Invasive Lobular Breast Cancer
July 21, 2008
The types of cancer vary in their prognosis and the way in which they present. Lobular carcinoma (in situ and invasive) will be discussed here. The term ‘in situ’ refers to pre-invasive breast cancer. This is breast cancer which has not yet penetrated (’invaded’) through the basement membrane (the membrane at the base of the epithelial lining of ducts or glands). In situ carcinoma has the potential to become invasive carcinoma, and so is treated as an early form of breast cancer. In the left-hand image below, you can see how the normal cells which form the lobules of the breast might look. In lobular carcinoma in situ (LCIS, the image to the right), the lobular cells have developed the ability to multiply out of control - one of the characteristics of cancer. The cancerous cells have not yet spread beyond the lining of the lobule. This is known as LCIS.
Despite the fact that its name includes the term “carcinoma,” LCIS is not a true breast cancer. Rather, LCIS is an indication that a person is at higher-than-average risk for getting breast cancer at some point in the future. For this reason, some experts prefer the term “lobular neoplasia” instead of “lobular carcinoma.” A neoplasia is a collection of abnormal cells.
As for most types of breast cancer, surgery will be the first treatment. This may be a mastectomy or wide local excision. You will usually be given a choice between these two types of surgery. If a wide local excision is possible there is a chance that a second operation may be necessary to make sure that a clear enough area of tissue around the lump is taken. In some cases, to get a clear area of tissue it may be necessary for the whole breast to be removed. Invasive lobular cancer can sometimes affect more than one area within the breast. If this is the case the surgeon may recommend a mastectomy.
LCIS is viewed as an uncommon condition, but we don’t know exactly how many people are affected. That’s because LCIS does not cause symptoms and usually does not show up on a mammogram. It tends to be diagnosed as a result of a biopsy performed on the breast for some other reason.
If you have a wide local excision you will usually be offered radiotherapy to reduce the risk of the cancer coming back in the same breast. If you have a mastectomy you may not need radiotherapy.
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