Azka Ali, MD

Tracking a Silent Threat: New Study Aims To Follow Lobular Breast Cancer Using the Novel Technology of Circulating Tumor DNA Over Time

About one in eight women will face invasive breast cancer in their lifetime. While most breast cancer cases are curable, about one-third may return as metastatic—an incurable form that spreads beyond the breast to other parts of the body.

Lobular breast cancer is the second most common type of breast cancer, making up about 10-15% of all breast cancers. What makes it especially concerning and unique is its stealth. This type often grows in a way that makes it difficult to detect on standard scans, allowing it to remain hidden until it’s more advanced.

Recognizing a need for better answers, Azka Ali, MD, and Megan Kruse, MD, were awarded a VeloSano Grant to launch a study focused on improving surveillance and outcomes for this sneaky form of breast cancer. The pair of breast medical oncologists are monitoring patients with stage IV lobular breast cancer who are receiving standard-of-care treatment.

“In addition to the routine scans that everybody gets, whether it’s a CT or PET scan, patients will be getting their circulating tumor DNA examined via a blood test every three months, which is right around the time we do their imaging,” says Dr. Ali. “The idea is to incorporate this novel technology to help inform us on the behavior of the cancer and, ideally, allow us to find disease progression earlier than with scans alone.”

By capturing both data points simultaneously, the team hopes to achieve a one-to-one comparison which is something that’s been missing in previous approaches. This could offer a clearer picture of how lobular tumors behave and respond to treatment, ultimately guiding more personalized and timely care. Because of its subtle growth pattern, patients are often diagnosed at later stages and often when patients have already developed too many symptoms when the disease is more difficult to treat.

“It’s like ivy on a wall,” says Dr. Kruse. “It grows in these little tendrils that don’t necessarily move the tissue around, so you don’t see a lump and you don’t see something that looks abnormal in the organ. Because lobular cancer can be missed on standard imaging and often picked up at later stages, there is a lot of opportunity for us to do better as clinicians and help patients improve on their symptoms quicker.”

While many questions about lobular breast cancer remain, the work of Dr. Ali and Dr. Kruse is helping to bring much-needed clarity to this complex disease. This is just one powerful example of how VeloSano is able to move the science forward.

“One of the unique things about VeloSano is it allows us, as the people who live and breathe this every day, to say ‘here are some areas we really need to focus on,’” says Dr. Kruse. “I think it’s a nice way for people to contribute and recognize that no contribution is too small because all of those smaller contributions really add up to make a project like this possible.”

This study is a reflection of what’s possible when clinical insight meets community-driven support. “I’m really grateful for this opportunity,” says Dr. Ali. “It’s an area where there are a lot of questions that need to be answered. This would not be possible without support from VeloSano, and we’re just excited to be able to be a part of this greater story.”