Stage III HR-Positive Invasive Lobular Carcinoma: Courtney's Patient Story

What happened, in summary

Courtney was 37 and pregnant with her 3rd child when she first found a lump in her left breast in February 2022. Ultrasound showed a 5 mm hypoechoic mass that was considered probably benign, and mammogram did not show it because of dense breast tissue. She asked several clinicians whether it should be biopsied, but during pregnancy and breastfeeding she was repeatedly reassured and followed with ultrasounds for about 18 months. On September 12, 2023, imaging showed new suspicious findings, including a 14 mm firm, fixed, spiculated mass. Biopsy results on September 16 showed invasive lobular carcinoma that was ER-positive, PR-positive, and HER2-negative. Courtney had a double mastectomy on November 1, 2023. Sentinel nodes were negative, but the tumor was estimated at 5.5 cm, involved all 4 quadrants, and had positive deep margins, making it Stage III/T3N0M0. Her team recommended aggressive treatment. She started Taxotere and Cytoxan chemotherapy on November 29, 2023 and had a rare hypersensitivity reaction to Taxotere, but completed treatment. Chemotherapy was followed by 25 rounds of radiation, which caused painful peeling skin and delayed reconstruction. As of June 2025, she was rebuilding life with her husband and 3 young sons while trying to be present through uncertainty. Her story underscores how dense breasts, pregnancy, and breastfeeding can complicate follow-up of a persistent lump.