Study sheds light on understudied breast cancer type

A multi-center analysis of patients with invasive lobular carcinoma, or ILC — the second most common histological subtype of invasive breast cancer in the U.S. — showed that, despite its prevalence, ILC is detected later and has worse outcomes than the predominant subtype of invasive breast cancer, known as invasive ductal carcinoma (IDC), or no special type.

Published today in the Journal of the National Cancer Institute, the study of more than 33,000 patient records from three large cancer centers — UPMC Hillman Cancer Center, Cleveland Clinic Cancer Center and The Ohio State University Comprehensive Cancer Center — Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC — James) — shows that ILC and IDC are biologically distinct, highlighting important differences between the two diseases and the need for specific detection and treatment options for the lobular subtype.

“Lobular breast cancer makes up about 10% to 15% of breast cancer cases, but it has historically been neglected by the research community, so we really don’t know that much about it,” said co-lead author Steffi Oesterreich, Ph.D., co-leader of the Cancer Biology Program at UPMC Hillman and professor at the University of Pittsburgh School of Medicine’s Department of Pharmacology & Chemical Biology. “There has been increasing awareness that ILC and IDC are distinct, but this large multi-center study provides compelling evidence that these are two different diseases that require different management.”

Co-senior authors Megan Kruse, M.D., a breast medical oncology specialist at Cleveland Clinic, and Nicole Williams, M.D., a breast medical oncologist at OSUCCC — James, worked with Oesterreich to analyze records from patients treated at the three cancer centers for ILC or IDC between 1990 and 2017.

“These findings likely indicate that detection of lobular breast cancer is delayed,” said Kruse. “When these tumors are finally detected, they’re larger and they’ve already moved to the lymph nodes, indicating the cancer is spreading. We need to put more effort into improving early detection of ILC by developing new imaging technologies or other methodologies.”

The idea for the study was sparked one evening as Oesterreich was washing dishes and listening to a recording of a Lobular Breast Cancer Alliance conference call that she’d missed. When Susan MacDonald, a lobular breast cancer advocate from Cleveland, mentioned that Cleveland Clinic researchers were beginning a project to analyze the center’s breast cancer registry, Oesterreich’s ears pricked up.

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