Invasive lobular carcinoma
|Invasive lobular carcinoma|
|Lobules of the mammary glands.|
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).
|Classic lobular||Pleomorphic lobular|
|Grades||Low or high (II/III)||High (III)|
|Lymph node status||Negative||Positive|
|Classical||40%||Round or ovoid cells with little cytoplasm in a single-file infiltrating pattern, sometimes concentrically giving a targetoid pattern|
|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.|
Histopathology of invasive lobular carcinoma (ILC), next to lobular carcinoma in situ (LCIS)
Overall, the five-year survival rate of invasive lobular carcinoma was approximately 85% in 2003.
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 shadowin.
Treatment includes surgery and adjuvant therapy.
- "Breast Cancer Treatment (PDQ®)". NCI. 23 May 2014. Archived from the original on 5 July 2014. Retrieved 29 June 2014.
- Pointon KS, Cunningham DA (August 1999). "Ultrasound findings in pure invasive lobular carcinoma of the breast: comparison with matched cases of invasive ductal carcinoma of the breast". Breast. 8 (4): 188–90. doi:10.1054/brst.1999.0042. PMID 14731438.
- Boughey JC, Wagner J, Garrett BJ, et al. (March 2009). "Neoadjuvant Chemotherapy in Invasive Lobular Carcinoma May Not Improve Rates of Breast Conservation". Ann. Surg. Oncol. 16 (6): 1606–11. doi:10.1245/s10434-009-0402-z. PMC 4338983. PMID 19280264.
- Nofal MN, Yousef AJ (December 2019). "The diagnosis of male breast cancer". The Netherlands Journal of Medicine. 77 (10): 356–359. PMID 31880271.
- Yang, Li-Peng; Sun, He-Fen; Zhao, Yang; Chen, Meng-Ting; Zhang, Nong; Jin, Wei (2017). "Clinicopathological characteristics and survival outcomes in pleomorphic lobular breast carcinoma of the breast: a SEER population-based study". Cancer Medicine. 6 (12): 2867–2875. doi:10.1002/cam4.1244. ISSN 2045-7634. PMC 5727339. PMID 29131529.
- Moore MM, Borossa G, Imbrie JZ, et al. (June 2000). "Association of Infiltrating Lobular Carcinoma With Positive Surgical Margins After Breast-Conservation Therapy". Ann. Surg. 231 (6): 877–82. doi:10.1097/00000658-200006000-00012. PMC 1421077. PMID 10816631.
- Spencer JT, Shutter J (March 2009). "Synchronous bilateral invasive lobular breast cancer presenting as carcinomatosis in a male". Am. J. Surg. Pathol. 33 (3): 470–4. doi:10.1097/PAS.0b013e318190d10d. PMID 19092630. S2CID 24935891.
- Fletcher's diagnostic histopathology of tumors. 3rd Ed. p. 931-932.
- Arpino G, Bardou VJ, Clark GM, Elledge RM (2004). "Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome". Breast Cancer Res. 6 (3): R149–56. doi:10.1186/bcr767. PMC 400666. PMID 15084238.
- Lopez, January K.; Bassett, Lawrence W. (January 2009). "Invasive Lobular Carcinoma of the Breast: Spectrum of Mammographic, US, and MR Imaging Findings". RadioGraphics. 29 (1): 165–176. doi:10.1148/rg.291085100. ISSN 0271-5333. PMID 19168843.
- Varga Z, Mallon E (Oct 2009). "Histology and Immunophenotype of Invasive Lobular Breast Cancer. Daily Practice and Pitfalls" (PDF). Breast Dis. 30: 15–19. doi:10.3233/BD-2009-0278. PMID 19850991.