This type of breast cancer starts in the glands that produce milk, they are called the lobules.
Lobular carcinoma is divided into two subtypes:
- Lobular carcinoma in situ (LCIS), it is also known as lobular neoplasia
- Invasive lobular carcinoma (ILB), it is also known as infiltrating lobular carcinoma
It is important to understand that the symptoms, diagnosis, and treatment for each differ.
Lobular Carcinoma in Situ
LCIS is not considered cancer, but it is believed to be a sign that breast cancer will take place. It indicates that there are abnormal cells in the lobules of the breasts, but these cells usually do not travel to other parts of the breast or body. The term “in situ” means “in the original place.”
Most women suffering from LCIS haven’t yet gone through menopause. Often, multiple lobules are affected. About a third of the time, there are areas of lobular carcinoma in situ in both breasts.
However, it does not go away, so you should be alert. From 20% to 40% of women with this diagnosis will suffer from a separate invasive breast cancer – one that can invade other parts of the body – within the next 15 years. Later on, it starts in the milk ducts, rather than the lobules.
How is lobular carcinoma in situ diagnosed?
There are no specific signs and symptoms of this state. Many times, it’s not even found by mammograms. Unlike other types of breast cancers, LCIS doesn’t cause lumps. It is most often found out when a biopsy is done for another reason.
The biopsy results for LCIS can be very identical to a common breast cancer called ductal carcinoma in situ. Thus you may need to see several doctors before knowing the correct diagnosis.
How is lobular carcinoma in situ treated?
Most women suffering from LCIS are not required treatment with surgery or medications. But your doctor may advise you do not turn a blind eye on your situation. That means regular breast self-exams, office visits, and routine mammograms or other tests such as MRIs.
If you have a family member who had breast cancer and are at a high risk, your doctor may prescribe medications such as anastrozole (Arimidex), exemestane (Aromasin), raloxifene (Evista), or tamoxifen (Nolvadex). These meds may minimize the risk that you will have invasive breast cancer.
Some women are more likely to have preventive surgery called a prophylactic mastectomy. The operation is considered to remove one or both breasts. This procedure can greatly lower the risk of breast cancer in the future.
Invasive Lobular Carcinoma
Invasive lobular carcinoma (ILC) is one of the most common breast cancers. It starts in one of the breast lobules, and then invades other parts of the breast. It may be found in both breasts than other forms of breast cancer.
How is invasive lobular carcinoma diagnosed?
You may not experience any lump. But you may find a thickening or a hardening of your breast. It often takes place in the part above your nipple toward your underarm. Your breast skin may dimple or nipple may invert.
Often, ILC can not be detected by a mammogram. If you think that you have some signs, a biopsy is used in order to find cancer cells. Most biopsies use a needle to extract a sample of cells from the breast. In some cases, larger samples will be necessary or the whole tumor will be removed for analysis.
Thanks to the results of biopsy your doctor will diagnose you and tell you whether there is invasive lobular carcinoma and how aggressive it may be.
Invasive lobular carcinoma expands. So additional tests may be required in order to find cancer cells in other parts of your body. These tests may include:
- CT scan. It is X-ray that provides detailed pictures inside your body.
- PET scan. In combination with a CT scan, this test can help find cancer in lymph nodes and other areas.
- MRI. It uses strong magnets and radio waves to provide pictures of the breast and other structures inside your body.
- Bone scan. A radioactive substance called a tracer is injected into your arm, and pictures are taken to find out if cancer may have spread to your bones.
- Chest X-ray: It uses radiation in low doses to provide images of structures inside your chest.
Your doctor will also take samples from your lymph nodes in the armpits to check for cancer. This is called axillary lymph node dissection.
The results of your exams will define the stage of your breast cancer and the best treatment options.
How is invasive lobular carcinoma treated?
Most women suffering from invasive lobular carcinoma have surgery to remove the cancer from the breast. Most of all, the tumor can be taken out without removing the entire breast. It will depend on the size of your tumor and how much it has affected your breast and surrounding lymph nodes.
Chemotherapy, radiation therapy, hormone therapy, or some combination of the three is common for treating ILC. Chemotherapy and hormone therapy are systemic treatments. Their main purpose is to eliminate cancer cells throughout your entire body. Radiation specifically focuses on the area around your breast cancer. Cells in invasive lobular carcinoma often contain estrogen and progesterone receptors. There are hormone treatments to kill these cells.
Other kinds of therapy may be helpful if the cancer is HER2-positive.