Invasive lobular carcinomas
Invasive lobular carcinoma (ILC) is a type of breast cancer that originates in the lobules, the milk-producing glands of the breast, and can invade surrounding tissues. It accounts for approximately 10 to 15 percent of all breast cancer diagnoses, primarily affecting women over the age of fifty-five. Risk factors for ILC include reproductive history, such as never having had a full-term pregnancy and late menopause, as well as genetic predispositions like mutations in the CDH1 and PIK3CA genes. Symptoms may manifest as changes in breast appearance, lumps, or alterations in nipple sensations, including discharge or tenderness.
Screening and early detection are crucial, with recommendations for monthly self-exams, yearly checkups, and regular mammograms starting at age forty. The staging of breast cancer utilizes the TNM system, assessing tumor size and spread to lymph nodes and distant sites, which is essential for determining appropriate treatment. Treatments may involve surgery, radiation, and chemotherapy, tailored to the cancer's stage and hormone-receptor status. Prognosis for ILC is generally favorable when detected early, with a nearly 100 percent five-year survival rate, though this rate decreases significantly as the cancer spreads. Lifestyle factors such as physical activity, multiple pregnancies, and breastfeeding may help reduce the risk of developing breast cancer, including ILC.
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Subject Terms
Invasive lobular carcinomas
ALSO KNOWN AS: Stage I-IV breast cancer, infiltrating lobular carcinomas, ILC
RELATED CONDITIONS: Breast cancer
DEFINITION: Invasive lobular carcinoma originates in the lobules (milk-producing glands) and has invaded other tissues of the breast.
Risk factors: Risk factors include reproductive factors such as never having had a full-term pregnancy, first becoming pregnant after age thirty, starting menstruation early, and entering menopause late. Using synthetic hormones, having a family history of breast cancer, carrying breast cancer susceptibility genes, and advanced age increase a woman’s risk. Mutations in the CDH1 and PIK3CA genes are also risk factors.
Etiology and the disease process: In invasive lobular carcinoma, the cancer starts in the lobules, invades the surrounding breast tissue and lymph nodes, and can spread throughout the body.
Incidence: More than 12 percent of women will be diagnosed with breast cancer, making it the most common type of cancer in women other than skin cancer. Ten to fifteen percent of breast cancer cases are diagnosed as invasive lobular carcinoma. Most diagnoses are in women over fifty-five.
Symptoms: Any change in the look, size, or shape of the breast and any lumps or thickening in or near the breast or underarm area may be a symptom of breast cancer. Symptoms also include any change in the feel of the breast or nipple, such as nipple discharge, tenderness, a nipple turned in toward the breast, and ridges or pitting of the breast (when the skin looks like the skin of an orange).
Screening and diagnosis: Women should undergo monthly self-exams after age twenty, yearly checkups, and regular mammograms after age forty. Once breast cancer is detected, biopsies of the tumor are taken to obtain a diagnosis.
Staging of breast cancer is based on the TNM (tumor/lymph node/metastasis) system:
- Stage I: Has not spread beyond the breast and some nearby lymph nodes, and the tumor is less than 2 centimeters (cm)
- Stage II: Has spread to under the arm, and the tumor is 2 to 5 cm
- Stage III: Has spread to nearby lymph nodes but not to distant areas of the body
- Stage IV: Has spread to other parts of the body, like the liver, bones, or brain
Treatment and therapy: Treatments include surgery, radiation treatment, and chemotherapy, with the extent of treatment depending on the stage and hormone-receptor status. Surgery followed by radiation is the standard treatment and may involve a lumpectomy or mastectomy. Other treatments include hormonal therapies, chemotherapy, and biological therapies.
Prognosis, prevention, and outcomes: Invasive lobular carcinoma has a five-year survival rate of nearly 100 percent when caught early. For patients with cancer that has spread to nearby tissue, the survival rate is around 93 percent, and for those with widespread cancer growth, the rate is 22 percent. Factors that reduce the risk of breast cancer include physical activity, multiple pregnancies, breast-feeding, and early removal of both ovaries.
Bibliography
DePolo, Jamie. "Invasive Lobular Carcinoma (ILC)." Breast Cancer, 12 Mar. 2024, www.breastcancer.org/types/invasive-lobular-carcinoma. Accessed 20 June 2024.
Lee, Eun-Sook. A Practical Guide to Breast Cancer Treatment. Springer, 2023.
Limaiem, Faten, et al. "Lobular Breast Carcinoma." National Library of Medicine, 3 June 2023, www.ncbi.nlm.nih.gov/books/NBK554578. Accessed 20 June 2024.
"Lobular Breast Cancer (Invasive Lobular Carcinoma)." Cleveland Clinic, 20 Sept. 2022, my.clevelandclinic.org/health/diseases/21180-lobular-breast-cancer. Accessed 20 June 2024.
McCart Reed, Amy E., et al. "Invasive Lobular Carcinoma of the Breast: The Increasing Importance of This Special Subtype." Breast Cancer Research, vol. 23, 2021, pp. 1-16. doi.org/10.1186/s13058-020-01384-6.
Rosen, Paul Peter. Rosen’s Breast Pathology. 5th ed., Wolters Kluwer, 2021.
Shetty, Mahesh K. Breast Cancer Screening and Diagnosis: A Synopsis. Springer, 2014.
Sikka, Madhulika. A Breast Cancer Alphabet. Crown, 2014.
Williams, Angela. Breast Cancer Sourcebook: Basic Consumer Health Information about the Prevalence, Risk Factors, and Symptoms of Breast Cancer. 6th ed., Omnigraphics, 2019.