Breast cancer can be broadly
categorized into - i) in-situ
carcinoma where tumor cells are localized and have not spread into surrounding
tissue and ii) invasive cancer. The in-situ
type of breast cancer is further classified into either ductal or lobular
depending upon their growth patterns and tissue features. Lobular breast cancer is a common form of breast cancer more often
found in both breasts.
Earlier studies have found
positive associations between lobular breast cancer and family history of
cancer, especially family history of breast cancer in first-degree relatives.
Studies have also found that the familial association of lobular breast cancer
could mainly be due to patients with BRCA2 gene mutation or the occurrence of
hereditary diffuse gastric cancer. However, not much information is available
on familial cancer patterns in lobular breast cancer.
So, Carolina Ellberg and Hakan
Olsson from the Clinical Sciences, Lund University, undertook a study on 1676
breast cancer patients with the aim to identify new hereditary patterns
predisposing to cancer by focusing on patients with lobular breast cancer and
cancer in their first-degree relatives. Breast cancer patients consisted of 41
percent invasive ductal carcinoma, 8 percent of invasive lobular carcinoma, 2
percent of medullary carcinoma, 1 percent of mucinous carcinoma, and 48 percent
of adenocarcinoma. The overall median age at diagnosis was 56 years with a range
between 23 and 89 years.
Results showed that:
Patients with lobular breast
cancer were found to be significantly positively associated with having a
father diagnosed with cancer.
Ductal breast cancer was
associated with having a mother diagnosed with cancer.
The five most common diagnoses
in fathers with cancer with a daughter with lobular breast cancer were prostate
cancer (6 percent), leukemia (4 percent), lung cancer (1 percent), lower
gastrointestinal tract cancer (3 percent), stomach cancer (2 percent) and
sarcoma (2 percent).
The occurrence of having a
father with prostate cancer for lobular breast cancer patients was higher in
the younger patient group, and was still high but lost statistical significance
in the older patient group.
The median age at cancer
diagnosis for the fathers of the lobular breast cancer patients was 70 years.
The median age of the father at their daughter's birth was 32 years. It does
not necessarily represent age at first child, since the patients diagnosed with
lobular breast cancer may not be the oldest children.
These results showed an association between lobular breast cancer and
cancer in the father, and which was seemingly independent of classical breast
The association with a father diagnosed with cancer also
remained after removing prostate cancer, indicating that different types of
tumors in the father are associated with lobular breast cancer in the daughter.
'That there might be a genetic
cause is strengthened by the fact that the younger lobular breast cancer
patients had an increased risk of having a father with prostate cancer,
compared to the other breast cancer subtypes', say the researchers.
There was no difference in cancer
diagnoses in second- and third-degree relatives on the paternal or maternal
side of the lobular breast cancer cases. This means that the association is not
connected to an imbalance in number of cancer diagnoses on the paternal side.
It also indicates that it may only be related to the father, or inherited from
The authors concluded that 'Our
study has identified a possible father-daughter inheritance pattern in lobular
breast cancer, independent of previous family history of breast cancer. These
findings need to be validated in other materials in order to later elucidate
the possible mechanism behind the association'.
Ellberg C, Olsson H. Breast
cancer patients with lobular cancer more commonly have a father than a mother
diagnosed with cancer. BMC Cancer. 2011 Nov 28;11:497.