{By: Dr. Pushpinder Gulia}
Worldwide, breast cancer has an occurrence rate of 46.3 per 100,000 population. Breast lobular carcinoma is responsible for roughly 5% to 15% of all invasive breast cancer and takes place at a mean age three years more than invasive ductal carcinoma. Breast health is integral to the overall state of well-being, and any abnormality should never be overlooked. One of the symptoms that is overlooked or downplayed is nipple discharge. While it may be a manifestation of benign processes, in other instances, it may indeed be a sign of a more dangerous condition, Invasive Lobular Carcinoma (ILC), an underpublicized but true type of breast cancer.
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What Is Lobular Breast Carcinoma?
Invasive lobular cancer is clinically silent and avoids detection on a mammogram or physical examination until the disease is found at a late stage. This is due to both the indolent growth and the infiltrative growth pattern of this neoplasm, and because early diagnosis is difficult using a mammogram. In later stages, there is a definite mass, with or without slight thickening of the nipple or an exudative scab over the skin, with other skin changes such as flushing, edema, the probability of metastasis within the axillary or supraclavicular lymph nodes. Therefore, the doctor needs to examine the patient carefully so that nothing important is overlooked.
Early Detection Of Symptoms And Importance
Nipple discharge is not always benign. If one notices any discharge, especially if it is bloody, clear, or spontaneous, immediately seek medical attention. Early diagnosis can significantly improve survival and treatment outcomes. Nipple discharge might be one of the first symptoms, especially if spontaneous and without any attendant breastfeeding. Other indications are breast pain, skin thickening or dimpling, change in breast form, or an inverted nipple. Because Lobular cancer does not always present with a palpable mass, these occult findings become significant as markers.
Risk factors Of Lobular Breast Carcinoma
The risk for developing ILC is elevated with age 55 years or above, with a family history of breast or ovarian cancer, having previously been diagnosed with breast cancer, and with some hormonal exposures such as hormone replacement therapy.
Diagnosis And Treatment
Diagnosis is most often a combination of imaging tests such as mammograms, breast ultrasound, and MRIs, and then a biopsy to confirm the presence of cancer cells. Because lobular cancer is so subtle, more advanced imaging techniques might be necessary to detect it accurately.
Treatment is mostly through surgery, chemotherapy, radiation therapy, and hormone therapy, especially if the cancer is estrogen receptor-positive (ER+). Lobular cancer generally has a good prognosis when it is caught early and a better five-year survival rate as compared to other types of breast cancer. Late effects do, however, differ and may include recurrence or metastasis years after initial treatment.
Knowledge is power. Nipple discharge must never be dismissed, especially with a supporting cast of other breast alterations. Invasive Lobular Carcinoma can be quiet, but its effect can be severe. Self-exams, regular screening, and early medical treatment to unusual symptoms can be the difference-maker. If you or someone you know has unexplained nipple discharge, don’t hesitate, get an examination.
The author, Dr. Pushpinder Gulia, is the Director, Surgical Oncology, at CK Birla Hospital, Gurugram.
[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]
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