Invasive Pleomorphic Lobular Carcinoma

Invasive pleomorphic lobular carcinoma (IPLC) is a rare kind of breast cancer. It makes up less than 1 percent of all breast cancer cases. Though it is less common, it can be more aggressive and more difficult to cure.^1,2

IPLC may cause larger tumors than other kinds of breast cancer. It also may be more likely to metastasize or move, to other areas of the body. Areas it may move to include:^1,3

• Bone
• Lung
• Liver
• Brain

IPLC starts in the lobules of the breast, the glands that create milk. It is "invasive" because as it grows, it breaks through the lobule and moves into other areas of the breast. "Pleomorphic" means that there are many different cell types that make up the cancer. These cell types are visible under a microscope.¹

Symptoms

The signs and symptoms of IPLC are similar to those of other breast cancers. In the early stages, there may be no symptoms at all. IPLC is less likely than other breast cancers to show up as a breast lump. Instead, as the cancer grows, it may cause:⁴

• Thickness in one area of the breast
• Breast fullness or swelling
• Skin changes over the breast like dimpling
• Nipple inversion

Causes

Scientists have not found a clear cause for IPLC. It begins in the same way as other breast cancers. A cell in one of the milk-producing glands makes a copy of itself in a process called mitosis.⁴

During mitosis, a cell may make a mistake when creating a copy of DNA for the new cell. The body finds and fixes most of these mistakes. But any mistake that is not fixed can result in a mutation, or a cell that looks or acts different from the original cell it came from.⁴

These mutations may not be noticeable, or they may cause a major change. They may stop a cell from being able to do something that it can usually do or give the cell the ability to do something new. Either of these processes can cause cancer.⁴

The most common mutations allow the cells to make many copies very quickly. Other mutations can give the cancer cells the ability to spread into other areas of the body.⁴

Risk factors

There are a few risk factors that can increase your chances of developing IPLC. They include:⁴

• Being female – Anyone can develop breast cancer, but it is more likely in women.
• Old age – Your body copies its cells over and over throughout your life. Every time a cell is copied, there is the chance that there will be a mistake in the DNA, causing a mutation. These can add up as you age, making breast cancer more likely the older you are. People with IPLC are often diagnosed when they are a few years older than people with other breast cancers.
• Lobular carcinoma in situ (LCIS) – LCIS is not cancer. It refers to abnormal cells in one or both breasts that are precancerous. Because these cells can continue to mutate, LCIS can increase your risk of developing breast cancer.
• Hormonal treatment – Some women take hormones like estrogen and progesterone after menopause to improve their menopause symptoms. These hormones affect breast tissue, so using them can increase the risk of IPLC.
• Family history of cancer – You may be at greater risk of IPLC if you have family members who have had breast or certain other cancers.

Diagnosis

It is important to schedule yearly doctor’s visits and mammograms. Your doctor can tell you when it is best to start having yearly mammograms. Also, get familiar with the look and feel of your breasts. If you discover a lump in your breast or notice any changes in the skin over your breasts, reach out to your doctor. They will evaluate you to decide if you need more testing.^4,5

Testing for breast cancer may include:^4,5

• Mammogram – This is an x-ray of your breast that can show lumps or abnormal tissue. It is useful but may not always find IPLC because it is less likely to form a tumor.
• Ultrasound – This is a noninvasive test that uses sound waves to create pictures of your breasts. Ultrasounds can also miss breast changes related to IPLC.
• MRI – Magnetic resonance imaging (MRI) scans use magnetic fields to create pictures of your breasts. They take longer and are more expensive than other tests, but they may do a better job of showing IPLC.
• Biopsy – When there is an area of tissue that looks like it may be cancer, your doctor may recommend a biopsy. They will remove a small piece of the suspicious tissue to examine it more closely.

Treatment

Your doctor will work with you to decide what treatment is best. It could include:^4,5

• Surgery
• Hormone therapy
• Radiation
• Chemotherapy
• A combination of the above

If you have questions or are concerned about your risk of breast cancer, speak to your doctor.