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Lobular breast cancer comes into the spotlight
Research collaborations, patient advocates push to explore ‘sneaky,’ understudied subtype’s standing as a distinct disease
Feb. 15, 2018
The first time Leigh Pate heard the term was when she got a phone call from her doctor following a series of diagnostic tests. The mammogram had been clean — like so many before it — but the ultrasound and biopsy told another story.
“After I hung up, I went to my computer and typed in ‘globular breast cancer,’” said Pate, a 51-year-old public policy consultant from Seattle of her diagnosis seven years ago. “Google had to correct me.”
Pate went through two surgeries; five months of chemotherapy; 33 courses of radiation and four years of tamoxifen, a daily pill that cuts off the fuel source for this very estrogen receptor-positive (ER+) disease. By the end of her treatment and recovery, she not only knew what lobular breast cancer was, she was determined to shine a spotlight on this idiosyncratic subtype.
“I started asking about lobular and realized they don’t know enough,” she said. “It’s lumped together and treated just like regular ER+ breast cancer. But lobular presents differently, it behaves differently and it has different subtypes and variants.”
Patients like Pate aren’t the only ones pushing for more lobular research.
In 2016, the Breast Cancer Research Foundation declared it an “understudied” cancer and helped convene the first International Invasive Lobular Breast Cancer Symposium in Pittsburgh. In December 2017, the San Antonio Breast Cancer Symposium held a mini-symposium packed with new genomic and clinical findings that posed the question: “Is lobular breast cancer a different disease?”
“If you were to put lobular cancer into the top cancers in women, subset it out by itself, it would be number six,” said Dr. Nancy Davidson, senior vice president and director of Fred Hutchinson Cancer Research Center’s Clinical Research Division and co-chair of the 2016 symposium. “It’s pretty common.”
President and executive director of Seattle Cancer Care Alliance and head of medical oncology at the University of Washington, Davidson was the powerhouse who built University of Pittsburgh’s strong lobular research program before joining Fred Hutch.
“Although superficially we think of lobular and ductal as the same, and treat them interchangeably, they might have biological differences that would have clinical differences,” she said.
Lobular, it would seem, is finally having its day.
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