About Lobular Carcinoma in Situ (LCIS)

Overview

Lobular breast carcinoma refers to a type of breast cancer that originates in the lobules, which are the milk-producing glands in the breast. It is also known as invasive lobular carcinoma (ILC) or infiltrating lobular carcinoma. Unlike other types of breast cancer, lobular breast carcinoma grows and spreads differently. It can move from the lobules to the surrounding breast tissue, lymph nodes, and other organs in the body. Symptoms of lobular breast carcinoma may not include palpable lumps, making it challenging to detect through physical examination or mammograms. Early diagnosis and treatment are crucial for improving long-term outcomes. While lobular carcinoma in situ (LCIS) is a separate condition that is not invasive, it is considered a marker for increased risk of developing invasive breast cancer in the future. Treatment options for lobular breast carcinoma may include surgery, radiation therapy, chemotherapy, hormone therapy, or targeted therapy. It is important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan tailored to individual circumstances.

Causes and Risk Factors

Lobular breast carcinoma (LBC) is a type of breast cancer that starts in the milk-producing glands of the breast. The exact causes of LBC are still unclear, but it is believed to begin when the cells in these glands undergo DNA mutations that disrupt their normal growth and death control mechanisms. As a result, these cancer cells start dividing and spreading out like branches, which makes it less likely for a lump to be felt.

When it comes to non-modifiable risk factors for LBC, they include factors that cannot be changed or controlled:

Age: The risk of LBC increases with age.
Genetic predisposition: Certain genetic mutations, such as CDH1 mutations, can increase the risk.

On the other hand, modifiable risk factors for LBC are those that can be influenced or changed:

Alcohol consumption
Use of combined hormone replacement therapy
Early menarche (onset of menstruation before the age of 12)
Late-onset menopause (menopause after the age of 55)
Nulliparity or low parity (less than 5 pregnancies with gestation periods of 20 weeks)
Late age at first birth (over 30 years)
Family history of hereditary diffuse gastric cancer syndrome

It's important to note that while these factors may increase the risk of developing LBC, they do not guarantee its occurrence. If you have concerns about your risk factors or symptoms, it's best to consult with your healthcare professional for personalized advice.

Symptoms

In the early stages of lobular breast carcinoma (LBC), it may not cause any noticeable symptoms. However, as the cancer progresses or becomes more severe, the following symptoms may occur:

Early symptoms of LBC:

Less likely to have obvious lumps compared to other types of breast cancer
No signs or symptoms in the early stages

Symptoms of later stages, progression, or higher severity of LBC:

Thickening or hardening in a certain area of the breast
Swelling or feeling fullness in a certain area of the breast
Changes in texture or skin appearance, such as dimpling
Development of a newly inverted nipple
Changes in size or shape of the breast
Breast pain or nipple pain
Discharge other than breast milk
Lump around the underarm area

It's important to note that these symptoms can also be associated with other conditions. If you notice any of these signs or symptoms, it is recommended to see a doctor for further evaluation.

Diagnosis

To diagnose lobular breast carcinoma, the following examinations, tests, and procedures are commonly performed:

Mammography: This is a standard imaging test that uses X-rays to detect abnormalities in breast tissue.
Ultrasound: It uses sound waves to create images of the breast and can help distinguish between solid masses and fluid-filled cysts.
Biopsy: A tissue sample is taken from the breast for examination under a microscope to confirm the presence of cancer cells. This can be done through various techniques, such as fine-needle aspiration or core biopsy.

To determine the stage or severity of lobular breast carcinoma, additional examinations, tests, and procedures may be performed:

Magnetic resonance imaging (MRI): This imaging technique provides detailed images of the breast and surrounding tissues, helping to assess the extent of cancer spread.
Lymph node evaluation: Sentinel lymph node biopsy or axillary lymph node dissection may be performed to determine if cancer has spread to nearby lymph nodes.
Molecular subtyping: This analysis helps classify the cancer based on specific genetic features, providing information about potential treatment options and prognosis.

It's important to note that the specific examinations and tests performed may vary depending on individual factors and clinical guidelines. Consult with your healthcare professional for personalized advice.

Treatment Options

The goals of treatment for lobular breast carcinoma (LC) are to remove or destroy the cancer cells, prevent the cancer from spreading or recurring, and improve overall survival. Here are the different types of treatments and how they work to achieve these goals:

Medication types:

Endocrine therapy: This treatment uses medications that block the effects of hormones on breast cancer cells, such as tamoxifen or raloxifene. They work by reducing estrogen levels or blocking estrogen receptors, which can slow down the growth of hormone receptor-positive LC.

Therapies:

Surgery: Surgical options include breast excisional biopsy, lumpectomy (removal of abnormal tissue plus a margin of healthy tissue), or mastectomy (removal of the breast). These procedures aim to remove the cancerous cells.
Chemotherapy: This treatment uses drugs to kill cancer cells throughout the body. It is often used after surgery to destroy any remaining cancer cells or before surgery to shrink tumors.
Radiation therapy: High-energy X-rays are used to kill cancer cells and reduce the risk of recurrence. It is typically given after surgery.

Therapeutic procedures:

Sentinel lymph node biopsy: This procedure involves removing a few lymph nodes near the breast to check for cancer spread.
Axillary lymph node dissection: If cancer has spread to lymph nodes, this procedure removes more lymph nodes from under the arm.

Health behavior changes:

Regular screenings: Clinical breast exams, self-exams, and mammography are important for early detection and monitoring.
Lifestyle modifications: Maintaining a healthy weight, exercising regularly, limiting alcohol consumption, and avoiding hormone replacement therapy may help reduce the risk of LC.

Other treatments:

Palliative surgery: In cases where LC has spread to other organs and causes complications like intestinal obstruction or perforation, surgery may be necessary for symptom relief.

Remember, treatment plans should be individualized based on factors like cancer stage, age, and overall health. Consult with your healthcare professional for personalized advice.

Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.