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Suggest Treatment For Invasive Lobular Carcinoma

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Posted on Mon, 7 Jul 2014
Question: I had a ductal excision on my right breast; no cancer was found. However, I noticed this in the pathology report: "Some of the ducts show pagetoid involvement by an epithelial cell population with lobular features. These cells show loss of E-cadherin expression." And "atypical lobular hyperplasia with pagetoid involvement of ducts." What can I do about it?
doctor
Answered by Dr. Deepika Patil (53 minutes later)
Brief Answer:
regular follow up

Detailed Answer:
Hi XXXXXXX

Welcome to HealthcareMagic.

Loss of E-cadherin is a diagnostic marker of invasive lobular carcinoma (specificity 97.7%; negative predictive value 96.8%; sensitivity 88.1%; and positive predictive value 91.2%).

And "atypical lobular hyperplasia with pagetoid involvement of ducts" also points to the same.

So, as after the excision there is no any mass left, so you should get regular follow up to detect an early lump. Physical examinations should be performed every 3 to 6 months for the first 3 years, every 6 to 12 months for years 4 and 5, and annually thereafter.

Hope i have been helpful.

Regards,
Dr. Deepika Patil
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Deepika Patil (3 hours later)
Hi Dr. XXXXXXX
Thank you for your answer. I should have explained a little more.
I did not have cancer, just a possible cancer, as I had green, then yellow, then clear, nipple discharge, which is why I had the excision. The doctor told me I had a 30% chance of having ductal cancer. But I did not.
I am just concerned that the loss of E-cadherin expression means that I have a greater chance, if I ever do get cancer, of having it spread?
I wonder if there is something I can do about reversing the loss of E-cadherin?
And is it possible that that force trauma, like falling on the breast, or hot tub jets, could have caused the loss of E-cadherin?
Thank-you, XXXXXXX XXXXXXX

doctor
Answered by Dr. Deepika Patil (5 hours later)
Brief Answer:
there is no reversing it

Detailed Answer:
Hi,

As told earlier, loss of e-cadherin is diagnostic of cancer.

Its just that yours was detected at an very early stage so the involved region has been removed before it could have spread.

Now you need to keep a close watch to detect an early similar growth if it occurs, as you have beed proved to be predisposed it.

There is nothing that is proven to reverse this change, though you may try antioxidants and multivitamins.

Regards,
Dr. Deepika Patil
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Deepika Patil

General Surgeon

Practicing since :2008

Answered : 745 Questions

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Suggest Treatment For Invasive Lobular Carcinoma

Brief Answer: regular follow up Detailed Answer: Hi XXXXXXX Welcome to HealthcareMagic. Loss of E-cadherin is a diagnostic marker of invasive lobular carcinoma (specificity 97.7%; negative predictive value 96.8%; sensitivity 88.1%; and positive predictive value 91.2%). And "atypical lobular hyperplasia with pagetoid involvement of ducts" also points to the same. So, as after the excision there is no any mass left, so you should get regular follow up to detect an early lump. Physical examinations should be performed every 3 to 6 months for the first 3 years, every 6 to 12 months for years 4 and 5, and annually thereafter. Hope i have been helpful. Regards, Dr. Deepika Patil