Invasive Lobular Carcinoma

Invasive Lobular Carcinoma is the second most common type of breast cancer and accounts for 8% to 14% of breast cancers, after Invasive Ductal Carcinoma. Carcinoma describes cancer occuring in the epithelial or lining layer of cells, almost all cases of breast cancer are carcinomas. The carcinoma can either be in the milk ducts or in the lobules and in some cases can be in both areas. ILC is characterised by small rounded cells that be difficult to find on mammograms as they do not readily form masses.

In this case, cancer has spread to surrounding tissues after being generated in the milk-producing lobules of the breast. It is invasive as it invades other parts of the breast. Over time, ILC can spread to the axillary lymph nodes, most commonly those situated under the armpits.

It is most common in women between the ages of 45 to 55, however, women outside of this range can develop ILC in some cases.

Symptoms include:

  • an area of thickening or swelling
  • a change in the nipple, for example if it turns inwards (inverted)
  • a change in the skin, such as dimpling or thickening

 

IF YOU EXPERIENCE ANY OF THESE SYMPTOMS OR OTHERS ASSOCIATED WITH BREAST CANCER, SEE YOUR DOCTOR IMMEDIATELY.

Mammograms, which are x-rays of the breasts, are usually used to diagnose breast cancer. Additionally, you could have a biopsy or an MRI scan, this is dependent on your physician.

In some cases a lumpectomy may be carried out, which is where the tumour/mass is removed without deconstruction of the breast. In some cases, a mastectomy is advised, especially if the tumours are relatively large. Many women also have their lymph nodes removed as a precaution or if the cancer has spread.

After surgery, radiotherapy, chemotherapy, biological therapy and hormone therapy may be used to treat cancer and can be a preventative measure. For some women, a hormone imbalance can cause uncontrolled growth of cancer cells so hormone therapy using oestrogen is used to reduce risk of recurrence.

Some breast cancers contain HER2/neu which is a growth-promoting protein that can cause the cancer to spread more quickly. Drugs that target the HER2 protein include Herceptin, a type of monoclonal antibody (antibody produced from a single clone of B cells), Tykerb, Perjeta and Kadcyla.

Testing of the sample can be done using immunohistochemistry (using antibodies that stick to the HER2 protein causing cells affected to change colour) and fluorescent in situ hybridisation (fluorescent DNA pieces stick to the HER2 gene, cells affected can be counted under a microscope).

References and Additional Information:

http://www.breastcancer.org/symptoms/types/ilc/subtypes

http://www.hopkinsmedicine.org/breast_center/breast_cancers_other_conditions/invasive_lobular_carcinoma.html

https://breast-cancer-research.biomedcentral.com/articles/10.1186/bcr767

https://www.cancer.org/treatment/understanding-your-diagnosis/tests/understanding-your-pathology-report/breast-pathology/breast-cancer-pathology.html

http://www.cancerresearchuk.org/about-cancer/breast-cancer/stages-types-grades/types/invasive-lobular-breast-cancer

Breast Cancer

Cancer is caused by the uncontrollable division of cells and can come in two forms: benign and malignant. Malignant tumors invade surrounding body tissue and are able to metastasize and spread to other parts of the body, whereas benign tumors are relatively harmless.

Symptoms of breast cancer include:

  • Breast Lumps (90% are not cancerous)
  • Change in size/shape/feel of breast
  • Breast pain
  • Skin Changes
  • Changes in nipple position
  • Fluid from nipples

Risks include:

  • Age
  • Ethnicity
  • Substance Abuse
  • Diet/Exercise
  • Overweight/Obese Patients
  • Genetics – family with cancer
  • Cancer genes
  • Many more

The TNM staging system stands for Tumour, Node, Metastasis.

  • T describes the size of the tumour
  • N describes whether there are any cancer cells in the lymph nodes
  • M describes whether the cancer has spread to a different part of the body

Number staging ranges from 1-4 and relate to size of tumor and its spread.

Early, locally advanced and secondary breast cancer.

Early: The cancer has not spread to areas outside the breast.

Locally Advanced: Cancer has not spread but the tumor is 5cm or larger, growing in chest skin/muscle or present in the lymph nodes in the armpits.

Secondary: Also known as stage 4 is when the cancer has spread to other parts of the body.

Grading is also used:

  • low grade – grade 1 (slow growing)
  • intermediate grade – grade 2
  • high grade – grade 3 (faster growing)

 

Diagnosis involves attending screenings, visiting a GP and then undertaking MRI and possibly CT scans to show the size and position of the tumor.

Treatment varies depending on the grading systems mentioned previously. Surgery, chemotherapy, radiotherapy, hormone therapy, biological therapy and clinical trials. Surgery is usually used for the lower grade cancers that are positioned in such a way that they can be easily removed. Types include:

  • Lumpectomy – removal of the cancerous tumor
  • Mastectomy – removal of the breast
  • Breast Reconstruction
  • Lymph Node Removal

 

For many patients and their families, breast cancer can be incredibly scary and difficult to deal with. It is important to learn as much as you can about breast cancer and to make an informed position. Breast cancer is not only hard on the person who has it, but also their friends and family. It can be difficult to adjust but it is vital to support one another and to ensure mental health does not deteriorate rapidly.

References:

http://www.cancerresearchuk.org/about-cancer/breast-cancer

http://www.nhs.uk/conditions/Cancer-of-the-breast-female/pages/symptoms.aspx

https://www.breastcancercare.org.uk/

Prostate Cancer and MRI Scanning

One of the biggest advances in cancer diagnosis occurred this week, in regards to the detection of prostate cancer using MRI scanning techniques, which eliminates the need for a biopsy. Prostate cancer is the most common type of cancer in men and affects millions of families each year.

The Prostate MRI Imaging Study (Promis), led by researchers at University College London (UCL), also showed that more than a quarter (27%) of all men with suspected cancer could avoid a biopsy altogether.

After the trial on 576 men, results showed that more than a quarter of them could be spared from invasive biopsies that often lead to side effects.  The trial, showed 27% of the men did not need a biopsy at all. 11 British hospitals took part in the trial. 93% of aggressive cancer’s were detected using an MRI compared to only 48% using biopsies.

However overall 40% of results could be interpreted as incorrect as in some cases the MRI shows up and gives an all clear when in fact there is a cancerous element to the prostate.

More extensive testing needs to be done until this type of treatment is used on a wider scale worldwide.

References

http://www.bbc.co.uk/news/health-38665618

http://press.thelancet.com/promisAPPX.pdf

http://www.nhs.uk/news/2017/01January/Pages/MRI-scans-could-spare-25-per-cent-of-men-from-prostate-biopsies.aspx

https://www.theguardian.com/society/2017/jan/19/mri-biopsy-prostate-cancer-diagnosis-research-nhs