Saturday, December 11, 2010 nikola asks

Q: IDC, ILC

Hello,

I was diagnosed in March and had double mastectomy in May. They founf three cancers. One was IDC, 1.3 cm, DCIS present, grade 2. Other was 1.1 cm, mixed ductal and lobular, grade 2. Last one was 0.2 cm, lobular, grade 2. Good breast had focal severe atypical hyperplasia with negative margins (7 mm anterior) and focal atypical hyperplasia.

I was put as stage 1. Her2 was done for two bigger ones and was negative. ER/PR was done for first one and was ER score 7 and PR score 6. I think I asked for second one and was told it was positive, too,but do not have that report, not sure.

I had 4 T/C, every three weeks, last one being end of Sept. No radiation. Was not put on Tamoxifen as had some clotting problems during surgery (DIEP). Zolodex, I am afraid to start as was diagnosed with prolactinoma in 1998. I was on Bromocriptine until I had my son (2004) and just stopped. Maybe that was mistake as I read somewhere there was correlation between increased prolactin and breast cancer.

What are Your suggestions re my Tx? Ovary removal? Should I ask for Her2 test for the smallest one? For ER/PR testings for smaller one and maybe second one?

Do I need to ask for CT scan for prolactinoma? I had elevated prolactin levels back in 1998 and had CT scan then and never again.

I am at lost, my hormons are out of control obviously.

I am 43, was premenoposal. Did not get my period yet. Last one was just after first chemo.

Sorry it is so long.

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Answers (1)

PJ Hamel, Health Guide

12/11/10 7:21am

Hi - Since prolactinoma actually reduces circulating estrogen, and your goal is to reduce estrogen, then I wouldn't think prolactinoma would have an adverse effect on your cancer - rather the opposite.

I'm not sure why they wouldn't test all three of your tumors for estrogen receptivity and HER2 status; clearly there's a reason the tests weren't done (if in fact they weren't); so this is a question your oncologist could answer.

Zoladex shuts down your ovaries, so that they stop producing estrogen. Not understanding your hesitancy to take it, since reducing estrogen is your goal. Not sure you'd need to be screened (via CT) for prolactinoma again, as that would lower estrogen, and estrogen is already pretty much shut down.

It doesn't sound to me like your hormones are "out of control," so please try not to stress over that. And I wouldn't think there's a need to remove your ovaries, at least until you see if your periods return, at which time you might consider it, after discussions of the pros and cons with your doctor.

Hope this helps. For more informed advice - speak to your doctor, OK? And if you question his/her answers, you might ask for a second opinion, preferably from someone at a Comprehensive Cancer Center. Good luck - PJH

Q: IDC, ILC

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