According to the National Cancer Institute, one in eight women will be diagnosed with breast cancer in her lifetime. This estimate is based on breast cancer statistics for the years 2001 through 2003, and the rate of new breast cancer cases remaining the same. Of these women, one in 10 of them will be diagnosed with infiltrating, or invasive lobular carcinoma (ILC), a cancer that originates in the milk-producing glands in the breast.
Definition
The human breast is a complex organ containing several different types of tissues and structures. Embedded in a complex of connective and fatty tissues known as stroma are lobules for producing milk, and ducts for transporting the milk to the nipple. In ILC, abnormal cells inside the lobule begin to divide and break through the wall of the lobule to invade the surrounding stromal tissue.
Signs and Symptoms
Early signs of ILC can be difficult to detect, as the cancer tends to spread in sheets or webs rather than accumulate in clusters as happens in a ductal carcinoma. The diffuse nature of the tumor means that a lump is rarely felt in cases of ILC. Instead, ILC tends to manifest itself as an area of increased swelling or fullness in the breast, a thickening of the tissue, or changes in the appearance or texture of the skin of the breast.
Testing and Diagnosis
Testing for ILC may involve the use of several different imaging techniques, including mammography, sonography and MRI. In general, ILC is more easily visualized using sonography as compared to mammography, according to breastcancer.org. If imaging studies are suggestive of the presence of ILC, a biopsy may be performed. Formal diagnosis of ILC requires microscopic examination of a tissue sample.
Treatment
Treatment plans for ILC can vary depending upon the size of the tumor, the stage of disease and the overall health of the patient. In most cases, treatment for ILC begins with surgery. Surgical treatment of ILC can consist of a lumpectomy, where the tumor and some surrounding tissue are removed, or a mastectomy, where all of the breast tissue is removed. If it is suspected that the cancer has spread to nearby lymph nodes, an axillary node dissection, where the lymph nodes under the arm are removed, may be performed along with the lumpectomy or mastectomy.
Post surgical, or adjuvant treatment plans can include various combinations of radiation, chemotherapy and hormone therapy.
Radiation treatments that direct high-energy rays into the breast and underarm area are often administered to the remaining breast tissue when ILC is treated with lumpectomy instead of mastectomy. The goal of radiation therapy is to kill any cancer cells that might remain in the area after surgery.
In chemotherapy, powerful drugs are used to kill any cancer cells that might have left the immediate area of the original tumor. Chemotherapy involves significant side effects as these drugs can damage or kill healthy cells even as they destroy cancerous ones. Chemotherapy is generally considered when the tumor is more than one cm in size, or if cancer cells are found in the lymph nodes. Chemotherapy is also sometimes used before surgery in order to shrink large tumors, according to breastcancer.org.
In most cases, the growth of ILC is fueled by the female hormone estrogen, according to breastcancer.org and MayoClinic.com. In cases where hormones are determined to be involved in cancer growth, hormone therapies are used to help prevent the return of the cancer by either preventing the body from producing estrogen, or by preventing estrogen from stimulating potentially cancerous cells. Women who are postmenopausal at the time of treatment may be given one of a class of drugs called aromatase inhibitors. These drugs, which include Aromasin, Femara and Arimidex, prevent the body from producing estrogen. Women who are still experiencing monthly menstrual cycles, or who have difficulty tolerating one of the aromatase inhibitors, may be given a drug that blocks the activity of estrogen such as tamoxifen. Hormone therapy is a long-term treatment that can last five years or more.
Risk Factors
Risk factors for developing ILC include being female, increasing age, previous or current use of hormone replacement therapy to treat symptoms of menopause, genetics, or a previous diagnosis of LCIS--a non-invasive carcinoma of the lobules.
