Invasive lobular carcinoma is a type of breast cancer affecting the lobules of the breast. The American Cancer Society categorizes 10 percent of diagnosed breast cancers as invasive lobular cancers. Treatment for this type of cancer involves biopsy, lumpectomy or mastectomy, chemotherapy and radiation if necessary. Treatment tends to be aggressive because invasive lobular means that the cancer has moved from the lobules into the tissues of the breasts. Invasive lobular cancer treatment involves not only mastectomy or lumpectomy to remove the tumor but also identification and removal of affected lymph nodes.
Anatomy of a Breast
To understand invasive lobular cancer, it's important to understand just where this cancer resides in the breast. Visualize the nipple of the breast and imagine tubular milk ducts extending back from the nipple. Branching out of these ducts are lobules. The milk ducts and lobules together look very similar to a branch of a tree. Tissue and fat surround the ducts and lobules to make up the bulk of the breast. Invasive lobular carcinoma begins with rapidly producing, abnormal cells in the lobules. The cancer becomes invasive when it moves from the lobules into the fat and tissue of the breast.
The Lymph System
Cancer Help.org describes the lymph system as a river of tubes that run throughout the body, branching down the arms and legs and into the head. This network of tubes carries a substance called lymph that contains a concentration of white blood cells. There are major intersections and points along the way called lymph nodes. The lymphatic system fights infection, filters blood, drains fluid and filters lymph fluid. Invasive lobular cancer treatment begins with determining if cancer cells have jumped into the lymphatic system to spread throughout the body. Finding and removing affected lymph nodes becomes a very major part of treatment and dictates exactly how chemotherapy and radiation will be conducted.
Lymph Node Removal
When cancer jumps from the breast tissue to the lymphatic system, treatment requires removal of certain lymph nodes. Along the chain of nodes throughout the lymphatic system lie major nodes called sentinels. Sentinel node biopsy is performed on some women under the presumption that removal of the main node for biopsy will tell doctors whether further nodes need removal. This sentinel node is the gateway to the smaller clusters of nodes in the breast. Other women have axillary node biopsies to remove the group of nodes under the armpit. These lymph nodes are biopsied to determine whether the cancer has moved into the lymphatic system.
Lumpectomy
Treatment for invasive lobular carcinoma can involve a lumpectomy for smaller tumors. Surgeons remove the affected area as well as surrounding tissue to establish a clean margin. This can be a difficult endeavor because invasive lobular cancer likes to throw out tentacles as it grows. The aim is to establish a clean margin to prevent recurrence. Doctors usually address the issue of spread of invasive cancer to the lymph nodes during the lumpectomy surgery.
Mastectomy
Mastectomy can involve the complete removal of the breast or a partial removal. Biopsy information, personal preference and your doctor's recommendations dictate the extent of the mastectomy. Some women with invasive lobular choose to have a bilateral mastectomy to remove the other healthy breast due to the increased chance of recurrence in the remaining breast.
Chemotherapy
In some cases, tumor size and grading (level) results in the requirement of chemotherapy to systemically treat the invasive lobular carcinoma. Women receive chemotherapy to attack any cells that moved from the original tumor site to other parts of the body. Treatment is given by IV into a special access port that is installed either in an arm vein or a mediport installed surgically in a main artery under the collarbone. Chemotherapy usually involves a combination of anti-cancer drugs based on specific information discovered during your tumor biopsy. Almost all staged (leveled) cancers require treatment with chemotherapy. Women with very early stage invasive lobular cancer are sometimes given hormone therapy to reduce the chance of future recurrences.
Radiation Therapy
When a woman has one or more lymph nodes affected with cancer cells, radiation therapy is recommended. Radiation targets the affected areas of the breast (tumor site) and lymph nodes with high-energy radiation that attacks the cancer cells. Radiation affects each person differently, depending on the intensity and duration of the treatment. Some women experience skin pain and fatigue. Radiation can be used after lumpectomy and mastectomy as additional treatment. Doctors usually conduct radiation therapies after the patient heals from surgery and recovers from chemotherapy.
Tags: lymph nodes, lymphatic system, invasive lobular, lobular carcinoma, cancer cells
