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Lobular Breast Cancer Initiative at CU Anschutz Cancer Center
Over 700 women in Colorado and 3,000 women across the Mountain West will be diagnosed with invasive lobular carcinoma of the breast (ILC, or lobular breast cancer) each year, accounting for 10-15% of all breast cancer diagnoses. Unlike other breast cancers that present as a lump in the breast, ILC cells sneak through the breast in a characteristic “single file” pattern without forming a solid mass. This distinct growth behavior is linked to challenges with detection, diagnosis, and treatment, which are not yet fully understood - ILC research is notably underrepresented and receives less than 1% of federal research support. With these unique challenges, current national guidelines do not account for breast cancer subtype, leading to generalized treatment strategies that are not evidence-based for ILC. However, recent advances in Colorado and nationwide point to new opportunities for patient care tailored to the biology ILC.
Researchers at CU Anschutz Cancer Center are leading the way in turning the diagnosis of ILC from a line in a pathology report into a gateway for precision cancer care.
→ An Understudied Type of Breast Cancer Poses a Lurking Threat
The Lobular Breast Cancer Initiative at CU Anschutz Cancer Center brings together laboratory scientists who are pioneering our understanding of ILC biology and physicians who tailor patient care to the distinct clinical considerations facing patients with ILC. With local/regional patient advocates from Front Range ILC, this program keeps patient needs at the forefront of research and works to translate research into advances in clinical care.
The Lobular Breast Cancer Initiative represents an interdisciplinary team engaged in cutting-edge basic, translational, and clinical research addressing critical questions in ILC:
- Understanding disparities in ILC diagnosis and management across Colorado and the United States.
- Early detection and treatment for pre-cancerous lobular tumors.
- Integrating advanced imaging to improve detection, treatment, and surveillance.
- Understanding response and resistance to standard-of-care therapies.
- Development of new treatments targeting ILC-specific biology.
- Optimizing the detection and treatment of ILC recurrence and metastasis.
Through collaboration with the Lobular American Research Consortium, the Lobular Breast Cancer Initiative also links Colorado to the latest international advances in ILC science and care.
The Lobular Breast Cancer Initiative puts Colorado at the forefront of precision cancer care for patients facing ILC through innovation, discovery, and collaboration.
Goals
Improve care and outcomes for patients with ILC by providing precision treatment and management tailored to the unique biology of ILC.
Build evidence-based, streamlined clinical practice guidelines for ILC and lobular precursor lesions based on up-to-date evaluation and incorporation of ILC research.
Integrate “bench-to-bedside-and-back” basic laboratory and translational research efforts.
Leverage basic research to develop groundbreaking ILC-focused clinical trials and studies.
Advance clinical management in detection, prevention, treatment, and surveillance for ILC while addressing the unique challenges of metastatic ILC.
Matthew J. Sikora, PhD – Basic Science
Lauren A. Gamble, MD – Breast Surgical Oncology
Meredith Asper, MSN – Breast Surgical Oncology
Liz Buchanan, MD – Musculoskeletal Radiology
Jennifer Diamond, MD – Breast Medical Oncology
Christine Fisher, MD – Radiation Oncology
Jan Lowery, PhD – Population Science
Hala Mazin, MD – Breast Imaging Radiology
Sanjana Mehrotra, MD – Pathology
Savannah Roy, MD – Medical Oncology
Anna Schreiber, MD– Breast Medical Oncology
The Lobular Breast Cancer Initiative will develop a ~quarterly ILC seminar series that pairs basic/translational and clinical presentations. Initial seminars will feature program members, with the goal of expanding to outside speaker invitations. Additionally, we will develop a local/regional ILC symposium to highlight care recommendations, new research, and opportunities/gaps in basic/clinical understanding of ILC.
Updates and news about ILC seminars and symposiums will be available on this website.
Near-term priorities include:
- Integrating tissue collection and analyses, clinical data and outcomes analyses, and basic/translational modeling.
- Addressing clinical gaps, such as defining the utility of MRI in assessing the extent of local disease staging and the optimal mode of adjuvant endocrine therapy for premenopausal patients with ILC.
- Advancing translational research, such as developing PARPi combination therapies for ILC clinical trials, and developing risk assessment strategies for lobular precursor/in situ disease.
- Developing basic/translational questions, including understanding the behavior of metastatic ILCin atypical sites and ILC-specific behavior in common sites, e.g. sclerotic bone metastases.
The Lobular Breast Cancer Initiative will develop evidence-based recommendations for ILC care, identifying contexts in which histology should be considered and where additional data are critically needed.
Near-term priorities include:
- Developing imaging recommendations to define the extent of disease, improve staging, optimize surveillance, and better understand metastatic disease, including the use of MRI or FES vs FDG-PET.
- Defining the importance of sentinel lymph node biopsy for ILC, or when it could be omitted.
- Identifying when treatment de-escalation may be appropriate for ILC, particularly for radiation therapy (balancing de-escalation against the potentially outsized benefit of radiation for ILC) and endocrine therapy (considering standard versus extended adjuvant endocrine therapy while addressing the risk of long-term recurrence).
Our team is developing a formal process for:
- Performing literature reviews on key clinical priorities to assess the state of ILC-specific clinical data.
- Developing care/management recommendations based on ILC data, versus identifying a critical gap where insufficient ILC data is available.
- Presenting recommendations to the UCHealth breast oncology community for feedback.
- Working to implement ILC care recommendations across UCHealth.
Lobular Breast Cancer In the News
Leadership
Matthew J. Sikora, PhD – Basic Science
Lauren A. Gamble, MD – Breast Surgical Oncology