From: healthline.com
Invasive Lobular Carcinoma Is an Understudied Form of Breast Cancer. It’s Time to Change That
You know how mammograms are supposed to help you spot breast cancer early so you have a better chance at survival?
Yeah, I bought into that, too. I dutifully went through those smash-and-screens for years, until early 2011 when I looked in the mirror and noticed a weird little dent just below my left nipple.
That dent turned out to be lobular breast cancer. Stage 3.
And I had four clumps of it, two in each breast. The tumors had been growing slowly and stealthily for years, maybe even as long as I’d been going in for those dang mammograms.
Never heard of lobular? I hadn’t either. But invasive (invisible, more like) lobular carcinoma is the sixth most diagnosed cancer in women. At least, when you break it out from its sister and partner-in-crime invasive ductal carcinoma (IDC).
Ductal breast cancer — the kind that makes a lump — accounts for about 80 percent of breast cancers.
Lobular, ILC for short, accounts for around 10 percent — or just 1 in 10 invasive cases.
The numbers are fuzzy because lobular hasn’t really been studied all that much. In a breast cancer paper in the late 1970s, a leading researcher basically said: “Look, women with lobular die at the same rates as women with ductal, so let’s just stick with what we’re doing.”
“There are no special considerations regarding its management,” he wrote. And that was that.
Unfortunately, this particular flavor of breast cancer (there are several) is not the same and shouldn’t be treated the same.
Lobular is notoriously hard to image — in mammography and other scans. As a result, people with lobular are often diagnosed at a later stage, like me.
Every one of my cancer docs called it “sneaky,” saying it’s harder to spot because it doesn’t usually make a lump.
Lobular hiding within already difficult-to-screen dense breast tissue? That’s a double-whammy (which is also how I ended up with my Twitter handle and blog, Double Whammied).
In the 9 years since my treatment, I’ve figured out a lot about lobular, and cancer, in general. I even work at a cancer research center these days, not as a scientist, but a science writer.
Interestingly, the place even has some lobular history. Back in 2000, epidemiologists at the Fred Hutchinson Cancer Research Center in Seattle discovered ILC breast cancer rates were on the rise. When they analyzed data from a huge Women’s Health Initiative studyTrusted Source, they quickly figured out why.
Women had recently begun using hormone replacement therapy (HRT) to deal with their menopause symptoms. Along with helping curb hot flashes, it also gave a lot of them lobular breast cancer. Strokes, too. And blood clots.
The FDA put the kibosh on the use of HRT and there’s been a raging debateTrusted Source about it ever since.
And lobular? It kind of got lost in the shuffle.
Instead of figuring out how and why a combination of estrogen and progestin would drive this cancer, the powers-that-be decided lobular was already solved. It was just another estrogen receptor positive breast cancer, like ductal. Nothing to see here.
Lobular got lumped in again with its big sister, despite clear molecular differences. And the needle on knowledge again stopped moving.
Barbara Jacoby is an award winning blogger that has contributed her writings to multiple online publications that have touched readers worldwide.