Invasive lobular carcinoma

Invasive lobular carcinoma
Lobules of the mammary glands.
SpecialtyOncology
Histopathologic types of breast cancer, with relative incidences and prognoses, with "invasive lobular carcinoma" at top right.

Invasive lobular carcinoma is breast cancer arising from the lobules of the mammary glands.[1] It accounts for 5-10% of invasive breast cancer.[2][3]

The histologic patterns include:[4][5][6]

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
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.

Overall, the five-year survival rate of invasive lobular carcinoma was approximately 85% in 2003.[7]

Loss of E-cadherin is common in lobular carcinoma but is also seen in other breast cancers.[8]

Treatment includes surgery and adjuvant therapy.

Most common features[9]
Classic lobular Pleomorphic lobular
GradesLow or high (II/III)High (III)
AJCC stageIII
Lymph node statusNegativePositive
ER/PR statusPositivePositive
Surgery typeLumpectomyMastectomy

References

  1. "Breast Cancer Treatment (PDQ®)". NCI. 23 May 2014. Archived from the original on 5 July 2014. Retrieved 29 June 2014.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. Fletcher's diagnostic histopathology of tumors. 3rd Ed. p. 931-932.
  7. 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.
  8. 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.
  9. 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.
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