapy would be needed since the cancer was caught and removed before it became invasive & sentinel node biopsy showed no lymph involvement.

I don't understand why women with cancer that is not yet invasive go through a lumpectomy (often a re-excision as well), 7 weeks of radiation 5 days a week, and 5 years of Tamoxifen, all the while crossing their fingers that it won't come back or show up in the other breast. With a double mastectomy, it's over and done. No further treatment.

DCIS cannot grow in the tiny bit of breast tissue that might remain because that tiny bit doesn't contain a duct. LCIS can't grow because there are no more lobules. Doesn't mean you don't have a tiny change (1-2%) of some other kind of cancer showing up in the bit of tissue, but it won't be IDC or LDC or a recurrence of DCIS or LCIS.
Posted 10/29/2013 6:14 PM (GMT 0)
Sandra,

Thanks for the reply. I assume you're happy and well? Do you look good as new? Are you happy with the reconstruction?

My wife did the lumpectomy 12 years ago and were it not for her recent breast reduction who knows how long she'd have gone before the 2mm cancer was discovered or the DCIS or LCIS would have turned into something else.

I'm not sure 12 years ago a double MX would have been called for and my gut says my wife is emotionally in a much better place to deal with this at 50+ with grown adult children than at 40+ with teenagers.

At this point we are where we are. Did you have the belly flap procedure to harvest tissue for the reconstruction? How did all that turn out for you??

Mike

Post Edited (Mike H) : 10/29/2013 12:27:29 PM (GMT-6)

Posted 10/30/2013 4:06 PM (GMT 0)
Hi Mike,
Yes, I'm sure you are right about age playing a big role in the decision. Also 12 years ago was equivalent to the Stone Age in breast cancer research and treatment. I had the BMX with immediate reconstruction with saline implants and woke up with the nice perky breasts of a 20 year old! It's a "one and done" operation. I knew from previous surgeries that it would be really hard to recover from an operation on my abdomen and adding surgery on my chest and pectoral muscles would make it difficult to even get out of bed, much less walk the halls, go to the bathroom, etc. Recovery at home would be harder as well. There didn't seem to be any point going through that when a safe saline implant would work fine.

I was not at all attached to having breasts. They had nourished three children and I didn't need them anymore. Plus, why would I save any part of them...they were trying to kill me!
Posted 10/30/2013 4:27 PM (GMT 0)
Thanks Sandra.

I just saw a t-shirt that said something like "Yeah my breasts are fake - the old ones tried to kill me". My wife loved it and laughed.

She/we are going with the DIEP flap which is the latest and greatest way to go as it takes belly fat and no muscles. The recovery may be a bit tougher but the woman ends up 100% "natural" and gets a bonus - free tummy tuck out of the deal. My wife is very excited for the tummy tuck and it's the silver lining if you will, to a bunch of bad stuff that turned out good!

Thanks for all your feedback and best of luck to you and your husband as we all fight the fight!


Mike
Posted 11/20/2013 4:38 AM (GMT 0)
Mike,
I just started signing on to this website again, after only being a "reader" some time back.
I was given a report of Invasive Lobular Carcinoma in May of 2012. I've learned a LOT about Lobular (vs. ductal) carcinomas. They often do NOT show up on mammographies; with or without dense breasts. Even when I went in for a diagnostic mammogram, the cells did not show up. The doctor used a sonogram to get a biopsy.
Lobular is irregularly shaped, often slow growing, and very unpredictable. It has a greater chance of showing up in the other breast once it's shown up in one. And lobular historically does not really respond as well to chemotherapy as it does Aromitase inhibitors.
My current understanding is that Femara might be a better option for your wife than Tamoxifen (if she is already menopausal).

Did your wife follow through with the BRCA testing?

I enjoyed the "my old ones tried to kill me" -- thanks for sharing.

I totally agree with the DIEP flap also -- by now she is probably well on her way to recovery.

Wishing you both all the best!!

--kc
Posted 11/20/2013 2:06 PM (GMT 0)
KC,

I'm honored to be the recipeint of your first ever posting.

Thankfully my wife dose not need any further treatment other than the reconstruction.
Today she has her second visit with the plastic surgeon to fill the tissue expanders a bit more.

She's now telling me she likes her super tiny boobs and doesn't want to go much bigger than she is now which is nearly NOTHING!! She went from a 44DDD to maybe a 40D after the reconstruction.

After the double mastectomey my guess is she's a 36 A or an A minus if there is such a thing.

"WE" will be negotiating on the final size but end of day I think her vote will carry more weight than mine, and she wants them tiny LOL!!

I hope your circumstances are good. Have you taken any action since your diagnosis?

We are in a much better place mentally and emotionally now that the cancer is gone and she has the beginning of some definition to her chest again. Life moves on!

Last week I purchased her another T-shirt. It says "my cupcakes licked cancer". It was so cute I had to buy it.
Every few weeks I order her another funny shirt. I think they are way better than greeting cards or flowers!
Just my way to let her know I'm there for her and always thinking about her.

Mike

Post Edited (Mike H) : 11/20/2013 2:46:22 PM (GMT-7)

Posted 11/20/2013 9:40 PM (GMT 0)
Mike,
LOL. Sorry to say it, but you get NO VOTE when it comes to the size of her chest! If I had it to do again, I would be even smaller than I am now. I'm the one who has to live with it so I should get to decide. Both my husband and plastic surgeon said I should go with a D implant and it didn't matter one way or the other to me prior to surgery because I was still in a fog from the diagnosis, so I didn't disagree. I think they are too big, but really, compared to what I was before - ridiculously huge FFF's, everything is small. I like little foobs. (The aren't breasts anymore...those are gone. These are fake boobs - foobs.) I love not having to wear a bra after 50 years!
Posted 11/20/2013 9:45 PM (GMT 0)
Sandra,

Maybe I need one of those sample things for the chest, like they give to expectant dads for the belly to see what it's like to be pregnant before I vote on the foobs!! She LOVES the no Bra T-shirt experience.

LOL.

I still think I should have some say ! ! ! !

MH
✚ New Topic ✚ Reply