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Treatments and drugs
By Mayo Clinic staffTreatment of ILC consists of surgery and additional (adjuvant) therapy, which may include chemotherapy, radiation and hormone therapy. At the time of the breast cancer surgery, the lymph nodes under your arm are also evaluated using the sentinel node technique. The sentinel lymph nodes are the first lymph nodes to receive drainage from breast tumors, and if they test negative for cancer cells, the cancer likely hasn't spread outside the breast. If the sentinel lymph nodes are positive for cancer, then the surgeon will discuss removing additional lymph nodes, a procedure known as an axillary node dissection.
If the tumor is large relative to the size of your breast and you're hoping to have breast-sparing surgery, your surgeon may recommend chemotherapy before surgery (neoadjuvant chemotherapy) to shrink the tumor. After you've completed this initial chemotherapy, your surgeon will then decide if breast-conserving surgery is an option.
Surgery
It's sometimes possible to remove early-stage ILC with a breast-sparing operation known as lumpectomy or wide local excision. The surgeon will remove the tumor itself, as well as a margin of normal tissue surrounding the tumor to make sure all the cancer that can be removed is taken out. Negative or "clean" margins reduce the chance of leaving any cancer in the breast. If the margins are positive, you may need additional surgery until negative margins are achieved, or the surgeon may decide to perform a mastectomy.
Chemotherapy
Chemotherapy uses drugs to destroy cancer cells. Treatment often involves receiving two or more drugs in different combinations. You may have four to eight treatments or "cycles" spread over three to six months.
Radiation
After a lumpectomy, a course of radiation therapy is given to kill any remaining cancer cells in the breast and under your arm. This can help decrease the chance of cancer coming back in the area. Radiation typically involves about 30 treatments over six weeks and begins about three to four weeks after the lumpectomy. If chemotherapy is recommended, you will receive the chemotherapy treatment first, followed by radiation therapy.
Hormone therapy
Hormone therapy — or more accurately, hormone-blocking therapy — is commonly used to treat ILC when the tumor tests positive for estrogen receptors. Two classes of medications are used in hormone therapy: selective estrogen receptor modulators (SERMs), such as tamoxifen; and aromatase inhibitors, such as anastrozole (Arimidex), letrozole (Femara) or exemestane (Aromasin).
