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Surgeon-scientist will mobilize national research network to improve treatment and survival for patients with invasive lobular breast carcinoma

Invasive lobular breast carcinoma (ILC) is an increasingly common cancer that accounts for about 10 to 15 per cent of invasive breast cancers. While breast cancer is recognized as the most common cancer affecting Canadian women, this subtype is unique: its cells don’t stick together to form a tumour, they grow as single cells or in a line.

“Because these cells don't form masses, women can have this breast cancer forming inside them and not know or seek help until it’s quite advanced,” says Dr. David Lim, assistant professor, University of Toronto, and medical director, Henrietta Banting Breast Centre, Women’s College Hospital (WCH). Dr. Lim is a breast surgical oncologist at WCH and has cared for many patients with lobular breast cancer.

“We know that women with lobular breast cancer have worse survival outcomes compared with ductal breast cancer, but we don't have anything more to offer them aside from the standard of care for any other breast cancer,” he says. “This new Terry Fox funding will allow us to learn more about its behaviour to see if we can identify the patients with lobular breast cancer who will relapse and potentially target them for additional treatments that improve their survival.”

The 2024 Terry Fox New Investigator awardee will spend three years studying the biology of invasive lobular breast carcinoma, as well as the psychological effects patients experience, to improve treatment and care for this aggressive, yet understudied, disease.

His team will first look at the various ways ILC is currently treated across the country to assess which treatments offer the best survival. Historically, this has been challenging to study considering the relatively small number of patients with this cancer type at a single treatment centre.

“We will overcome this challenge using an existing national research network to prospectively recruit patients with invasive lobular breast carcinoma,” says Dr. Lim. “We will be looking for risk factors that may contribute to its development and examining what treatments patients have already received to assess their cancer outcomes such as survival and recurrence rates.”

They will also consider the psychosocial effects of ILC. For example: Do these patients experience more distress than patients with other breast cancers? Would additional psychosocial support or informational materials be beneficial?

Lastly, his team will perform gene profiling on surgically removed tumour specimens in hopes of identifying more reliable gene signatures for predicting treatment outcomes.

“The gene signatures we currently use to direct treatment do not work well for invasive lobular breast cancer, so many patients aren’t offered chemotherapy. And there is emerging research that suggests chemotherapy may not even work for lobular breast cancer,” says Dr. Lim. “We're hoping to discover molecular markers that can better predict which patients may or may not respond well to existing treatments and identify those who may benefit from much-needed novel therapies.”