Skip to Content
800-533-8762
  • Careers
  • Newsroom
  • Health Care Professionals
  • About Us
  • Contact Us
UPMC
  • Find a Doctor
  • Services
    • Frequently Searched Services
    • Frequently Searched Services
      Allergy & Immunology Behavioral & Mental Health Cancer Ear, Nose & Throat Endocrinology Gastroenterology Heart & Vascular Imaging Neurosciences Orthopaedics
      Physical Rehabilitation Plastic & Reconstructive Surgery Primary Care Senior Services Sports Medicine Telemedicine Transplant Surgery Walk-In Care Weight Management Women’s Health
      See all Services
    • Services by Region
    • Find a UPMC health care facility close to you quickly by browsing by region.
      UPMC in Western Pa. Western Pa. and New York
      UPMC in Central Pa. Central Pa.
      UPMC in North Central Pa. North Central Pa.
      UPMC in Western Md. Maryland & West Virginia
    • See All Services
  • Locations
    • Locations by Type
    • Locations by Type
      UPMC hospitals
      Hospitals
      Physical Therapy
      Physical Therapy
      Urgent care
      Walk-In Care
      UPMC Outpatient Centers
      Outpatient Centers
      UPMC Imaging Services
      Imaging
      Community Health Centers
      Community Health Centers
      See All Locations
    • Locations by Region
    • Locations by Region
      UPMC in Southwest Pa. Southwest Pa.
      UPMC in North Central Pa. North Central Pa.
      UPMC in Northwest Pa and Ny. Northwest Pa. & Western N.Y.
      UPMC in West Central Pa. West Central Pa.
      UPMC in Central Pa. Central Pa.
      UPMC in Western Md. Maryland & West Virginia
    • See All Locations
  • Patients & Visitors
    • Patient & Visitor Resources
    • Patient & Visitor Resources
      Patients and Visitors Resources Pay a Bill Classes & Events Medical Records Health Library Patient Information
      Patient Portals Privacy Information Shared Decision Making Traveling Patients Visitor Information
      Man uses mobile phone
      Pay a Bill
      Nurse reviews medical chart
      Request Medical Records
  • Patient Portals
  • Find Covid-19 updates
  • Schedule an appointment
  • Request medical records
  • Pay a bill
  • Learn about financial assistance
  • Find classes & events
  • Send a patient an eCard
  • Make a donation
  • Volunteer
  • Read HealthBeat blog
  • Explore UPMC Careers
Skip to Content
UPMC
  • Patient Portals
  • For Patients & Visitors
    • Find a Doctor
    • Locations
    • Patient & Visitor Resources
    • Pay a Bill
    • Services
    • More
      • Medical Records
      • Financial Assistance
      • Classes & Events
      • HealthBeat Blog
      • Health Library
  • About UPMC
    • Why UPMC
    • Facts & Stats
    • Supply Chain Management
    • Community Commitment
    • More
      • Financials
      • Support UPMC
      • UPMC Apps
      • UPMC Enterprises
      • UPMC International
  • For Health Care Professionals
    • Physician Information
    • Resources
    • Education & Training
    • Departments
    • Credentialing
  • Careers
  • Contact Us
  • Newsroom
  • UPMC >
  • Media Relations >
  • News Releases >
  • 101422 breastcancertype
Media Relations
News Releases
Central Pa. News
North Central Pa. News
Contact Us
Experts
Community-Focused News
Media Kits
Media RSS
Media Relations
News Releases
Central Pa. News
North Central Pa. News
Contact Us
Experts
Community-Focused News
Media Kits
Media RSS

Chat Keywords List

  • cancel or exit: Stops your conversation
  • start over: Restarts your current scenario
  • help: Shows what this bot can do
  • terms: Shows terms of use and privacy statement
  • feedback: Give us feedback
Continue
Chat with UPMC
RESTART
MENU
CLOSE

Multi-Center Study Sheds Light on Understudied Breast Cancer Type

For Journalists

Asher Jones
Manager, Science Writing
412-647-3555
jonesag@upmc.edu

Ellie Westerburg
Project Manager IV, Cleveland Clinic
216-312-4755
Westere@ccf.org

Amanda Harper
Director of Media Relations, Ohio State University
513-659-6847
Amanda.Harper2@osumc.edu

Want to Make an Appointment or Need Patient Information?
Contact UPMC at

1-800-533-8762.

