New Clinical Trial Launched To Tackle “Elusive” Lobular Breast Cancer

Auckland radiologist Dr Remy Lim is inviting Kiwis who’ve recently been diagnosed with lobular breast cancer to take part in a new clinical trial funded by Breast Cancer Foundation NZ. The trial is aiming to increase survival rates and quality of life for patients with this challenging subtype of the disease by using a new technology to more accurately diagnose it.

Lobular breast cancer is the second most common type of breast cancer, with around 450 women diagnosed in New Zealand each year. Rather than forming as a lump or mass, lobular breast cancer cells grow along single layers, making them harder to detect. Complexities in diagnosis and response to treatment mean patients with lobular breast cancer are far likelier to either receive more aggressive treatment than necessary or insufficient treatment, putting them at greater risk of their cancer returning or spreading.

Dr Lim, who is the medical director of Mercy Radiology, has been awarded a $550,000 research partnership grant from Breast Cancer Foundation NZ to conduct the four-year trial, which is now recruiting patients from public hospitals across New Zealand.

He says this study, the first of its kind in NZ, has the potential to transform the way lobular breast cancer is diagnosed and treated: “Lobular breast cancer is notoriously difficult to detect and is often diagnosed later, making it harder to treat. The elusive nature of lobular breast cancer means the traditional ways of diagnosing it don’t give us an accurate picture of the cancer’s size and spread.

“We’ve designed a completely new approach to imaging lobular breast cancer using PET-CT with a newly discovered radioactive tracer called Fibroblast Activation Protein Inhibitor, or FAPI. By proving this is a more effective way to assess the extent of disease, patients will be able to receive treatment that is more reliably tailored to them and avoid unnecessary treatment.”

The trial will involve 50 lobular breast cancer patients recruited from around the country who will receive a PET-CT scan. The radiotracer FAPI will be used during the scan which binds with cancerous cells to more accurately show the size of cancer in the breast and where it might have spread to. If there are areas of cancer that haven’t shown up on previous imaging, the clinical team will determine whether the patient was initially incorrectly staged and if a different treatment pathway should be recommended for them.

Jackie Patterson, a 61-year-old mother living in Hamilton, was one of the first New Zealanders to have a FAPI PET-CT scan. She was diagnosed with lobular breast cancer that had spread to four of her lymph nodes. Other tests couldn’t determine whether the cancer had spread further, so her oncologist recommended Jackie have the FAPI PET-CT scan to decide on the best course of treatment. The scan showed Jackie’s cancer wasn’t elsewhere in her body, so she was able to avoid chemotherapy.

“It gave me peace of mind that my oncologist had all the information she needed to advise the best treatment for me. It was such a relief to know the cancer hadn’t spread beyond the lymph nodes and we could confidently say chemotherapy wouldn’t give me any benefit. If I didn’t have that reassurance, I would’ve put myself through chemo just to make sure we got every sneaky bit of cancer out.”

Dr Lim has already had success with a different kind of PET-CT to detect prostate cancer and Ah-Leen Rayner, chief executive of Breast Cancer Foundation NZ, says his latest work will make a huge difference to improve equity in care for Kiwis with breast cancer: “FAPI is at the forefront of the international stage for its ability to diagnose lobular breast cancer in way that hasn’t been possible before, so this trial will undoubtedly lead to immediate benefits for breast cancer care in Aotearoa.”

“By funding this research partnership, we’re hoping the results will make the case for PET-CT becoming funded for lobular breast cancer patients being treated in the public health system because currently, only women receiving private treatment can access it outside of this trial,” Rayner adds.

In 2016, Dr Lim carried out a similar trial in prostate cancer which led to PET-CT being funded for high-risk men in New Zealand in 2017 – long before many other developed countries. It’s now considered the gold standard for staging patients with high-risk prostate cancer.

If anyone is interested in participating in the trial, they should discuss this with their medical team. They can also call our team of breast cancer nurse specialists for free, private and confidential advice on 0800 226 8773.

© Scoop Media