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HomeAnswersMedical oncologybreast cancerHaving chemotherapy for stage IV invasive lobular carcinoma. Is it right?

Do stage IV lobular carcinomas benefit from chemotherapy?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At February 26, 2023
Reviewed AtMay 6, 2024

Patient's Query

Hi doctor,

The first case of cancer was on stage 3 ER+ invasive cancer of the left breast. Now, it is in stage IV invasive lobular carcinoma, with results of ER positive, PR positive, and HER2 with equivocal recurrent cancer. The site of disease is present on the abdominal lymph nodes and omentum with ascites and pleural effusions. Is the current treatment right? Are there any other tests recommended that helps to find more information? Any further recommendations required? Should we need to try clinical trials or immunotherapy? Please help.


Welcome to icliniq.com.

I have gone through the attachment (attachment removed to protect patient identity). Yes, it is appropriate to use chemotherapy at this juncture. The HER2 (human epidermal growth factor receptor 2) result is mentioned as equivocal. So please do a FISH test (fluorescence in-situ hybridization) to find out whether it is positive or negative. After chemotherapy, consider doing a maintenance hormonal therapy. Immunotherapy in breast cancer is still in infancy, and promising results are seen in triple negative breast cancer women. I will not suggest a clinical trial at this juncture.

Patient's Query

Hi doctor,

Thank you for your reply.

I have a couple of follow-ups:

1) Yes, her FISH test reports are going to come in the next two weeks.

2) Do you recommend genomic testing?

3) Would you recommend we look for options for immunotherapy?

4) Could you provide more detail on why you do not recommend clinical trials at this point?


Welcome back to icliniq.com.

I read your query and can understand your concern.

1. Let us wait and see what FISH (fluorescence in situ hybridization) results show.

2. Genomic sequencing and testing are useful in adjuvant or curative settings to look at the efficacy of chemotherapy.

3. Immunotherapy is a new concept and has been explored in various cancers. To the best of my knowledge, triple-negative breast cancer is an area of promise.

4. There is no scientific backing for using immunotherapy in breast cancer in daily clinical practice for lobular cancer at this stage.

However, if you find ongoing trials, feel free to get enrolled.

Hope this helps.

Thanks and take care.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Kumar Varadarajan Senthil
Dr. Kumar Varadarajan Senthil

Radiation Oncology

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