Invasive lobular carcinoma of the breast

Surgical excision of my left breast mass resulted in a diagnosis of infiltrating lobular carcinoma of the breast, stage T4a (tumor infiltrates into chest wall muscle). Size of lesion 25 mm in aggregate diameter, resected margins clear. ER positive more than 80%, PR negative, c-erb B2 positive in majority of tumor cell membrane, intensity of stain 3+. Can someone please help me to understand clearly what all this means?

My ultrasound had shown no axilliary lymphadenopathy. My surgeon recommends axilliary lymph node removal with radiation after surgery and hormone therapy. He says another option is mastectomy with no radiation and hormone therapy. Is all this necessary?  I am 78 years old and am very anxious about having to undergo multiple surgeries and general anaesthesia..  

Additional questions:
Is it possible to undergo hormone therapy only?
Is it possible I would have to have a mastectomy anyway even after lymph node removal?
If I have my left breast removed, what is the likelihood of cancer developing in the right breast? Right breast was normal in the ultrasound.

[SueYoung55]

Hi Bel,

I had invasive lobular carcinoma as well. Not too many of us on these boards with this type of cancer. I know you don't really want to do surgeries but if your overall health is good you should consider it. This type of cancer does have bilateral tendencies so if you're going to move forward I'd get them both done at the same time. If you have not had an MRI I would suggest doing so before having any surgery. That will pinpoint everything they see and may offer more information. It did for me. It took my 1.5 cm mass and proved it was really 10 cm.

Our type of cancer tends to grow very quickly. Yours is already into your chest wall muscle and for me, when I had my mastectomies, they had to remove most of my chest wall muscle because they were trying to get clear margins. They do also need to at minimum do a sentinal node biopsy during your surgery. This can all be done at once. I had one night in the hospital with my mastectomy. Really that was all that was needed. Most women don't even do that much, they leave a few hours later.

The numbers T1-T4 describe the size and/or how much the cancer has grown into the breast tissue. The higher the T number, the larger the tumor and/or the more it may have grown into the breast tissue.

As for hormone therapy, they will most likely put you on an AI afterwards to stop/block estrogen from being produced in your body. Even though you are menopausal it's still produced by the adrenals and the fat in our bodies.

Best wishes and let us know how you're doing.