Invasive lobular carcinoma is the second most common breast cancer right after invasive ductal carcinoma. Invasive lobular carcinoma begins in the lobules or the milk passageway leading to the nipple. Invasive means it has the ability to spread to other parts of the body. Lobular signifies that that the cancer begins in the milk lobules of the breast. Over 180,000 women will be told that they have an invasive breast cancer each year in the United States. Of those 180,000 women, 10 percent of them will have invasive lobular Carcinoma. Eighty percent of all breast cancers will be invasive ductal carcinoma and the last 10 percent will represent everything else.

Invasive lobular carcinoma can affect women of any age. but it is most common among older women. Two thirds of all women suffering from invasive breast cancer will be 55 years old or over when first diagnosed. Invasive ductal cancer diagnosis is usually made around 55 years of age, however with invasive lobular carcinoma it is even older. The average age for the diagnosis of this breast cancer is 60. Research suggests that hormone replacement therapy before or after menopause may increase the risks of contracting invasive lobular cancer.

Symptoms

Often there are no symptoms until a routine mammogram picks up an abnormality. Invasive lobular cancer does not form a lump that is detectable by feeling the breast. Instead the cancer forms around the stroma or tissue of the breast in a line formation. However, the breast can swell in areas and feel hard to the touch and the nipple may invert. There could also be skin irritation, redness, nipple or breast pain, scaling, thickening of the nipple or breast skin, discharge from the nipple, or a lump under the arm.

Diagnosing Invasive lobular carcinoma

The diagnosis often begins with a breast examination in the doctor’s office where the doctor might discover lumps under the arm. A mammogram may be ordered, but it is difficult to detect invasive lobular carcinoma because of the line formation rather than lump, which is easier picked up on the mammogram. Even if the mammogram does pick up invasive lobular carcinoma, it may appear to be smaller than it actually is. Additional mammograms and other imagine testing will most likely be done at this point. An ultrasound is more accurate than a mammogram for detecting invasive lobular carcinoma; however, it too can determine the cancer to be smaller than it actually is. The doctor may order a breast MRI and biopsies of the breast.

The doctor will choose the quickest and easiest biopsy that will fit your personal situation. It may be a fine needle biopsy that uses a tiny hollow needle to extrapolate the cancer cells, or a core needle biopsy which is bigger and takes out more cells for examination or tissue biopsy which remove a piece of the cancer tissue (incisional biopsy) or attempt to remove the entire cancerous area (excisional biopsy). Staging tests will be done to see how far the cancer has progressed and a bone scan, CT scan, and PET scan may be ordered depending upon the individual invasive lobular carcinoma case.

Treatments

The treatment will include surgery to remove the cancerous lump under the armpit, a mastectomy to remove part of or all of the breast, or a radical mastectomy, which removes not only the breast, but the lining of the chest wall muscle and lymph nodes, and breast reconstruction surgery. Again this will depend upon the individual case and the doctor will choose which surgery is necessary in your particular case. The doctor will always choose the least evasive surgery which have the best results for you.

The doctor will order radiation therapy after therapy to kill off any existing cancer cells, which were not picked up during surgery. Depending upon the case, chemotherapy may also be required to shrink and kill off any remaining cancer cells, and or hormonal therapy to block the estrogen receptors, which are known to facilitate cancer growth, and hormonal therapy that will target the cancer blood vessels and prevent new blood vessels from forming. Your doctor will discuss with you the right overall breast cancer treatment.

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