What is the best treatment for stage 1 invasive lobular carcinoma?

Question

Hello doctor,

Three years ago, I was diagnosed with lobular carcinoma in situ (LCIS) in my left breast. Since then, my doctors have advised regular monitoring. At my last routine check-up, something abnormal showed up on my mammogram. After additional tests, I was diagnosed with stage 1 invasive lobular carcinoma that is HER2-positive, ER-positive, and PR-negative. What do you think is the best treatment option for me? Would surgery alone be enough to make me cancer-free? Will I need other treatments after surgery? What are my chances of recurrence? Are there any lifestyle changes or medications that can help reduce the risk of the cancer coming back? I am 45 years old and would appreciate your advice to help address my concerns.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Early-stage breast cancer is treated with curative intent, based on receptor status, tumor size, and lymph node involvement. For stage 1 invasive lobular carcinoma in situ (HER2-positive, ER-positive, PR-negative), treatment may begin with surgery if the tumor is under 2 inches and the nodes are clear. Post-surgery, chemotherapy, HER2-targeted therapy (for example Trastuzumab or Herceptin), and five to ten years of Tamoxifen or aromatase inhibitors reduce recurrence risk.

If the tumor is over two inches or nodes are involved, preoperative chemotherapy and HER2-targeted therapy are needed. Breast-conserving surgery often requires radiation. Genetic testing for BRCA1, BRCA2, and CDH1 mutations is advised for younger patients to assess risks. Recurrence risk is highest in the first five years, so regular follow-ups are essential. Diet and lifestyle help but can not replace proper medical treatment.

I hope this helps you.

Thank you.