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Invasive lobular breast cancer is uncommon, and affects about 10-15% of all women with breast cancer. It can occur at any age, but more commonly affects women in the 45-55 year age group. Men can also get invasive lobular breast cancer but this is very rare. Invasive lobular breast cancer is generally no more serious than other types of breast cancer. However, it is sometimes found in both breasts at the same time and there is also a slightly greater risk of it occurring in the opposite breast at a later date.
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.
Once your GP has referred you to a specialist, certain tests may be done to help make the diagnosis. They include mammogram, ultrasound scan, fine needle aspiration and needle core biopsy. Invasive lobular breast cancer can sometimes be difficult to diagnose. This is because it is less likely to present as a firm lump and is therefore not easy to feel. It is also more difficult to see on a mammogram. This is because the white dots (calcifications) that may be seen on a mammogram with other types of breast cancer are not usually formed by invasive lobular cancers.
Invasive lobular breast cancer does not always show up as a firm lump. And it does not form the pattern on a mammogram called calcification. So it can be difficult to diagnose. Because of this, invasive lobular cancers may be larger than other types of breast cancer when they are diagnosed. You may have a thickened area of breast tissue instead of a definite lump. The tests for lobular breast cancer are the same as for ductal breast cancer.
The treatment for invasive lobular breast cancer is the same as for ductal breast cancer. Usually, you will have surgery, possibly followed by radiotherapy or chemotherapy, or both. You may also have hormone therapy after surgery, if your breast cancer cells are oestrogen receptor positive. Look at the which treatment for breast cancer? page to find out more about how the various treatments are used.
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.
