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Invasive lobular carcinoma

Field	Value
name	Invasive lobular carcinoma
image	Lobules and ducts of the breast.jpg
caption	Lobules of the mammary glands.
field	Oncology

Invasive lobular carcinoma (ILC) is breast cancer arising from the lobules of the mammary glands. It accounts for 5–10% of invasive breast cancer. Rare cases of this carcinoma have been diagnosed in men (see male breast cancer).

Types

Classic lobular	Pleomorphic lobular
Grades	Low or high (II/III)
AJCC stage	I
Lymph node status	Negative
ER/PR status	Positive
Surgery type	Lumpectomy

The histologic patterns include:

Type	Prevalence	Description	Image
Classical	40%	Round or ovoid cells with little cytoplasm in a single-file infiltrating pattern, sometimes concentrically giving a targetoid pattern	[[File:Classic Invasive Lobular Carcinoma of the Breast (6813147194).jpg	180px]]
Mixed	40%	No dominant pattern
Solid	10%	Sheets of classical-appearing cells with little intervening stroma
Alveolar	5%	Aggregates of classical-appearing cells
Tubulolobular	5%	Cells form microtubules in 90% of tumor (smaller than in tubular carcinoma)
Pleomorphic		Classical-appearing but with pleomorphic cells. It may include signet-ring cells, or plasmacytoid cells (pictured) which have abundant cytoplasm and eccentric nuclei.	[[File:Histopathology of pleomorphic lobular carcinoma with plasmacytoid cells.jpg	180px	center]]

File:Histopathology of invasive lobular carcinoma, next to lobular carcinoma in situ, annotated.jpg|Histopathology of invasive lobular carcinoma (ILC), next to lobular carcinoma in situ (LCIS) File:Breast invasive lobular carcinoma (2).jpg|Invasive lobular carcinoma demonstrating a predominantly lobular growth pattern File:LobularBreastCancer.jpg|Lobular breast cancer. Single file cells and cell nests. File:Histopathology of subtle invasive lobular carcinoma, annotated.png|ILC may be subtle on low magnification (left). Higher magnification (right) shows invasive growth pattern and vesicular nuclei with prominent nucleoli.

Prognosis

Overall, the five-year survival rate of invasive lobular carcinoma was approximately 85% in 2003.

Diagnosis

On mammography, ILC shows spiculated mass with ill-defined margins that has similar or lower density than surrounding breast tissues. This happens only at 44–65% of the time. Architectural distortion on surrounding breast tissues is only seen in 10–34% of the cases. It can be reported as benign in 8–16% of the mammography cases.

Ultrasound has 68–98% sensitivity of detecting ILC. ILC shows irregular or angular mass with hypoechoic or heterogenous internal echoes, ill-defined or spiculated margins, and posterior acoustic shadowing.

Loss of E-cadherin is common in lobular carcinoma but is also seen in other breast cancers.

Treatment

Treatment includes surgery and adjuvant therapy.

References

(23 May 2014). "Breast Cancer Treatment (PDQ®)".
(August 1999). "Ultrasound findings in pure invasive lobular carcinoma of the breast: comparison with matched cases of invasive ductal carcinoma of the breast". Breast.
(March 2009). "Neoadjuvant Chemotherapy in Invasive Lobular Carcinoma May Not Improve Rates of Breast Conservation". Ann. Surg. Oncol..
(December 2019). "The diagnosis of male breast cancer". The Netherlands Journal of Medicine.
(2017). "Clinicopathological characteristics and survival outcomes in pleomorphic lobular breast carcinoma of the breast: a SEER population-based study". Cancer Medicine.
(June 2000). "Association of Infiltrating Lobular Carcinoma With Positive Surgical Margins After Breast-Conservation Therapy". Ann. Surg..
(March 2009). "Synchronous bilateral invasive lobular breast cancer presenting as carcinomatosis in a male". Am. J. Surg. Pathol..
Fletcher's diagnostic histopathology of tumors. 3rd Ed. p. 931-932.
(2004). "Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome". Breast Cancer Res..
(January 2009). "Invasive Lobular Carcinoma of the Breast: Spectrum of Mammographic, US, and MR Imaging Findings". RadioGraphics.
(Oct 2009). ["Histology and Immunophenotype of Invasive Lobular Breast Cancer. Daily Practice and Pitfalls"](http://www.zora.uzh.ch/23649/2/Varga_BreastDis_2009.pdf }}{{Dead link). Breast Dis..

Info: Wikipedia Source

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