Invasive lobular carcinoma of the breast: mammographic and sonographic evaluation

Albayrak, Zeynep Kirkali; Onay, Hulya Kapran; Karatağ, Gülden Yenice; Karatağ, Ozan

doi:10.4261/1305-3825.dir.598-06.3

Cited by 10 publications

(11 citation statements)

References 37 publications

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“…Women with ILC had a disease upstaging rate of 45% and an ICDR of 27% in the ipsilateral breast, concordant with prior studies that showed the value of US as an adjunct to mammography in evaluating ILC [13,33–35]. Women with EIC were upstaged by 28% and had an ICDR of 24% in the ipsilateral breast.…”

Section: Discussionsupporting

confidence: 85%

Incremental Cancer Detection of Locoregional Restaging with Diagnostic Mammography Combined with Whole-Breast and Regional Nodal Ultrasound in Women with Newly Diagnosed Breast Cancer

et al. 2017

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RATIONALE AND OBJECTIVES To determine if locoregional restaging with diagnostic mammography and ultrasound of the whole breast and regional nodes performed for quality assurance in women with newly-diagnosed breast cancer referred to a tertiary care center yields incremental cancer detection. MATERIALS AND METHODS An institutional review board-approved retrospective, single institution database review was performed on the first 1000 women referred to our center in 2010 with a provisional breast cancer diagnosis. Locoregional restaging consisted of diagnostic full-field digital mammography combined with ultrasound of the whole breast and regional nodal basins. Bilateral whole breast ultrasound was performed in women with contralateral mammographic abnormality or had heterogeneously or extremely dense parenchyma. Demographic, clinical and pathologic factors were analyzed. RESULTS Final analyses included 401 women. 34% (138/401) of women did not have their outside images available for review upon referral. Median age was 54 years, range 21–92; median tumor size was 2.9 cm, range 0.6–18, for women whose disease was upstaged and 2.2 cm, range 0.4–15, for women whose disease was not upstaged. Incremental cancer detection rates were 15.5% (62/401) in the ipsilateral breast and 3.9% (6/154) in the contralateral breast (p<0.0001). Total upstage rate was 25% (100/401). Surgical management changed from segmentectomy to mastectomy in 12% (50/401). Re-excision rate after segmentectomy was 19% (35/189). CONCLUSION Locoregional restaging with diagnostic mammography combined with whole breast and regional nodal ultrasound that is performed for standardization of the imaging workup for newly-diagnosed breast cancer patients can reduce underestimation of disease burden and impact therapeutic planning.

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Section: Discussionsupporting

confidence: 85%

Incremental Cancer Detection of Locoregional Restaging with Diagnostic Mammography Combined with Whole-Breast and Regional Nodal Ultrasound in Women with Newly Diagnosed Breast Cancer

et al. 2017

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“…Even though the sonographic appearance was of the small mass size, 8 of 13 small ILCs had multifocal disease in the breast on histopathology (61.5%), 4 had bilateral disease, 3 had angioinvasion, and 3 had axillary lymph node metastases. Altogether, 6 of 40 patients (15%) in our patient group had bilateral ILC, which is fewer compared to 20%-29% patients in other studies ( 7 , 8 ). Ultrasonographic measurement of the largest visible mass and elastographic evaluation of stiffness do not seem to be good markers for evaluation of the disease extent in ILC, as is the case in IDC.…”

Section: Discussioncontrasting

confidence: 62%

“…However smaller lesions differed considerably, and small ILC had significantly higher stiffness, which, to the best our knowledge, had not been reported so far. In order to determine why small ILC are stiffer than small IDC we correlated ultrasound findings with the histopathologic findings of resected breast specimens of ILC, since ILC is known to have the propensity for multifocality and bilaterality ( 3 , 7 , 8 ). Even though the sonographic appearance was of the small mass size, 8 of 13 small ILCs had multifocal disease in the breast on histopathology (61.5%), 4 had bilateral disease, 3 had angioinvasion, and 3 had axillary lymph node metastases.…”

