Invasive Lobular Carcinoma

Lobular breast cancer is a type of cancer that starts in the milk-producing glands of the breast, called lobules. Think of these lobules as tiny sacs in your breast.

In this type of cancer, the abnormal cells grow within these lobules and eventually break out of them. When this happens, the cancer cells can invade surrounding breast tissue. This means they can potentially spread to nearby lymph nodes and other parts of the body.

While lobular breast cancer is a type of breast cancer, it's actually less common than another kind called ductal breast cancer. Ductal cancer starts in the milk ducts, which are the tiny tubes that carry milk from the lobules to the nipple.

Sometimes, invasive lobular breast cancer doesn't cause any noticeable problems at first. But as the cancer grows, you might notice changes in your breast. These changes can include:

• Changes in the skin: The skin over your breast might feel different, like it's dimpled, puckered, or thickened. Imagine the skin looking or feeling a little like an orange peel.

• A new lump or swelling: A new area in your breast might feel full or swollen. This could be a noticeable change in how your breast feels.

• An inverted nipple: Your nipple might become inverted (pulled inward), which wasn't there before.

• Thickening in a part of the breast: A section of your breast might feel thicker or denser than the surrounding tissue.

Unlike some other types of breast cancer, invasive lobular carcinoma is less likely to create a hard, easily-felt lump. This is why it's important to pay attention to any changes in your breasts.

If you notice any of these changes – a lump, unusual skin texture, thickening, or nipple discharge – schedule an appointment with your doctor or other healthcare provider right away. It's crucial to get these checked out. They can help determine what's going on and recommend the best course of action.

Your doctor can also advise you on when to start getting screened for breast cancer and how often you should be screened. Most doctors recommend starting routine breast cancer screenings in your 40s. However, this might vary based on your individual risk factors, family history, and other health considerations. Talk to your healthcare professional to create a personalized screening plan.

If you notice any changes in your breasts, like a lump, unusual skin (like puckering), thickened areas, or nipple discharge, see a doctor or other healthcare provider right away.

Talk to your doctor about when and how often you should get breast cancer screenings. Most doctors recommend starting regular breast cancer screenings around age 40.

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Your breasts have 15 to 20 sections of tissue, like the petals of a flower. These sections, called lobes, are made up of smaller parts called lobules. These lobules produce the milk you use to breastfeed. Tiny tubes called ducts carry the milk to a storage area right under your nipple.

What causes a type of breast cancer called invasive lobular carcinoma isn't completely understood.

This cancer starts when the DNA inside some of the milk-producing cells in your breast changes. DNA is like a set of instructions for the cell. In healthy cells, the instructions tell the cells to grow and multiply at a certain speed, and then die at a certain time. But in cancer cells, the changed DNA gives new instructions. These instructions tell the cancer cells to grow and divide much faster than normal. They also tell the cancer cells to live much longer than healthy cells would. This leads to an uncontrolled growth of cells.

Unlike other breast cancers that often form a hard lump, invasive lobular carcinoma spreads more like a creep or a thickening. The area affected might feel different from the surrounding breast tissue. It might feel more like a thickening or fullness rather than a hard lump.

Increased Breast Cancer Risk Factors, Including Invasive Lobular Carcinoma

Many of the risk factors for invasive lobular carcinoma, a type of breast cancer, are similar to those for breast cancer in general. Here's a breakdown of some key factors:

Family History: If close relatives (parents, siblings, or children) have had breast cancer, especially at a young age or if multiple family members have been diagnosed, your risk goes up. However, most people with breast cancer don't have a family history.

Personal History: Having breast cancer in one breast raises the risk of getting it in the other.

Previous Breast Conditions: Certain breast problems, like lobular carcinoma in situ (LCIS) and atypical hyperplasia, signal a higher risk of breast cancer. If you've had a biopsy revealing one of these conditions, talk to your doctor about increased monitoring.

Early Menstruation and Late Menopause: Starting your period before age 12 or going through menopause after age 55 can slightly increase your risk.

Being Female: Women are significantly more likely to get breast cancer than men. Everyone has breast tissue, so anyone can develop breast cancer.

