Search

Introduction The Lobular Breast Cancer Alliance (LBCA) was founded in 2017 by patient advocates attending the First International Invasive Lobular Breast Cancer Symposium sponsored by the University of Pittsburgh. The conference underscored that invasive lobular breast cancer (ILC) is an understudied unique subtype of breast cancer requiring refinements in treatments. ILC is the sixth most frequently diagnosed cancer of women and the second most common histological subtype of breast cancer with more than 39,000 patients diagnosed a year in the U.S. LBCA’s goals are to advance research and educate about ILC. Challenges An early goal of LBCA was to address the absence of a central source of quality information about lobular breast cancer. A website, lobularbreastcancer.org, launched December, 2017 with over 98,000 hits to-date. It is maintained by patient-advocate volunteers with content reviewed by LBCA’s Scientific Advisory Board. Methods A survey of users was conducted from May 1 to June 3, 2019 to determine value of the website to users and identify potential ways to improve it. Specific goals were: Understand who was visiting the site, identify the information sought, obtain feedback on the usefulness of content, and seek input on content and navigation. Results The online survey was taken by 950 participants. Current or former patients treated for lobular breast cancer comprised 94.7% of respondents. 75.8% were from U.S. Health professionals/researchers represented 3.04% of responders. Patients ranged in age from under 35 to over 75 years; 71.5% were 46-65 years. Most (66.5%) had Stage 1-2 disease at time of diagnosis; 7% reported de novo metastatic disease. An additional 9% reported a metastatic recurrence. LBCA (43.8%), other cancer organizations (43.2%),and Internet searches (38.3%) were the most frequently used sources for information about lobular breast cancer; doctor/health care provider ranked fourth (35.3%). The survey confirmed that LBCA goals for the website were aligned with the reason responders visited - i.e., general information (33%), research/clinical trials (21.9%) and treatment information (17.8%). Most consulted the site 2-4 times (46%), 11% visited more than 10 times. Nearly all responders (83.7%) found the information they were seeking, and (45.4%) agreed that the LBCA website provided information they could not find elsewhere. There were 249 participants who responded to an open ended question with 273 recommendations for the site. The largest category of requests (17%) was for more frequent updates of research and treatment guidelines; requests for a list of providers with expertise in treating ILC patients and for LBCA to provide additional education about ILC to MDs/clinicians ranked second and third (11%). Conclusions LBCA is driving increased awareness of lobular breast cancer by sponsoring a website devoted to providing research-based information about lobular breast cancer. There were a number of actionable suggestions regarding organization and navigation of the LBCA website. Results confirmed that the LBCA goals for the website are aligned with the reason responders visited. Primarily, users searched for general information about ILC (33%), research/clinical trials (21.9%) and treatment information (17.8%). The need for a central online source for information about lobular breast cancer was confirmed by findings that the most frequently used sources of information about lobular were the LBCA, other cancer organizations and Internet searches. Doctors/health care providers ranked fourth as a source of information about lobular disease. Many responders wanted the website to list ILC treatment specialists, address the gap in provider expertise about ILC detection and treatment, and report research and treatment guidelines specifically for ILC. Citation Format: Lori Petitti, Janice Axelrod, Margaret Campbell-Kotler, Julia Levine, Flora Migyanka, Elizabeth Viggiano, Steffi Oesterreich, Leigh Pate. Survey of Lobular Breast Cancer Alliance website users confirms value and identifies unmet information needs [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-16-02.

Background: There is growing awareness of the unique etiology, biology, clinical presentation and progression of Invasive lobular breast cancer (ILC), but additional research is needed to assure translation of findings into management and treatment guidelines. We performed a survey to: 1) analyze the landscape of the current understanding of ILC, and 2) identify consensus research questions on ILC. Methods: The IRB-approved survey was developed with input from representatives of three major stakeholder groups - breast cancer clinicians/researchers, laboratory-based researchers, and advocates/patients. We fielded the survey from March to May 2022 using targeted email and via social media. Results: 1,774 participants answered at least one question and 1,310 finished the survey. Participants are from 66 countries from all continents (except Antarctica). Respondents self-identified as clinicians (mostly medical oncologists and surgeons) (N=413), researchers (N=376), and breast cancer patients (1,121), with some belonging to more than one category. 26% of the patients who participated in the survey belong to advocate groups. Only 46% of clinicians reported being confident in describing the differences between ILC and no special type (NST) (invasive ductal) breast cancer. Knowledge of histology was seen as important (73%), affecting their treatment decisions (51%), and refined treatment guidelines would be valuable for patients with ILC in the future (76%). 85% of clinicians have never powered a clinical trial to allow subset analysis for histological subtypes, but the majority would consider it. 88% would participate in a consortium to conduct clinical trials on ILC. The top two most important research questions were: 1) determining mechanisms of endocrine resistance, and, 2) identifying novel therapeutic targets, repurposing existing drugs and progressing them to clinical trials. Of the researchers, 48% reported being confident in describing differences between ILC and NST. They reported that ILCs are inadequately presented in large genomic data sets (52%), and that ILC models are insufficient (42%). Only 13% of respondents have inadequate access to tissue or blood from patients with ILC. The top two most important research questions identified by the laboratory researchers overlapped with those identified by the clinicians, i.e. understanding of endocrine resistance and identifying novel drugs that can be tested in clinical trials. The majority of patients (52%) thought that their health care providers did not explain unique features of ILC, and that in general communication was limited. When asked about top research question, they chose: 1) Improvement of ILC screening/early detection, and, 2) Identifying new and specific imaging tools for ILC. When comparing top priority topics across six research domains, there was a high degree of consistency, especially among clinicians and researcher, but less so when compared with the breast cancer patients (Table 1). Conclusion: In summary, we have gathered timely and representative information from an international community of clinicians, researchers, and patients/advocates that we expect will lay the foundation for a community-informed collaborative research agenda, with the goal of improving the management and personalizing treatment for patients with ILC. Table 1. Ratings by all three stakeholder groups of the most critical and impactful ILC research topics. Top box scores between stakeholder groups were compared using chi-square analysis. Citation Format: Steffi Oesterreich, Leigh Pate, ADRIAN V. LEE, Rachel C. Jankowitz, Patrick Derksen, Rita Mukhtar, Otto Metzger, Matthew J. Sikora, Christopher Li, Christos Sotiriou, Gary Ulaner, Jorge Reis-Filho, Nancy E Davidson, Karen Van Baelen, Laurie Hutcheson, Siobhan Freeney, Flora Migyanka, Claire Turner, Todd Bear, Christine Desmedt. An international survey on invasive lobular breast cancer (ILC) reveals gaps in knowledge and top priority research areas [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-10.