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Invasive Lobular Carcinoma (ILC)

Writer's picture: Kaitlyn TurnerKaitlyn Turner

Treatment of invasive lobular carcinoma

  • Treatments for invasive lobular carcinoma may include:

    • Surgery: You and your doctor will work together to determine the type of surgery that is right for you, based on the characteristics of the cancer, your family and medical history, and your preferences.

    • Radiation therapy: Radiation therapy is always recommended after lumpectomy and may be recommended after mastectomy if the cancer is large, or cancer is found in the lymph nodes.

    • Chemotherapy: Chemotherapy may be given before or after surgery. Your doctor will consider the characteristics of breast cancer and your medical history when deciding if chemotherapy is right for your unique situation.

    • Hormonal therapy: If breast cancer has receptors for the hormone estrogen, progesterone, or both, your doctor will recommend hormonal therapy, which is also called anti-estrogen therapy or endocrine therapy. Hormonal therapy medicines work by lowering the amount of estrogen in the body or by blocking the action of estrogen on breast cancer cells.

    • Targeted therapy: Targeted cancer therapies are treatments that target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow rapidly or abnormally. Some targeted therapies are antibodies that work like the antibodies made naturally by our immune systems. These types of targeted therapies are sometimes called immune-targeted therapies.

    • Immunotherapy: Immunotherapy medicines use the power of your body’s immune system to attack cancer cells. The characteristics of the cancer will determine if immunotherapy is an effective treatment option for you.

  • Surgery

    • Surgery for invasive lobular carcinoma may include:

      • Removing cancer and a small portion of healthy tissue. Called a lumpectomy (wide local excision), this procedure allows you to keep most of your breast tissue.

      • The surgeon removes the tumor itself, as well as a margin of normal tissue surrounding the tumor to make sure all the cancer that can be removed is taken out.

      • If the tissue around the tumor shows signs of cancer cells (positive margins), you may need additional surgery until negative margins are achieved. In some cases, this may mean removing all the breast tissue.

      • Removing all the breast tissue. Mastectomy is an operation to remove all your breast tissue. During a total (simple) mastectomy the surgeon removes all the breast tissue — the lobules, ducts, fatty tissue, and skin, including the nipple and areola. Some other types of mastectomies may leave the skin or the nipple in place and maybe options based on your specific situation.

      • Sentinel lymph node biopsy. To determine whether cancer has spread to the lymph nodes near your breast, your surgeon identifies the first few lymph nodes that receive the lymph drainage from your cancer. These lymph nodes are removed and evaluated for breast cancer cells (sentinel node biopsy).

      • If no cancer is found, the chance of finding cancer in any of the remaining nodes is small and no other nodes need to be removed.

  • Axillary lymph node dissection. If cancer is found in the sentinel node, then your surgeon may remove additional lymph nodes in your armpit (axillary lymph node dissection).

    • Knowing if cancer has spread to the lymph nodes helps determine the best course of treatment, including whether you will need chemotherapy or radiation therapy.

Hormone therapy

  • Hormone therapy — more properly termed hormone-blocking therapy — is often used to treat breast cancers that are sensitive to hormones. Most invasive lobular carcinomas are hormone receptor-positive, meaning they use hormones to grow.

  • To decrease the chance of your cancer returning, hormone therapy can be used before or after surgery or other treatments. If the cancer has already spread, hormone therapy may shrink and control it.

  • Treatments that can be used in hormone therapy include:

  • Medications that block hormones from attaching to cancer cells (selective estrogen receptor modulators)

  • Medications that stop the body from making estrogen after menopause (aromatase inhibitors)

  • Surgery or medications to stop hormone production in the ovaries.

Radiation therapy

  • Radiation therapy uses high-powered energy, such as X-rays and protons, to kill cancer cells.

  • During radiation therapy, you lie on a table while a large machine moves around you, directing energy beams at precise points in your breast.

  • Radiation therapy may be recommended after a lumpectomy. It may also be recommended after a mastectomy if your cancer is large or involves the lymph nodes.

Chemotherapy

  • Chemotherapy uses drugs to kill cancer cells. Treatment often involves receiving two or more drugs in different combinations.

  • Chemotherapy can be given through a vein, in pill form, or both ways.

  • Chemotherapy may be recommended after surgery to kill any cells that may remain.

  • Chemotherapy can also be used before surgery to shrink a large tumor. For women with larger tumors, chemotherapy before surgery may make it possible to choose lumpectomy over mastectomy.

Alternative medicine

  • Alternative treatments for hot flashes

  • Hot flashes — bouts of sudden, intense warmness that can leave you sweaty and uncomfortable — can be a symptom of natural menopause or a side effect of hormone therapy for breast cancer.

  • Women with breast cancers who use hormones to grow may receive hormone therapy to block the interaction between hormones and cancer cells. Most invasive lobular carcinomas are hormone receptor-positive.

  • If treatment for hot flashes will not work as well as you would like, it might help to add complementary and alternative treatments to make you feel better.

Options might include:

  • Acupuncture

  • Hypnosis

  • Meditation

  • Relaxation techniques

  • Tai chi

  • Yoga

  • While none of these alternative treatments is proven to help control hot flashes, some preliminary evidence shows that some breast cancer survivors find them helpful.

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