Have you ever wondered why some types of breast cancer are harder to detect than others? Breast cancer is a reality that affects millions of women around the world, and in India, its prevalence has been rising at an alarming rate, particularly among younger women. One type of breast cancer that’s becoming increasingly common, but often goes unnoticed is Lobular Breast Cancer (LBC). Unlike the more well-known types, LBC tends to be subtle, growing in a way that makes it difficult to catch early. We spoke to Dr Jasmeet C. Singh, MD, Breast Medical Oncologist, Memorial Sloan Kettering Cancer Center, New York, who explained this cancer, the complexities of this breast cancer, its risk factors, and the critical need for early detection and innovation in treatment.
Breast cancer is the most common malignancy among women worldwide, with its prevalence in India rising significantly over recent decades. From being the fourth most common cancer in the 1990s, it has now become the leading cancer affecting Indian women, according to a 2022 study.
“Alarmingly, a recent study in India found that over 25% of breast cancer cases now occur in women aged 40 or younger, a demographic for whom routine screenings like mammograms are not typically recommended. This presents a critical challenge in early detection and intervention efforts,” highlighted Dr Singh.
The Silent Threat of Lobular Breast Cancer
LBC or Invasive Lobular Carcinoma (ILC), is the second most prevalent form of breast cancer, making up approximately 15% of all breast cancer cases. It begins in the milk-producing lobules of the breast and has distinct characteristics that set it apart from other types, particularly Invasive Ductal Carcinoma (IDC), which is the most common form, as stated in the Memorial Sloan Kettering Cancer Center.
Unique Risk Factors
LBC or ILC has several risk factors that contribute to its development. The risk of developing LBC increases with age, with most diagnoses occurring in women over the age of 55.
“Hormone replacement therapies, especially those combining oestrogen and progestin, are linked to a slightly higher risk. Genetic mutations, particularly in the CDH1 gene, are a significant risk factor, as they affect cell adhesion and contribute to the cancer's diffuse growth pattern,” said Dr Singh.
Additionally, a family history of breast cancer and other reproductive factors, such as early menarche, late menopause, and nulliparity can elevate the risk. "Emerging trends show a growing incidence of LBC among younger women, highlighting the importance of awareness and proactive management, especially in regions like India where breast cancer is increasingly prevalent at an earlier age," added Dr Singh.
Also Read: How Does Alcohol Consumption Increase The Risk Of Breast Cancer?
Why Early Detection Is Challenging?
Early diagnosis of LBC can be challenging due to its subtle symptoms and non-cohesive growth pattern. Patients may experience vague sensations like fullness or firmness in the breast, along with possible skin or nipple changes, such as redness or discharge.
“However, in its early stages, LBC often presents with little to no noticeable symptoms. Unlike ductal breast cancer, which typically forms a distinct lump that is easier to detect through physical exams or imaging, LBC's scattered and non-cohesive cell growth can lead to missed diagnoses on standard mammograms,” added Dr Singh.
As a result, individuals may be diagnosed at a more advanced stage when the tumour is larger and lymph node involvement is more significant. Utilising advanced imaging techniques, such as ultrasound, contrast-enhanced mammography, and MRI, can enhance detection, especially for individuals at higher risk or those showing symptoms.
Also Read: Early-Onset Breast Cancer: What Younger Women Need to Know
Tailored Treatment Approaches
Treatment for LBC involves a tailored and multi-faceted approach, addressing the disease’s unique characteristics. This targeted, personalised approach helps improve the overall effectiveness of the treatment plan for individuals with lobular breast cancer. Here are some treatment approaches listed by Dr Singh:
Surgery is often the initial step, aiming to remove cancerous tissue and assess lymph node involvement.
Hormone therapy is commonly used since LBC is frequently hormone receptor-positive, meaning it depends on hormones like oestrogen for growth. The blocking of these hormones prevents cancer cells from proliferating.
In addition, targeted therapies have become increasingly important, focusing on specific molecular changes associated with breast cancer, including inherited mutations and cancer-specific alterations.
Following surgery, radiation therapy may be used to eliminate any remaining cancer cells in the breast or surrounding tissues, minimising the risk of recurrence and enhancing treatment outcomes.
Bottomline
Dr Singh concluded, “Improving outcomes relies heavily on advances in imaging techniques and personalised treatment approaches. To tackle the complexities of this cancer type, continued research and the development of tailored strategies are vital. This is especially crucial in regions like India, where the incidence of lobular breast cancer is on the rise, underscoring the importance of early diagnosis and effective management.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your professional if you are dealing with any health issues to avoid complications.]
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