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 + Most common features Classic lobular Pleomorphic lobular GradesLow or high (II/III)High (III) AJCC stageIII Lymph node statusNegativePositive ER/PR statusPositivePositive Surgery typeLumpectomyMastectomy
The histologic patterns include:Fletcher's diagnostic histopathology of tumors. 3rd Ed. p. 931-932. 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.
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.
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