Section: Discussionmentioning

confidence: 99%

“…IDC usually clinically manifests as a firm lump, while ILC usually manifests as a palpable thickening and skin or nipple retraction ( 3 , 5 ). ILC has increased tendency for multifocality and multicentricity, a higher risk of bilateral breast cancer (20%-29%), and older age at onset ( 7 , 8 ). Lymph node metastases are less common in ILC than in IDC of equal size, because ILC tumor cells lack cellular atypia and often have low mitotic rate ( 9 ).…”

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confidence: 99%

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Shear-wave sonoelastographic features of invasive lobular breast cancers

et al. 2016

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AimTo evaluate shear-wave elastographic (SWE) and related gray-scale features of pure invasive lobular breast carcinoma (ILC) and compare them with invasive ductal breast cancers (IDC).MethodsQuantitative SWE features of mean (El-mean), maximum (El-max), minimum (El-min) elasticity values of the stiffest portion of the mass, and lesion-to-fat elasticity ratio (E-ratio) were measured in 40 patients with pure ILC and compared with 75 patients with IDC. Qualitative gray-scale features of lesion size, echogenicity, orientation, and presence of distal shadowing were determined and compared between the groups.ResultsILC were significantly larger than IDC (P = 0.008) and exhibited significantly higher El-max (P = 0.015) and higher El-mean (P = 0.008) than IDC. ILC were significantly more often horizontally oriented, while IDC were significantly more often vertically oriented (P < 0.001); ILC were significantly more often hyperechoic than IDC (P < 0.001). Differences in stiffness between ILC and IDC determined by quantitative SWE parameters were present only in small tumors (≤1.5 cm in size), ie, small ILC had significantly higher El-max (P = 0.030), El-mean (P = 0.014), and El-min (P = 0.045) than small IDC, while tumors larger than 1.5 cm had almost equal stiffness, without significant differences between the groups.ConclusionSpecific histopathologic features of ILC are translated into their qualitative sonographic and quantitative sonoelastographic appearance, with higher stiffness of small ILC compared to small IDC. Gray-scale and sonoelastographic features may help in diagnosing ILC.

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“…4 In addition, it has higher rate of distant metastasis. 2, 4 . Many investigators have reported that PLC has worse disease-free survival, advanced stage at presentation, and shorter time to recurrence.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcome in pleomorphic lobular carcinoma: a case-control study with comparison to classic invasive lobular carcinoma

Narendra¹,

Jenkins²,

Khoór³

et al. 2015

Annals of Diagnostic Pathology

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Aim Pleomorphic lobular carcinoma (PLC) is a variant of invasive lobular carcinoma (ILC) that is described in the literature as an aggressive tumor with poor prognosis. Multiple studies have shown a decrease in overall survival when compared to classic ILC (cILC). In the current study, we sought to compare the clinicopathologic parameters of PLC to cILC. Materials and methods All cases with a diagnosis of ILC, Nottingham grade II-III between 1990 and 2010 were retrieved from the pathology files in the anatomic pathology database at Mayo Clinic in Rochester, MN. The cases were reviewed, and those that met the criteria for pleomorphic lobular carcinoma (PLC) were selected. An E-cadherin immunostain confirmed the lobular immunophenotype. Clinicopathological data was assessed and analyzed. A control group of cILC, Nottingham grade I was selected, comprising two controls for each case, matched according to age and year of diagnosis. Results PLC was more associated with in situ carcinoma (p = 0.03), and had lower PR expression (p = 0.03) when compared to cILC. Both disease-free and overall survival was similar between patients with PLC and matched cILC controls, and depended on disease stage, tumor size and lymph node status. Conclusion PLC has a similar behavior to cILC in terms of survival and outcome.

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Invasive lobular carcinoma of the breast: mammographic and sonographic evaluation

Cited by 10 publications

References 37 publications

Incremental Cancer Detection of Locoregional Restaging with Diagnostic Mammography Combined with Whole-Breast and Regional Nodal Ultrasound in Women with Newly Diagnosed Breast Cancer

Incremental Cancer Detection of Locoregional Restaging with Diagnostic Mammography Combined with Whole-Breast and Regional Nodal Ultrasound in Women with Newly Diagnosed Breast Cancer

Shear-wave sonoelastographic features of invasive lobular breast cancers

Clinical outcome in pleomorphic lobular carcinoma: a case-control study with comparison to classic invasive lobular carcinoma

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