Invasive lobular carcinoma


Invasive lobular carcinoma 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.

Types

The histologic patterns include:
TypePrevalenceDescriptionImage
Classical40%Round or ovoid cells with little cytoplasm in a single-file infiltrating pattern, sometimes concentrically giving a targetoid pattern
Mixed40%No dominant pattern-
Solid10%Sheets of classical-appearing cells with little intervening stroma-
Alveolar5%Aggregates of classical-appearing cells-
Tubulolobular5%Cells form microtubules in >90% of tumor -
PleomorphicClassical-appearing but with pleomorphic cells. It may include signet-ring cells, or plasmacytoid cells which have abundant cytoplasm and eccentric nuclei.

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.