Causes and risk factors
The exact cause is unknown. ILC is caused in patients with history of lobular carcinoma in situ. It is common in women between age group 45 – 55 years. It is found to be caused due to genetic mutations in the DNA of lobular cells of the breast. It can be inherited. There are some risk factors which are associated with the disease like overweight women, close relatives with breast cancer, past history of breast cancer, past history of non-cancerous lumps, dense breast tissue, women on hormones replacement therapies, women with early menarche or late menopause, women with first pregnancy after age 30, radiation exposure, alcohol consumption, jobs causing exposure to carcinogens or endocrine disturbance.
Clinical presentation
A patient with ILC is mostly asymptomatic. A thickened or hardened area around nipple is felt in ILC. Fullness or swelling in the breast is experienced. Additional symptoms may include swelling in the armpit, flattening or indentation on the breast, change in the size, contour, texture, or temperature of the breast. There may be inversion of nipple.
Investigation
Self breast examination may reveal lump in breast. Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Mammogram is an essential diagnostic tool for early detection of any type of breast cancer however ILC is rarely diagnosed on mammogram. Further investigations include fine needle aspiration cytology [FNAC] which confirms the diagnosis. Imaging studies such as USG of breast, MRI scan of breast is useful for further evaluation.
Treatment
Treatment depends upon type and stage of cancer. In general, cancer treatments include. Chemotherapy – to destroy the cancer cells, Radiation therapy. Surgery includes – Lumpectomy- In this surgery the surgeon removes the tumour and a small margin of surrounding healthy tissue. It is done for small tumours. Mastectomy- a surgery to remove all of your breast tissue. Most mastectomy procedures remove all of the breast tissue, which include the lobules, ducts, nipple, areola, fatty tissue and some skin. But in a skin-sparing mastectomy, the skin over the breast is left intact to improve reconstruction and appearance. Sentinel Node Biopsy includes removing a limited number of lymph nodes. Removing both breasts [prophylactic mastectomy] –if there is a high risk of cancer in the other breast. Hormonal therapy and targeted cell therapy also help in managing the disease.
Other Modes of treatment
The other modes of treatment can also be effective in treating ILC. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating ILC.
Facts and figures
Out of all breast cancers about 10 % are ILC.