Breast Density: Breast tissue is a mix of fatty and dense tissue. Dense tissue includes milk glands, ducts, and fibrous material. If you have denser breasts, it might be harder to spot cancer on a mammogram. If your mammogram shows dense breasts, discuss additional screening tests with your doctor.

Alcohol Consumption: Drinking alcohol increases the risk of breast cancer.

Motherhood Timing: Giving birth to your first child later in life (after age 30) might slightly increase your risk. Having had one or more pregnancies tends to lower the risk.

Inherited Genes: Some genetic changes, passed down from parents, can significantly increase the risk of breast cancer. Two genes linked to invasive lobular carcinoma are BRCA2 and CDH1. BRCA2 is also connected to ovarian cancer, and CDH1 is strongly linked to a rare condition called hereditary diffuse gastric cancer syndrome, which also raises the risk of stomach cancer.

Hormone Therapy: Certain hormone therapies used to manage menopause symptoms can increase the risk of breast cancer, particularly those containing estrogen and progesterone. The risk decreases when you stop the therapy.

Obesity: Being overweight or obese raises your risk of breast cancer.

Age: The risk of breast cancer, including invasive lobular carcinoma, generally increases with age.

Radiation Exposure: If you had radiation treatments to your chest as a child or young adult, it increases your risk of breast cancer later.

It's important to remember that these are risk factors, not guarantees. Many factors influence breast cancer development, and discussing these risks with your doctor is essential for personalized health decisions.

Making lifestyle changes can help lower your chances of getting invasive lobular carcinoma and other breast cancers. Here's how:

Breast Cancer Screening: Talk to your doctor about when to start getting breast cancer screenings. Discuss the pros and cons of different tests, like mammograms. Together, you can decide what's best for you.

Breast Awareness: Get to know your breasts. Regularly examine your breasts to be familiar with how they normally look and feel. This is called a breast self-exam. If you notice any new changes, like a lump or anything unusual, tell your doctor right away. Knowing your breasts can help you spot any changes more easily. Important: Breast awareness doesn't prevent breast cancer, but it can help you be more aware of potential problems.

Alcohol: If you drink alcohol, limit it to one drink or less per day. There's no safe amount of alcohol when it comes to preventing breast cancer. So, if you're concerned about your risk, you may choose not to drink at all.

Exercise: Aim for at least 30 minutes of exercise most days of the week. If you haven't been active for a while, talk to your doctor first and start gradually to build up your activity levels.

Hormone Therapy: Combination hormone therapy can increase your risk of breast cancer. Talk to a doctor about the benefits and risks of hormone therapy if you're considering it. If you're going through menopause and experiencing discomfort, you may decide the benefits of hormone therapy outweigh the risks. To reduce breast cancer risk, use the lowest possible dose for the shortest time needed.

Weight Management: If you have a healthy weight, try to maintain it. If you need to lose weight, work with your doctor to find healthy ways to do it. This often involves eating fewer calories and increasing activity slowly.

Family History and High Risk: If you have a family history of breast cancer or think you might have a higher risk, talk to your doctor. They can discuss options like preventive medications, surgery, or more frequent screenings. It's important to discuss your individual risk factors with a healthcare professional.

Diagnosing Breast Cancer, Including Invasive Lobular Carcinoma

Finding out if you have breast cancer, including invasive lobular carcinoma, often starts with a checkup and a discussion about your symptoms. Doctors use different tests to examine your breast tissue and look for anything unusual. To know for sure if there's cancer, a small piece of breast tissue is taken for testing.

Physical Exam: A doctor will examine your breasts visually, checking for changes in the skin or nipples. They will also feel your breasts, and the areas around your collarbone and armpits, for any lumps or unusual sensations.

Mammogram: A mammogram is an X-ray of your breasts. A technician positions your breasts on a special machine. Mammograms are often used to screen for breast cancer, looking for any signs that might be cause for concern. If a screening mammogram shows something unusual, a more detailed mammogram (diagnostic mammogram) might be done to get a closer look at the area. Sometimes, both breasts are examined. Invasive lobular carcinoma can sometimes be harder to detect on a mammogram than other types of breast cancer, but it's still a valuable tool.

