The breasts in a woman’s body contain milk producing glands called lobules. The milk produced by these lobules reach the nipples via ducts. And while most forms of breast cancer originate in the ducts and then spread to other areas of the breast, in certain cases, the cancer may originate in the lobules before spreading throughout the breast. This form of cancer is called Lobular Breast Cancer.
The different forms of lobular breast cancer fall into two main categories, Invasive Loubular Carcinoma (otherwise called ‘Lobular Carcinoma’) and Lobular Carcinoma In Situ (otherwise called ‘Lobular Neoplasia’).
This form of lobular breast cancer happens to be the most common type of breast cancer (invasive) in women. The cancer originates in the breast lobules (in either one or both the breasts) and spreads to the other areas of the breast. In certain cases, the cancer can spread to other areas of the body via the lymph nodes and bloodstream as well.
Lobular Neoplasia or LCIS
Although this is adjudged to be a form of breast cancer, in reality it is not. Lobular Neoplasia can be considered as a warning flag for all other types of breast cancer (invasive and non invasive). LCIS is characterized by the presence of abnormal, cancerous like cells in the lobules and glands (possibly in both the breasts).
Unlike lobular carcinoma, LCIS does not spread to the other areas of the breast or body, and remains restricted to the milk producing glands. Although LCIS is not a cause for immediate concern, it can possibly lead to invasive breast cancer with time (ever after several years). As such, women diagnosed with LCIS would need to monitor the condition regularly to spot anomalies if any earlier on.
Risk Factors Associated with Lobular Breast Cancer
The risk factors associated with lobular breast cancer vary for both categories. Accordingly, the risk factors associated with lobular carcinoma in women include old age (the chances of contracting the condition increases steadily with age), gender (the condition is prevalent in females), inherited genetic traits (certain inherited genes and medical conditions can increase the risks of being affected by lobular carcinoma), hormone medications and therapies during and after menopause (changes in estrogen and progesterone levels in the body could fuel the development of lobular carcinoma in addition to camouflaging existing growths to the extent that they do not show on mammograms) and LCIS (the presence of abnormal cells inside the breasts could increase the risks of lobular carcinoma at a later stage).
The risk factors associated with LCIS in women include inherited genetic traits (more than one relative being diagnosed with breast cancer), old age (LCIS is more common in women in their 40s) and certain hormone replacement therapies (usually prescribed for menopausal symptoms).
Diagnosis of Lobular Breast Cancer
Diagnostic Tests for Lobular Carcinoma
Lobular Carcinoma is usually characterized by the thickening or hardening of a specific area of the breast (right above the location of the cancerous growth). The hardened area would spread to the other areas of the breast and the underarms with time. The presence of a large tumor could lead to nipple dimpling wherein the skin in and around the nipple area becomes dimpled due to the presence of cancerous cells beneath it.
In most cases, a mammogram would not be enough to correctly diagnose lobular carcinoma. There are chances for the tumor to remain undetected by t he mammogram. In these cases, the doctor would recommend a surgical biopsy which would involve inserting either a needle (for small samples) or another surgical device (for either a larger sample or the complete tumor) into the breast and removing a portion of the tumor for clinical evaluation. The lab results would indicate the presence of lobular carcinoma and the severity of the condition as well.
lobular carcinoma can easily spread to the other areas of the body. Therefore, the doctor would also recommend a few additional tests like an MRI, a CT scan, a PET scan, a bone x-ray and a chest x-ray to determine whether the cancer has already spread to these regions and beyond. If initial tests for invasive lobular come out positive, the doctor would also recommend a procedure called axillary lymph node dissection which would involve the use of surgery to inspect the lymph nodes in the underarms for the presence of cancerous cells.
Diagnostic Tests for Lobular Carcinoma in Situ
Unlike other forms of breast cancer, LCIS does not form calcium deposits in the breast cells. The condition does not cause any symptoms (in most cases) is also often missed during routine mammograms. The only way to diagnose LCIS would be via a biopsy which would be recommended after an abnormality is suspected during a mammogram or physical checkup. The biopsy would involve removing a sample of the tumor and sending it to a lab for clinical evaluation. In the case of LCIS, the biopsy would also be done to detect any other abnormalities in the breast that could be contributing to the condition.
In certain cases, the test results for LCIS would be similar to the results of another form of breast cancer called as Ductal Carcinoma in Situ. Therefore, it is always considered wise to get a second opinion and probably undergo some more tests to correctly diagnose LCIS.
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Treatment Options for Lobular Breast Cancer
Treatment options for both forms of lobular breast cancer would differ for different individuals. The specific treatment plan chosen for the condition (both LCIS and lobular carcinoma) would depend on factors like the size of the tumor and the severity of the condition. Treatment plans would also differ according to individual preferences.
Treatment for Lobular Carcinoma
The best form of treatment for lobular carcinoma would be surgery wherein the doctor would surgically remove the cancerous growth from the breast, including tissues and lymph nodes which might have contracted the condition. In these cases, the doctor would recommend certain breast conserving procedures wherein only a small portion of one or both breasts would be removed. The exact size of the portion removed would depend again on the size of the tumor and its severity.
In certain cases, the doctor would recommend the use of local as well as systematic treatments for lobular carcinoma. Local treatments include radiation that would get rid of the cancer cells in and around the breasts. Systematic treatments on the other hand target all the areas of the body where the cancer might have spread, and include treatments like anti-estrogen endocrine therapy and chemotherapy
Treatment for Lobular Carcinoma in Situ
LCIS is usually not dangerous and so does not need to be treated immediately although the doctor would recommend regular tests (physical exams, mammograms and self breast exams) to monitor the condition.
In certain cases, LCIS can be treated with the help of anti-estrogen drugs (like raloxifene and tamoxifen) which target the estrogen and progesterone receptors in the body. These medications are usually prescribed for women who have high risks of contracting lobular carcinoma or other forms of breast cancer (invasive).
LCIS can also be treated with a surgical procedure called prophylactic mastectomy. This preventive procedure involves the complete removal of the affected breast(s). The procedure usually guarantees a cancer free life for the individual in question.
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