Lobular breast cancer, also known as invasive lobular carcinoma, is the second most common type of breast cancer worldwide, but unfortunately it is not as well understood or easy to cure as other forms of the disease. Unlike other types of breast cancer, it rarely forms a lump making it harder to spot and hindering treatments. Here we unpick what makes lobular breast cancer harder to cure and how research is helping give hope to patients around the world.
How is lobular breast cancer different to other types of breast cancer?
There are many different types of breast cancers and they all need different approaches to prevention, diagnosis and treatment. Breast cancer generally start in the milk ducts, which transport milk for breastfeeding. The most common type of breast cancer, ductal breast cancer, begins in the lining of the milk ducts.
Lobular breast cancer gets its name because it develops in tiny milk-producing glands at the end of the ducts called lobules. Around 1 in 7 breast cancer patients have lobular breast cancer. Sometimes it is referred to as invasive lobular carcinoma or ILC for short.
Lobular breast cancer grows in a line or as single cells, rarely forming a lump in the way that other breast cancers do. This makes it harder to show up on scans. It also spreads differently, and to different parts of the body and this metastasis can also be harder to spot.
Is lobular breast cancer curable?
The sooner lobular breast cancer is detected, the easier it is to cure and for many patients it can be treated effectively. However it can sometimes be more challenging to diagnose than other types of breast cancer and it doesn't always respond as well to treatment.
If you or a loved one have been diagnosed with lobular breast cancer your oncology team will be able to advise about your personal prognosis.
The more we understand about lobular breast cancer and the unique way it grows, the easier it is to find new cures. Historically it has been treated in the same way as other breast cancers, but we know this doesn’t work so well for lobular breast cancer patients. Discovery research can lead the way towards new ways to specifically prevent, diagnose and treat lobular breast cancer.
Why do we need more cures for lobular breast cancer?
Unfortunately, because it can be harder to spot than other types of breast cancer, lobular breast cancer is often diagnosed at a more advanced stage, making it hard to treat. Another challenge facing lobular breast cancer patients is the fear of the cancer returning. Lobular breast cancer can recur as much as ten or more years later.
Until recently lobular breast cancer was managed similarly to other types of breast cancer, but international cancer research has revealed useful information about lobular breast cancer and how it differs to other cancers. This is helping scientists and doctors discover more tailored, unique cures for lobular breast cancer.
Symptoms, diagnosis and treatment of lobular breast cancer
Symptoms of lobular breast cancer
Unlike other breast cancers, lobular breast cancer does not tend to cause a lump. Instead symptoms of lobular breast cancer can include:
A tugging or welling feeling in your breast
Constant or stabbing pain
Change in the breast appearance, such as puckering or dimpling
Itch on or inside your breast
Changes to your nipple including inverting or oozing discharge
A lump or welling under your arm
If you are worried at all about any symptoms please speak to your doctor.
How is lobular breast cancer diagnosed?
Spotting lobular breast cancer can be harder than some other breast cancers. You may need a combination of tests to discover the cancer and what stage it is at, including:
Mammogram. This is an x-ray of the breast tissue.
Ultrasound. Scan that uses sound waves to visualise the breast area.
Biopsy. A biopsy involves taking a sample of your breast tissue to examine under a microscope and to undergo testing.
Fine needle aspiration (FNA). This takes a sample of cells using a fine needle and syringe, so that they can be examined under a microscope.
MRI scan. A way to get a more detailed picture of the breast area.
How is lobular breast cancer treated?
If you or a loved one has been diagnosed with lobular breast cancer, your treatment plan will be developed by your oncology team for your specific cancer. Not everyone has the same treatments, or in the same order since everyone’s cancer is different.
Treatment for lobular breast cancer can include:
Surgery. A lumpectomy (also called breast-conserving surgery) involves removing the cancer and a margin of regular breast tissue. A mastectomy is surgery to remove all of the breast tissue. The type of surgery you need will depend on the stage of your cancer, where in the breast it is located and the size of it.
Chemotherapy. This involves taking strong medicine designed to destroy cancer cells. Although chemotherapy is not as effective for lobular breast cancer as it can be for other breast cancers, it can still be useful for some patients, particularly if it has spread to the lymph nodes or is more aggressive.
Radiotherapy. This form of treatment uses special radiation to target cancer cells. It is sometimes used after surgery to kill any remaining cancer cells.
Hormone therapy. A lot of lobular breast cancers grow with the help of the hormone oestrogen. This means that they can often respond well to a type of treatment called oestrogen blockers.
Targeted therapies. These work by killing cancer cells, whilst sparing healthy cells, and are becoming a reality for some cancer patients thanks to international cancer research about the differences between cancer cells and their healthy neighbours. Herceptin is an example of a targeted therapy that can sometimes be used for lobular breast cancers if you are positive for the HER2 protein. More research is needed to identify potential new targeted treatments for lobular breast cancer.
Why is lobular breast cancer harder to detect?
A lot of breast cancers grow in a lump which may be noticed by the patient or seen on a scan. Lobular breast cancer is different. It grows in thin lines or individual cells. This makes lobular breast cancer hard to detect by touch, and it can even go unnoticed in medical scans.
