Hereditary diffuse gastric and lobular breast cancer syndrome associated with germline CDH1 variants: focus on lobular breast cancer

Abstract Background Hereditary lobular breast cancer (HLBC) is a distinct subset of hereditary breast cancer primarily associated with germline pathogenic variants in the CDH1 gene, which encodes E-cadherin, a crucial protein in cell adhesion. Loss of E-cadherin disrupts tissue architecture, contrib...

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Main Authors: Giovanni Corso, Francesca Magnoni, Giorgio Bogani, Paolo Veronesi, Viviana Galimberti, Adriana Albini
Format: Article
Language:English
Published: Springer 2025-05-01
Series:Journal of Cancer Research and Clinical Oncology
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Online Access:https://doi.org/10.1007/s00432-025-06222-w
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author Giovanni Corso
Francesca Magnoni
Giorgio Bogani
Paolo Veronesi
Viviana Galimberti
Adriana Albini
author_facet Giovanni Corso
Francesca Magnoni
Giorgio Bogani
Paolo Veronesi
Viviana Galimberti
Adriana Albini
author_sort Giovanni Corso
collection DOAJ
description Abstract Background Hereditary lobular breast cancer (HLBC) is a distinct subset of hereditary breast cancer primarily associated with germline pathogenic variants in the CDH1 gene, which encodes E-cadherin, a crucial protein in cell adhesion. Loss of E-cadherin disrupts tissue architecture, contributing to the invasive growth pattern characteristic of lobular carcinoma. CDH1 mutations are also implicated in hereditary diffuse gastric cancer, predisposing some patients to both cancers. However, variable cancer risk is observed, as many HLBC patients with a family history of gastric cancer do not develop gastric malignancies, reflecting the complex interplay of E-cadherin's role in cell cohesion and tumorigenesis. Main body HLBC accounts for 4–5% of lobular breast cancer cases, even in the absence of a personal or family history of gastric cancer. These tumors typically present as hormone receptor-positive (estrogen receptor-positive and progesterone receptor-positive) and are often diagnosed at advanced stages due to their diffuse growth pattern and subtle imaging characteristics. Recent evidence underscores the importance of genetic screening for CDH1 mutations in women with early-onset bilateral lobular breast cancer or a strong family history of breast cancer. Despite the strong correlation between CDH1 mutations and HLBC, the absence of diffuse gastric cancer in many patients presents diagnostic challenges. Updated guidelines emphasize targeted surveillance and risk-reduction strategies, including prophylactic mastectomy for high-risk individuals, aiming to improve clinical outcomes. Conclusion This mini-review synthesizes recent advancements in understanding the genetics, diagnostic complexities, and clinical management of HLBC. The findings highlight the critical need for early identification and personalized approaches to optimize surveillance and therapeutic strategies for patients with this unique hereditary cancer.
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spelling doaj-art-20d4e06ed8df43a38fcd2da4972d03412025-08-20T03:20:59ZengSpringerJournal of Cancer Research and Clinical Oncology1432-13352025-05-0115151610.1007/s00432-025-06222-wHereditary diffuse gastric and lobular breast cancer syndrome associated with germline CDH1 variants: focus on lobular breast cancerGiovanni Corso0Francesca Magnoni1Giorgio Bogani2Paolo Veronesi3Viviana Galimberti4Adriana Albini5Division of Breast Surgery, European Institute of Oncology, IRCCSDivision of Breast Surgery, European Institute of Oncology, IRCCSGynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale Dei TumoriDivision of Breast Surgery, European Institute of Oncology, IRCCSDivision of Breast Surgery, European Institute of Oncology, IRCCSEuropean Institute of Oncology, IRCCSAbstract Background Hereditary lobular breast cancer (HLBC) is a distinct subset of hereditary breast cancer primarily associated with germline pathogenic variants in the CDH1 gene, which encodes E-cadherin, a crucial protein in cell adhesion. Loss of E-cadherin disrupts tissue architecture, contributing to the invasive growth pattern characteristic of lobular carcinoma. CDH1 mutations are also implicated in hereditary diffuse gastric cancer, predisposing some patients to both cancers. However, variable cancer risk is observed, as many HLBC patients with a family history of gastric cancer do not develop gastric malignancies, reflecting the complex interplay of E-cadherin's role in cell cohesion and tumorigenesis. Main body HLBC accounts for 4–5% of lobular breast cancer cases, even in the absence of a personal or family history of gastric cancer. These tumors typically present as hormone receptor-positive (estrogen receptor-positive and progesterone receptor-positive) and are often diagnosed at advanced stages due to their diffuse growth pattern and subtle imaging characteristics. Recent evidence underscores the importance of genetic screening for CDH1 mutations in women with early-onset bilateral lobular breast cancer or a strong family history of breast cancer. Despite the strong correlation between CDH1 mutations and HLBC, the absence of diffuse gastric cancer in many patients presents diagnostic challenges. Updated guidelines emphasize targeted surveillance and risk-reduction strategies, including prophylactic mastectomy for high-risk individuals, aiming to improve clinical outcomes. Conclusion This mini-review synthesizes recent advancements in understanding the genetics, diagnostic complexities, and clinical management of HLBC. The findings highlight the critical need for early identification and personalized approaches to optimize surveillance and therapeutic strategies for patients with this unique hereditary cancer.https://doi.org/10.1007/s00432-025-06222-wHereditary lobular breast cancerCDH1 geneGenetic screeningE-cadherinIGCLC guidelines
spellingShingle Giovanni Corso
Francesca Magnoni
Giorgio Bogani
Paolo Veronesi
Viviana Galimberti
Adriana Albini
Hereditary diffuse gastric and lobular breast cancer syndrome associated with germline CDH1 variants: focus on lobular breast cancer
Journal of Cancer Research and Clinical Oncology
Hereditary lobular breast cancer
CDH1 gene
Genetic screening
E-cadherin
IGCLC guidelines
title Hereditary diffuse gastric and lobular breast cancer syndrome associated with germline CDH1 variants: focus on lobular breast cancer
title_full Hereditary diffuse gastric and lobular breast cancer syndrome associated with germline CDH1 variants: focus on lobular breast cancer
title_fullStr Hereditary diffuse gastric and lobular breast cancer syndrome associated with germline CDH1 variants: focus on lobular breast cancer
title_full_unstemmed Hereditary diffuse gastric and lobular breast cancer syndrome associated with germline CDH1 variants: focus on lobular breast cancer
title_short Hereditary diffuse gastric and lobular breast cancer syndrome associated with germline CDH1 variants: focus on lobular breast cancer
title_sort hereditary diffuse gastric and lobular breast cancer syndrome associated with germline cdh1 variants focus on lobular breast cancer
topic Hereditary lobular breast cancer
CDH1 gene
Genetic screening
E-cadherin
IGCLC guidelines
url https://doi.org/10.1007/s00432-025-06222-w
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