Stage IV HR-Positive Invasive Lobular Carcinoma: Ann's Patient Story
This breast cancer diagnosis at a glance
- Stage at diagnosis
- Stage IV
- Subtype
- Invasive Lobular Carcinoma
- Biomarkers
- ER-positive; HER2-negative
- Sex
- Female
- Spread to
- peritoneum; intestines/bowel
- Treatment
- surgery, reconstruction, chemotherapy, radiation, hormone therapy, ostomy and systemic therapy
- Outcome
- Living With Cancer
Treatment course, step by step
- Initial treatment in 2017: right mastectomy, lymph-node dissection, reconstruction, AC-T chemotherapy, radiation, and 5 years of an aromatase inhibitor.
- Metastatic recurrence in 2023: emergency surgery for complete bowel obstruction with ileostomy, followed by 9 months of an unnamed treatment regimen and later successful ileostomy reversal.
What happened, in summary
Ann was diagnosed in February 2017 with two large ER-positive, HER2-negative invasive lobular cancers in her right breast. The tumors had not been felt and had not appeared on mammograms, and cancer was found in 17 lymph nodes. She underwent right mastectomy, lymph-node dissection, and reconstruction, followed by AC-T chemotherapy, radiation, and five years of an aromatase inhibitor.
In 2022, anemia and worsening reflux led to further evaluation. Breast-cancer antigen tests were elevated, but two PET scans were negative. By mid-2023, Ann had severe abdominal pain, weight loss, vomiting, constipation, and diarrhea. A CT scan in the emergency department found complete bowel obstruction. Emergency surgery showed extensive metastatic invasive lobular breast cancer embedded in the peritoneum and intestines, and an ileostomy was necessary.
The recurrence left Ann angry that she had not understood how invasive lobular cancer can spread to the abdomen and may be difficult to see on PET imaging. After nine months of treatment, she pursued ileostomy reversal with a surgeon who believed it could be successful. The reversal gave her more freedom to travel, while peer support from other people with lobular breast cancer helped her understand and live with metastatic disease.
Where this story comes from
This is a lay summary of an account first published by breastcancer.org. Read the original in full
How we source and attribute stories Accuracy and limitations
These are lay summaries of published cancer stories, for information only. No two cancers behave the same way, and nothing here predicts your own diagnosis or replaces advice from your oncology team. Read the full disclaimer