Ultrasound: An ultrasound uses sound waves to create pictures of internal structures. A breast ultrasound can help your doctor learn more about a lump, determining if it's a solid mass or a fluid-filled cyst. This information helps your doctor decide what further tests might be needed. Sometimes, invasive lobular carcinoma is harder to see on ultrasound than other types of breast cancer.

MRI (Magnetic Resonance Imaging): An MRI uses a powerful magnet and radio waves to create detailed images of the inside of your body. A breast MRI can provide detailed images of your breasts, helping to find any other areas of cancer in the affected breast and possibly checking for cancer in the other breast. Before an MRI, you may receive a special dye injection to help the tissue show up more clearly on the images.

Biopsy: A biopsy is a procedure where a small sample of tissue is removed for testing in a lab. A doctor uses imaging (like X-rays or ultrasound) to guide a needle into the suspicious area and collect the tissue sample. A small marker is often placed at the site to help track the area during follow-up appointments. The tissue sample is sent to a pathologist, a doctor who specializes in examining body tissues. Lab tests on the tissue sample can determine if the cells are cancerous, the type of cancer, and how quickly it's growing. These results help your doctor determine if you have invasive lobular carcinoma.

Further Testing: After a diagnosis of invasive lobular carcinoma, your doctor might order additional tests to figure out the extent (stage) of the cancer. This helps to determine the best treatment plan and prognosis. These tests can include blood tests (like a complete blood count and kidney/liver function tests), bone scans, CT scans, MRIs, and PET scans (positron emission tomography). Not everyone needs all of these tests; your doctor will select the most appropriate ones for your situation.

Cancer Staging: The stages of invasive lobular carcinoma are similar to other types of breast cancer, ranging from 0 to 4. Lower stages (0-3) indicate less advanced cancer and better chances of a cure. Stage 0 cancer is contained within the milk ducts. As the cancer grows and spreads, the stage increases. Stage 4 cancer has spread to other parts of the body. Sometimes, complete staging information may not be available until after breast surgery.

Invasive lobular carcinoma, a type of breast cancer, is treated similarly to other breast cancers. The main treatment often starts with surgery to remove the cancer. This is usually followed by other treatments, like radiation, chemotherapy, and hormone therapy. Sometimes, chemotherapy or hormone therapy is given before surgery to help shrink the tumor and make it easier to remove.

Key Differences in Invasive Lobular Carcinoma Treatment:

• Hormone Sensitivity: Most invasive lobular carcinomas are sensitive to hormones (estrogen and progesterone). This means they're likely to respond well to hormone therapy, which blocks these hormones from fueling the cancer's growth.
• HER2 Status: Unlike some other breast cancers, invasive lobular carcinomas usually don't produce excessive amounts of a protein called HER2. Treatments targeting HER2 are therefore less likely to be effective.

Choosing Your Treatment:

Your specific treatment plan is personalized and depends on several factors:

• Cancer Stage and Growth Rate: The stage of the cancer (how far it has spread) and how quickly it's growing are important considerations.
• Overall Health: Your general health plays a role in determining the best treatment approach.
• Personal Preferences: Your preferences and choices are also factored into the treatment plan.

Surgical Options:

Surgery may involve removing the cancer or all breast tissue, or both. The goal is to remove the cancer and as much of the surrounding tissue as needed.

• Lumpectomy (Breast-Conserving Surgery): This procedure removes the cancer and some surrounding healthy tissue. It's often followed by radiation therapy, especially for smaller tumors. Chemotherapy might be used before a lumpectomy to shrink the cancer.
• Mastectomy: This removes the entire breast. There are different types, including:
  • Total Mastectomy (Simple Mastectomy): Removes the entire breast, including the lobules, ducts, fatty tissue, skin, nipple, and areola.
  • Skin-Sparing Mastectomy: Removes the breast tissue but leaves the skin and nipple.
  • Nipple-Sparing Mastectomy: Removes the breast tissue but leaves the nipple and areola. These newer procedures can help maintain the appearance of the breast.
  • Mastectomy might be necessary for larger tumors or multiple areas of cancer within one breast. It's also an option if radiation therapy isn't desired or possible.
• Sentinel Node Biopsy: This procedure identifies and removes the first lymph nodes where the cancer might spread. A harmless dye and a radioactive solution help locate these nodes. If no cancer is found in these sentinel nodes, it's unlikely to be found in other lymph nodes, reducing the need for more extensive lymph node removal.
• Axillary Lymph Node Dissection: If imaging shows the cancer has spread to the lymph nodes under the arm, this procedure removes these lymph nodes.