Go to Find a Doctor to search for a UPMC doctor.

Release Combined Logo

10/14/2022

PITTSBURGH — A multi-center analysis of patients with invasive lobular carcinoma, or ILC — the second most common histological subtype of invasive breast cancer in the U.S. — showed that, despite its prevalence, ILC is detected later and has worse outcomes than the predominant subtype of invasive breast cancer, known as invasive ductal carcinoma (IDC), or no special type.


Published today in the Journal of the National Cancer Institute, the study of more than 33,000 patient records from three large cancer centers — UPMC Hillman Cancer Center, Cleveland Clinic Cancer Center and The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC -– James) — shows that ILC and IDC are biologically distinct, highlighting important differences between the two diseases and the need for specific detection and treatment options for the lobular subtype. 


SteffiOHR“Lobular breast cancer makes up about 10% to 15% of breast cancer cases, but it has historically been neglected by the research community, so we really don’t know that much about it,” said co-lead author Steffi Oesterreich, Ph.D., co-leader of the Cancer Biology Program at UPMC Hillman and professor at the University of Pittsburgh School of Medicine’s Department of Pharmacology & Chemical Biology. “There has been increasing awareness that ILC and IDC are distinct, but this large multi-center study provides compelling evidence that these are two different diseases that require different management.”


Co-senior authors Megan Kruse, M.D., a breast medical oncology specialist at Cleveland Clinic, and Nicole Williams, M.D., a breast medical oncologist at OSUCCC – James, worked with Oesterreich to analyze records from patients treated at the three cancer centers for ILC or IDC between 1990 and 2017. kruse_megan


“These findings likely indicate that detection of lobular breast cancer is delayed,” said Kruse. “When these tumors are finally detected, they’re larger and they’ve already moved to the lymph nodes, indicating the cancer is spreading. We need to put more effort into improving early detection of ILC by developing new imaging technologies or other methodologies.”


The idea for the study was sparked one evening as Oesterreich was washing dishes and listening to a recording of a Lobular Breast Cancer Alliance conference call that she’d missed. When Susan MacDonald, a lobular breast cancer advocate from Cleveland, mentioned that Cleveland Clinic researchers were beginning a project to analyze the center’s breast cancer registry, Oesterreich’s ears pricked up.

 

“I thought, ‘Wow, we have been doing the very same thing at UPMC. It would make sense to collaborate and work together,’” said Oesterreich.


ILC’s key feature is loss of a gene called E-cadherin that helps cells stick together. As a result, lobular cancer cells grow in lines, producing tumors that look more like spider webs than the familiar round lumps of IDC, explained Oesterreich. These web-like tendrils make ILC difficult to spot on mammograms until the cancer has grown and often advanced.


The analysis found that ILC cells were lower grade than IDC, meaning that they looked more similar to normal cells. However, ILC tumors were diagnosed twice as often at stage III or IV— advanced stages in which cancer cells have spread beyond breast tissue to the lymph nodes or metastasized to other parts of the body. Lobular tumors were also larger in size than their ductal counterparts. 


The researchers restricted the next part of their analysis to patients with tumors bearing estrogen receptors and lacking the HER2 receptor. They found that patients with lobular cancer had worse disease-free survival and overall survival. ILC patients also had more disease recurrence than those with IDC, and recurrences tended to occur later.

   

“In other words, more tumors are coming back, and they’re coming back later for patients with ILC,” explained Oesterreich, who also holds the Shear Family Endowed Chair in Breast Cancer Research and is co-director of the Women’s Cancer Research Center, a partnership between UPMC Hillman and Magee-Womens Research Institute. “This suggests that tumor cells hibernate somewhere in the body until they are reawakened. We need to find where these cells hang out and why they reawaken.”

