Lobular Breast Cancer: Comprehensive Overview by Dr. Lizza Raiden

Introduction

• Presenter: Dr. Lizza Raiden
• Personal Experience: Mixed ductal and lobular breast cancer since 2015
• Purpose: To provide information on lobular breast cancer (LBC)

What is Lobular Breast Cancer?

• Develops from glandular tissue in the breast
• Comprises 10-15% of all breast cancers
• Common in menopausal women
• Often ER positive and HER2 negative
• Tends to be larger and multifocal
• Possibly bilateral at diagnosis
• Rare type: Pleomorphic Lobular Breast Cancer

Detection Challenges

• Lobular cancer cells grow in sheets, not clumps
• Harder to detect on mammograms
• Detected better via ultrasound and MRI
• Occult cancers can still be missed

Symptoms and Signs

• Symptoms include skin dimpling, fuller breast, nipple inversion
• Hard to detect through self-examination

Diagnosis Methods

• Mammogram: picks up 2/3 of lobular cancers
• Ultrasound: detects 90% of lobular cancers
• MRI: detects 95% of lobular cancers

Treatment Approaches

• Surgery: Lumpectomy or mastectomy to remove cancer with clear margins
• Chemotherapy: Less effective for slow-growing lobular cancers
• Hormonal Therapy: Main treatment, aiming to lower estrogen levels
  • Often combined with CDK inhibitors
• Targeted Therapy: E.g. CDK4/6 inhibitors

Recurrence and Metastasis

• Lobular cancer can recur 10-20 years post-treatment
• Metastasizes to liver, bones, abdominal cavity
• Symptoms: indigestion, constipation, urinary difficulties

Research and Future Directions

• Immunotherapy: Trials like Gelato examining new treatment options
• Genetic Mutations: Investigation into mutations like PIK3CA and CDH1 genes
• Liquid Biopsies: Potential future diagnostic method

Personal Story and Advice

• Regular self-checks and professional consultations critical
• Ask for regular MRI if previous mammograms missed the cancer

Conclusion

• Continuous research is pivotal
• Patients encouraged to stay informed and proactive in management
• Links to support and further information provided

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