Other Treatments:

• Hormone Therapy (Endocrine Therapy): This treatment uses medications to block hormones that fuel cancer growth. Many invasive lobular carcinomas respond well to hormone therapy.
  • Types of Hormone Therapy Medications: These include medications that block hormones from attaching to cancer cells, medications that stop the body from producing estrogen after menopause, or procedures to stop the ovaries from making hormones.
  • Side Effects: Possible side effects include hot flashes, night sweats, vaginal dryness, bone thinning, and blood clots.
• Radiation Therapy: This uses high-energy beams (like X-rays) to kill cancer cells. It's often used after surgery to eliminate any remaining cancer cells and reduce the risk of recurrence.
  • Side Effects: Common side effects include tiredness and a sunburn-like rash in the treated area. Rarely, more serious side effects like heart or lung damage can occur.
• Chemotherapy: This uses strong medicines to kill cancer cells. It's often used after surgery to reduce the risk of recurrence or before surgery to shrink the tumor.
  • Side Effects: Possible side effects include hair loss, nausea, vomiting, fatigue, increased infection risk, premature menopause, and nerve damage. Very rarely, certain chemotherapy drugs can lead to blood cancers.
• Targeted Therapy: This uses medicines that target specific molecules in cancer cells. Some targeted therapies are effective against breast cancers with excessive HER2 protein production. Since most invasive lobular carcinomas don't overproduce HER2, these treatments are less effective.

Complementary and Alternative Medicine:

While no alternative treatments cure breast cancer, some therapies might help manage treatment side effects, such as hot flashes. These include acupuncture, hypnosis, meditation, relaxation techniques, Tai chi, and yoga. Always discuss any alternative treatments with your doctor.

Coping with a Breast Cancer Diagnosis:

Dealing with a breast cancer diagnosis can be overwhelming. Seeking support from friends, family, support groups, counselors, or clergy can be helpful. Taking care of your physical health through proper nutrition, exercise, and adequate rest is also important.

Important Note: This information is for general knowledge and does not constitute medical advice. Always consult with your healthcare team for personalized guidance and treatment options.

Facing a breast cancer diagnosis can be incredibly overwhelming, especially when you need to make important treatment decisions quickly. It's completely normal to feel stressed and unsure. However, ways to cope will emerge. In the meantime, here are some helpful strategies:

Understanding Your Cancer: Learning about invasive lobular carcinoma (ILC) can empower you to make informed choices about your care. Ask your healthcare team for details about the type, stage, and hormone receptor status of your cancer. Don't hesitate to ask for reliable sources of information about treatment options. Understanding your disease and available choices can boost your confidence. Importantly, if you prefer not to delve into the specifics of your cancer, communicate this to your medical team. This is perfectly acceptable.

Building Support: Friends and family are vital during cancer treatment. They can offer a crucial support network. When sharing your diagnosis, you'll likely receive many offers of help. Think about what kind of support you might need, such as someone to listen when you need to talk, or help with meal preparation.

Connecting with Others: Talking to other breast cancer survivors can be incredibly helpful and reassuring. Reach out to a local cancer support organization (like the American Cancer Society in the U.S.) to find support groups, either in person or online.

Addressing Your Emotions: It's important to find someone to talk to about your feelings. This could be a supportive friend, family member, a spiritual advisor, or a counselor. If you need professional help, ask your healthcare team for a referral to a counselor or therapist specializing in cancer patients.

Prioritizing Self-Care: During treatment, prioritize rest and relaxation. Aim for sufficient sleep, and make time for activities that help you relax. Nourish your body with a healthy diet rich in fruits and vegetables. Maintain as much of your normal routine as possible, including social activities, to the extent you are able. Physical activity, to the degree you can handle, is also important. Take care of your body as much as you can, within the constraints of your treatment.