Saturday, September 6, 2008

Lobular Breast Cancer

By Ray Lam

About 1 in 10 breast cancers diagnosed (10%) are invasive lobular carcinoma. This means that the cancer is growing in the cells that line the lobules of the breast. Invasive lobular cancer can develop in women of any age. But is most common in women between 45 and 55 years old. It is possible for men to get invasive lobular breast cancer, but this is very rare.

The types of cancer vary in their prognosis and the way in which they present. Lobular carcinoma (in situ and invasive) will be discussed here. The term 'in situ' refers to pre-invasive breast cancer. This is breast cancer which has not yet penetrated ('invaded') through the basement membrane (the membrane at the base of the epithelial lining of ducts or glands). In situ carcinoma has the potential to become invasive carcinoma, and so is treated as an early form of breast cancer. In the left-hand image below, you can see how the normal cells which form the lobules of the breast might look. In lobular carcinoma in situ (LCIS, the image to the right), the lobular cells have developed the ability to multiply out of control - one of the characteristics of cancer. The cancerous cells have not yet spread beyond the lining of the lobule. This is known as LCIS.

The outlook for invasive lobular breast cancer is much the same as for ductal breast cancer. Lobular breast cancer is not a more aggressive cancer, as is sometimes said. It is more common for it to be diagnosed in both breasts at the same time. And if you have invasive lobular breast cancer diagnosed in one breast, there is a slightly higher risk than there is for ductal breast cancer of getting it in the other breast in the future.

As for most types of breast cancer, surgery will be the first treatment. This may be a mastectomy or wide local excision. You will usually be given a choice between these two types of surgery. If a wide local excision is possible there is a chance that a second operation may be necessary to make sure that a clear enough area of tissue around the lump is taken. In some cases, to get a clear area of tissue it may be necessary for the whole breast to be removed. Invasive lobular cancer can sometimes affect more than one area within the breast. If this is the case the surgeon may recommend a mastectomy.

LCIS is viewed as an uncommon condition, but we don't know exactly how many people are affected. That's because LCIS does not cause symptoms and usually does not show up on a mammogram. It tends to be diagnosed as a result of a biopsy performed on the breast for some other reason.

If you have a wide local excision you will usually be offered radiotherapy to reduce the risk of the cancer coming back in the same breast. If you have a mastectomy you may not need radiotherapy.

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