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ILC and Bilateral mastectomy
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ILC and Bilateral mastectomy

I  recently  had been diagnosed with IDC of the left breast. I had a thickening which showed suspicious on the mammogram. A needle biopsy did not show anything. The surgeon sent me for an ultrasound guided biopsy which indicated IDC. I had a lumpectomy/axillary dissection done. The pathology report indicated I had a 1.7 cm ILC, (no IDC at all) no lymph nodes involved (only 5 were checked). ER/PR positive. The medical onocologist advised that there is about a 30% recurrence rate of lobular cancer in the same or both breasts. He also advised that ILC  doesn't always show easily on mammogram. My course of treatment will be 4 cycles of chemo (AC), then 5 weeks of radiation, followed by 5 yrs of Tamoxifen. I also have Lupus  and have been advised that radiation may cause more severe side effects in lupus patients. The medical onocologist suggested that many women with ILC prefer a bilateral mastectomy. However, my surgeon thinks this is a little too drastic. He suggested I continue checking my breasts and have yearly mammograms. I don't feel comfortable about this as I've been told that ILC is sometimes difficult to detect. I am leaning toward the bilateral mastectomy. Would I still require radiation or tamoxifen if I were to have the bilateral mastectomy. Also, the surgeon said that a bilateral mastectomy does not result in removal of 100% of the breast tissue and there would still be a small chance of recurrence. I am trying to make an informed decision. Is there any help that anyone can give me on this? My chemo started last week. I still have a few months to decide......THANKS.
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Dear metalgear:  It is true that lobular cancer can be more difficult to detect on mammogram.  Mastectomy of the affected breast would eliminate the need for radiation therapy but tamoxifen would likely still be recommended – to prevent recurrence.  Bilateral mastectomy is considered an aggressive approach but is chosen by some women – and it is really a personal decision.  The surgeon is correct in that a mastectomy does not always remove 100% of the breast tissue but it does remove most of it.  
6 Comments
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Avatar_n_tn
I too had ILC, and I knew it could come back.  I decided to have a mastectomy, as I wanted no Chemo., or Radiation.  I decided this when the Surgeon told me about having ILC Cancer.  The operation wasn't bad at all, this was almost two years ago.  The lymph nodes were clear, so were the margins.  I am on Arimidex.  I did not need to hang on to something that would put me in danger.  I hope this will help you.  God Bless.

Annie
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Avatar_n_tn
Thanks Annie. I think I am leaning toward the bilateral mastectomy, at this point anyway.
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Avatar_n_tn
Dear Metalgear,

I had a bilateral mastectomy last year for left breast 1.4cm invasive ductal carcinoma with 3-4cm of DCIS. Although recurrence is still possible, I chose to have a bilateral because I have 2 small kids. Improving my odds helped me decide. I had chemo, no radiation. Its been a tough year but I'm glad I had the surgery. I'm recovering great! The chemo was harder for me than the surgery. Hope this helps, best wishes.  
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Avatar_n_tn
What was your side effects of chemo?
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CHEMO EFFECTS

http://www.healthtalk.com/otherconditions/programs/14_342/page03.cfm

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