Caption: Steffi Oesterreich
Ten years ago, Steffi Oesterreich launched a symposium for one of the most difficult-to-detect forms of breast cancer, gathering researchers, patients and advocates together in Pittsburgh to bring attention to a disease she knew was woefully understudied.
The first Invasive Lobular Carcinoma (ILC) Symposium attracted an international audience, along with dozens of patients whose attendance was, at the time, unusual at a scientific conference.
On Sept. 25, at this year’s ILC Symposium in San Francisco, Oesterreich gave the keynote lecture in honor of one of those patients, Leigh Pate, who died in 2022 from cancer complications. She also accepted a grant for a high-risk, high-reward research project that she hopes will lead to clinical trials for therapies specifically targeted at the cells of one of ILC’s most aggressive variants.
“After the symposium, Leigh and I became really good friends,” said Oesterreich, coleader of the Hillman Cancer Center Cancer Biology Program and professor of pharmacology and chemical biology at the University of Pittsburgh School of Medicine. “She was a force for advocacy, getting the patients together and starting the Lobular Breast Cancer Alliance with me and others. It has grown significantly and is now also able to give grants. I’m so proud of her and all that we’ve accomplished.”
Caption: Steffi Oesterreich with Leigh Pate, a founder of the Lobular Breast Cancer Alliance, who died in 2022 from cancer complications.
ILC is the most common special histological type of breast cancer, representing 10% to 15% of all breast cancer diagnoses—accounting for 48,000 individuals diagnosed in the United States each year. Despite its prevalence and rising incidence, ILC remains underfunded and understudied, receiving less than 1% of dedicated breast cancer research funding.
Unlike more common forms of breast cancer, ILC exhibits distinct biology and growth patterns. Rather than forming discreet, easily palpated lumps, lobular cancer cells typically spread in single-file strands through surrounding tissue. This characteristic makes ILC notoriously difficult to detect through standard screening mammography and challenging to track when it metastasizes. Consequently, tumors are frequently discovered at later stages.
At the symposium, the Lobular Breast Cancer Alliance Inc awarded $1 million for ILC research, with half going to Oesterreich for a study to map genes and gene expression pathways with the goal of discovering key drivers of pleomorphic ILC, a particularly aggressive form of breast cancer with high recurrence rates.
“This generous funding from the Lobular Breast Cancer Alliance—made possible by a gift from lobular breast cancer survivor Dr. Shannon Klingman—is critical to enabling high-risk, high-reward research. We hope our studies will lead to impactful discoveries in pleomorphic ILC that can be translated from the laboratory into clinical trials and ultimately bring life-saving therapies to thousands of patients,” Oesterreich said. “It provides me and my fellow scientists with the unique opportunity to think outside the box and find innovative approaches to identify targets on the pleomorphic lobular cancer cells that we can exploit to destroy the cancer with novel therapies.”
Multiple trainees in the Lee-Oesterreich Lab also earned travel grants to attend and learn at this year’s ILC Symposium. Lab codirector Adrian Lee, Pittsburgh Foundation Professor of Precision Medicine and professor of pharmacology and chemical biology at Pitt, presented on the many new ILC models the team has generated that will allow ILC researchers all over the world to study the disease better. Other Hillman Cancer Center scientists and clinicians presented research, as did several of Oesterreich’s protégés, who have since gone on to join and launch their own research programs at other academic medical centers.
Reflecting on the decade since launching the symposium, Oesterreich is thrilled with the advances that have been made in the ILC field, while also feeling the weight of all that still needs to be accomplished.
“ILC used to be a bit of an afterthought, but now it has a visible presence at all breast cancer symposium meetings and Programs of Excellence for research and treatment—including at UPMC Hillman Cancer Center—have been established,” she said.
“But we’re still far from reaching the final goal, which is true precision medicine for patients with ILC. We need tailored detection techniques and dedicated drugs, neither of which exist yet,” Oesterreich said. “They’re coming, though—there are now multiple clinical trials running specifically for patients with ILC and far, far more companies are interested in getting drugs tested. The future looks bright.”