  

A commercially available advanced genomic test called Oncotype DX was used to predict risk of recurrence and response to chemotherapy for patients with early-stage estrogen-receptor-positive, HER2-negative breast cancer.


The analysis found that there was a significant association between the Oncotype DX score and cancer recurrence for patients with IDC.  Very few ILC cases were classified as high-risk, despite more late recurrences, highlighting the need for specific molecular tests that improve predictions for lobular breast cancer.williams_nicole


“Lobular breast cancer and ductal breast cancer are two distinct diseases. Our study shows that lobular breast cancers are diagnosed at a more advanced stage and have increased chance of recurrence.  However, invasive lobular cancer was less likely to be classified as high-risk by a commonly used genomic test,” said Williams. “Despite their differences, these cancers are often treated the same.  We hope these findings will spark research aimed at developing new diagnostic tools and drugs to improve outcomes for patients with lobular breast cancer.”


Other researchers who contributed to the study were co-first authors Azadeh Nasrazadani, M.D., Ph.D., and Jian Zou, M.S., both of Pitt or UPMC; Neil Carleton, B.S., Yujia Li, B.S., Kathryn Demanelis, Ph.D., George Tseng, Ph.D., Adrian V. Lee, Ph.D., all of Pitt or UPMC; Tiffany Onger, M.D., and Matthew D. Wright, M.D., both of Cleveland Clinic; and Bhuvaneswari Ramaswamy, M.D., of The Ohio State University Wexner Medical Center.

 

This work was supported by the Breast Cancer Research Foundation, the National Cancer Institute of the National Institutes of Health (P30CA047904, P30CA016058 and 1F30CA264963-01), Susan G. Komen, The Henry L. Hillman Foundation, via The Hillman Fellows for Innovative Cancer Research, the 2019 Gianna Bonadonna Breast Cancer Research Fellowship awarded by Conquer Cancer, the MacDonald Fund at Cleveland Clinic and the Anderson Breast Cancer Fund at OSUCCC.

  

ExactSciences/Mdxhealth, the manufacturer of Oncotype DX, reviewed the manuscript but had no input on study design or analysis.

 Left photo:
 
CREDIT: UPMC

CAPTION: : Steffi Oesterreich, Ph.D., co-leader of the Cancer Biology Program at UPMC Hillman and professor at the University of Pittsburgh School of Medicine’s Department of Pharmacology & Chemical Biology

Right photo:


CREDIT: Cleveland Clinic

CAPTION: Megan Kruse, M.D., breast medical oncology specialist at Cleveland Clinic

Bottom photo:

CREDIT: OSUCCC - James

CAPTION:  Nicole Williams, M.D., breast medical oncologist at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute

 

UPMC
200 Lothrop Street Pittsburgh, PA 15213

412-647-8762 800-533-8762

Patients And Visitors
  • Find a Doctor
  • Locations
  • Pay a Bill
  • Patient & Visitor Resources
  • Disabilities Resource Center
  • Services
  • Medical Records
  • No Surprises Act
  • Price Transparency
  • Financial Assistance
  • Classes & Events
  • Health Library
Health Care Professionals
  • Physician Information
  • Resources
  • Education & Training
  • Departments
  • Credentialing
Newsroom
  • Newsroom Home
  • Inside Life Changing Medicine Blog
  • News Releases
About
  • Why UPMC
  • Facts & Stats
  • Supply Chain Management
  • Community Commitment
  • Financials
  • Supporting UPMC
  • HealthBeat Blog
  • UPMC Apps
  • UPMC Enterprises
  • UPMC Health Plan
  • UPMC International
  • Nondiscrimination Policy
Life changing is...
Follow UPMC
  • Contact Us
  • Website/Email Terms of Use
  • Medical Advice Disclaimer
  • Privacy Information
  • Active Privacy Alerts
  • Sitemap
© 2025 UPMC I Affiliated with the University of Pittsburgh Schools of the Health Sciences Supplemental content provided by Healthwise, Incorporated. To learn more, visit healthwise.org
Find Care
Providers
Video Visit
Portal Login