Around 1 in 3 lobular breast cancers are not identified using a mammogram, meaning that diagnosis is delayed and treatment is harder. Some studies suggest that MRI scans could be better at detecting lobular breast cancers, but more research is needed to find better ways to spot this cancer as early as possible.
Who is more likely to develop lobular breast cancer?
Risk factors for lobular breast cancer are similar to other types of the disease. We don’t yet fully understand what causes lobular breast cancer but these factors can play a role:
Gender. Anyone can develop breast cancer, but it is more common in women and when breast cancer develops in men it is more likely to be ductal breast cancer.
Age. Lobular breast cancer most commonly happens in older women, particularly after menopause.
Lifestyle. Drinking alcohol increases your risk of breast cancer and other cancers. Having obesity also increases your risk.
Family history. Having a relative with breast cancer does not mean you will get it too, but some genetic mutations that can put you at a higher risk are able to be passed down through families.
LCIS. Lobular carcinoma in situ (LCIS) is not a type of cancer itself but having this condition puts you at a higher risk of developing lobular breast cancer.
Hormone exposure. The hormone oestrogen is a risk factor for some breast cancers including lobular breast cancer. So the age of your first period, age of menopause, age of childbirth or if you are taking hormone replacement therapy may all impact your risk of lobular breast cancer.
For a lot of patients though, cancer-causing mutations can happen randomly in your breast cells. More research is needed to understand what kickstarts this life-threatening process and how we can stop lobular breast cancer in its tracks.
Where does lobular breast cancer spread to?
When any cancer spreads to other parts of the body, it becomes harder to treat. In lobular breast cancer, this problem can be even more challenging because it tends to spread to more unusual locations and it is harder to see it spreading.
Ductal breast cancer most commonly spreads to the bones, lungs, liver and brain. Lobular breast cancer though tends to spread to the ovaries, bones, the intestines, or tissue around the kidneys or uterus. This distinction makes it harder to spot the cancer spreading.
Discovery research to better understand how lobular cancer spreads and why it spreads to these other parts of the body is key to helping patients live better, for longer.
Why is lobular breast cancer research important?
In the past different breast cancers would have all been treated the same way, but thanks to international cancer research we now understand this isn’t the best approach for patients.
Lobular breast cancer has its own unique challenges. It doesn’t form lumps, so is harder to detect. It can sometimes respond differently to chemotherapy and it can also come back even after more than a decade. By understanding more about what causes lobular breast cancer, how it grows and why it spreads, we can begin to find solutions to these problems.
In 2016 lobular breast cancer was declared as ‘understudied’, meaning that more research is urgently needed to help the thousands of people affected by it worldwide. Discovery research is the first step towards new ways to prevent, diagnose and treat lobular breast cancer.
How Worldwide Cancer Research is working towards cures
There are over 200 different cancer types and they all need their own cures. Even within breast cancer, there are several types. Professor Cleton-Jansen and Professor Jonkers established that lobular breast cancer is a distinct disease from other types of breast cancer. This work, partly funded by Curestarters, laid the foundations for more specific lobular breast cancer research and treatment approaches.
Thanks to you, Professor Darran O’Connor in Ireland has discovered a new drug combination that looks like it could be a powerful way to treat lobular breast cancer. The research is still in early stages, but by kickstarting this idea Curestarters have helped it get closer to a clinical trial.
This sort of discovery research is vital to help reach a day where no life is cut short. Thanks to Curestarters new ideas are being supported every year which could help patients around the world with any type of cancer.
The Worldwide Cancer Research grant was instrumental in looking for a new therapeutic option for lobular breast cancer patients. Before the grant we had no data to support a clinical trial in humans, now we do.
Your FAQs about lobular breast cancer
Can lobular breast cancer be seen on a mammogram?
One challenge of lobular breast cancer is that it is harder to detect than other cancers. Because it normally does not involve a lump, it can sometimes go undetected on mammograms. To diagnose lobular breast cancer a combination of different scans may be used to help detect it.
Is lobular breast cancer hereditary?
Most cases of lobular breast cancer are not hereditary. The cancer starts because of mutations in your DNA and most of the time these mutations happen due to random chance or other risk factors. Occasionally mutations in genes including BRCA1 and BRCA2 can be passed on through families, increasing your risk of developing lobular breast cancer.
Can men get lobular breast cancer?
Anyone with breasts can develop breast cancer, including men. However, in most cases men tend to develop a different type of breast cancer called ductal breast cancer rather than lobular breast cancer.
Does lobular breast cancer come back?
Unfortunately lobular breast cancer can come back. Unlike other breast cancers which tend to come back within a few years if they do recur, lobular breast cancer can go quiet for over a decade before re-appearing. Discovery research to help us better understanding why lobular breast cancer behaves like this is vital to help patients live without this fear
What research is being done into lobular breast cancer cures?
Curestarters are helping find new cures for lobular breast cancer. Professor O’Connor and his team in Ireland have been testing new targeted drugs to overcome treatment resistance in invasive lobular breast cancer. Excitingly, they have discovered a potential treatment combination they hope to take to clinical trials in the future.
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