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INVASIVE LOBULAR CARCINOMA (IDC) /INVASIVE LOBULAR BREAST CANCER

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Written by : Dr.M.D.Mazumdar, MD

Diagnosis of ILC

Any breast symptom, such as a lump or nipple discharge, is assessed with the 'triple test'. This test includes (a) examination of the breast, (b) imaging of the breast through mammography or ultrasound and (c) biopsy of the suspicious tissue.

  • Screening Mammography : Mammography is not very effective in identifying ILC. This is because the cells in ILC do not form a definite lump but may only show up a somewhat thicker area of the breast tissue which may or may not be due to cancerous growth.

  • Diagnostic Mammography : It is important that any thickening of breast tissue is rescanned with a diagnostic mammography. This is a more detailed study of the breast which takes views at higher magnification and from more angles.

  • Ultrasound of the breast : Ultrasound imaging, also known as ultrasonography or sonogram, produces a picture of the internal structures of the breast and can help identify a breast mass and its characteristics. A special type of ultrasound, known as Doppler ultrasound can evaluate blood flow or lack of flow in any breast mass. A malignant mass will have more blood flow than normal tissue.

  • MRI of the breast : Sometimes an MRI of the breast may be necessary to identify invasive lobular carcinoma.

  • Breast Biopsy : If the areas identified by mammography and ultrasound need more evaluation, the next step is a breast biopsy. There are different types of breast biopsies.

    • Fine Needle Aspiration Biopsy : This proocedure uses a very thin needle and syringe to remove either fluid from a cyst or clusters of cells from a solid mass. Removal of tissue from a small mass with a fine needle requires a great deal of expertise.

    • Core Needle Biopsy : This procedure uses a somewhat larger needle with a sharp cutting edge. A core of tissue is cut from inside the mass. If the breast mass is quite large, as many as 15 samples, each about the size of a grain of rice, may be taken and sent to a lab for microscopic analysis.

      MRI showing Invasive Lobular Cancer

    • Stereotactic Biopsy : This is a procedure in which tissue is removed from lumps which can be seen on a mammogram but cannot be felt on physical examination. It is done under the guidance of a mammogram or ultrasound. It helps in accurate localizing of the suspicious area.

    • Surgical Biopsy : In surgical biopsy, the suspicious area is first identified by mammogram. A needle is then inserted and fixed in the mass. Using this needle as a guide, the lump can be more accurately identified on the operating table and biopsied. If the lump is small enough, it may be completely removed - it is then called an excision biopsy.

Treatment of ILC:

Treatment of ILC depends on the stage. There are diferent treatment procedures depending on the type of cellular change, the size of the tumor, the number of tumors or microcalcifications and whether the tumor is hormone dependent or not.

The first line of treatment in ILC is invariably surgery. But there are various options of treatment which may be used in conjunction with each other:

  • Surgery : Includes Lumpectomy, Mastectomy, mastectomy with lymph node dissection (called radical mastectomy).

  • Chemotherapy : Chemotherapy means the use of drugs , alone or in combination are used for the treatment. Chemotherapy may be used in association with surgery and radiotherapy.

  • Radiation Therapy : Indicates treatment with radiation alone or a combination treatment of radiotherapy following surgery.

  • Hormonal Therapy : Hormonal Therapy becomes necessary when the cancerous cells have hormone positive receptors.

  • Targeted Therapy : Certain breast cancers may be positive for a type of growth receptor which need targetted treatment with medicines like herceptin.

  • Alternative Treatment : Includes acupuncture, yoga etc and how they can help support treatment for invasive lobular carcinoma.

See Page 1 for:

  • Symptoms of Invasive Lobular Breast Cancer
  • Stages of Invasive Lobular Breast Cancer



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