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Invasive Lobular Carcinoma (invasive + lobular_carcinoma)
Selected AbstractsThe Yale University Experience of Early-Stage Invasive Lobular Carcinoma (ILC) and Invasive Ductal Carcinoma (IDC) Treated with Breast Conservation Treatment (BCT): Analysis of Clinical-Pathologic Features, Long-Term Outcomes, and Molecular Expression of COX-2, Bcl-2, and p53 as a Function of HistologyTHE BREAST JOURNAL, Issue 6 2009Meena S. Moran MD Abstract:, To evaluate our experience of the clinical-pathologic features and outcomes of early-stage Invasive Lobular (ILC) versus Invasive Ductal (IDC) carcinoma treated with breast conservation treatment (BCT). 142 ILC and 1,760 IDC patients were treated with BCT at our institution. All patients underwent breast conserving surgery and radiation therapy (median total dose: 64 Gy). Clinical-pathologic and outcome parameters were analyzed to detect differences between the two cohorts. In addition, COX-2, Bcl-2, and p-53 expression was analyzed from our existing tissue micro-array database. Median follow-up was 6.8 years. A higher percentage of ILC patients presented at >40 years of age (94% ILC versus 89% IDC, p = 0.0353) and had more mammographically occult tumors (p < 0.002). There were no significant differences in T stage, nodal status, family history, final margin, ER/PR/HER-2 status or triple negative tumors (all p-values >0.05). From the immuno-histochemical analysis, expression of p53, COX-2, and Bcl-2 did not differ significantly (all p-values >0.05) between the two cohorts. At 10 years, there was no difference in breast relapse (20% versus 13%, p = 0.25), distant relapse (26% versus 20%, p = 0.28), cause-specific survival (72% versus 84%, p = 0.09) and OS (68% versus 78%, p = 0.08). Patients with ILC had higher contralateral breast relapses (26% versus 12%, p = 0.0006). Patients with early-stage ILC have comparable outcomes to IDC when treated with BCT. Because of the higher risk of contralateral breast cancers for ILC patients, careful evaluation of the contralateral breast will be important in the follow-up of these patients. Future investigations of chemo-preventive strategies to decrease contralateral breast cancers are warranted. [source] Invasive Lobular Carcinoma and Breast Conserving Therapy: Implications for the PathologistTHE BREAST JOURNAL, Issue 5 2003Article first published online: 8 SEP 200 No abstract is available for this article. [source] Role of E-cadherins in development of lymphatic tumor emboliCANCER, Issue 9 2003Anita Gupta M.D. Abstract BACKGROUND E-cadherin (E-cad) is a cell adhesion molecule that is expressed in normal breast tissue. While loss of E-cad expression is a characteristic feature of lobular carcinoma, it also is observed in infiltrating ductal carcinoma (IDC). The presence of peritumoral intralymphatic emboli also is a poor prognostic feature in IDC. Invasive lobular carcinoma rarely is associated with intralymphatic emboli. In the current study, the authors assessed E-cad expression in cases of IDC with and without intralymphatic tumor emboli to examine the potential role played by these molecules in the development of lymphatic emboli. METHODS Fifty patients with high-grade invasive ductal carcinoma,25 with prominent lymphatic invasion (LVI) and intralymphatic tumor emboli and 25 without LVI,were tested for expression of E-cad. For both groups, the intensity and frequency of E-cad expression was evaluated in tumor cells and lymphatic emboli; normal lobules were used as internal controls. RESULTS Membranous expression of E-cad was observed in normal lobules and tumor cells in all patients, with the tumor cells exhibiting varying degrees of loss of expression. In the 25 LVI-positive patients, the majority of tumor cells (including intralymphatic emboli) expressed E-cad with an intensity and distribution similar to what was seen in normal lobules. In the LVI-negative patients, the intensity and the distribution of E-cad staining varied significantly. Tumor cells at the tumor-stroma interface showed a greater frequency and intensity of E-cad expression than did cells in the central region of the tumor. CONCLUSIONS Strong expression of E-cad was observed in LVI-positive patients with high-grade IDC but not in LVI-negative patients. Emboli also exhibited high-intensity expression. These findings, taken in conjunction with the knowledge that intralymphatic tumor emboli in lobular carcinoma (which is E-cad-negative) are rare, suggest that E-cad plays an important role in tumor development and growth within the lymphatics. Cancer 2003;97:2341,7. © 2003 American Cancer Society. DOI 10.1002/cncr.11332 [source] Role of sonography in diagnosing and staging invasive lobular carcinomaJOURNAL OF CLINICAL ULTRASOUND, Issue 7 2004Veronica L. Selinko MD Abstract Purpose The goal of this study was to compare the sensitivity of sonography with that of mammography in the detection of invasive lobular carcinoma (ILC), to identify ILC's typical imaging characteristics, and to further show the important role of ultrasound in the staging and treatment planning of this elusive tumor. Methods We identified all patients with ILC seen at our institution from 1998 through 2001; 62 had pathologically proven pure ILC. We retrospectively reviewed and analyzed the sonographic appearances in correlation with mammographic, pathologic, and clinical findings. We reviewed the results of sonographic examinations of the nodal basins and fine-needle aspiration (FNA) of suspicious nodes and correlated them with initial clinical and final pathologic staging. We noted all cases of multicentricity or multifocality and analyzed the relative sensitivity of mammography and sonography according to tumor size. Results Sonography had a sensitivity of 98% versus 65% for mammography. The most common mammographic pattern was a spiculated mass or architectural distortion (39%). On sonography the most common pattern was a hypoechoic mass with (58%) or without (27%) shadowing. An infiltrative pattern was observed in 13% of the cases. Ultrasound-guided FNA confirmed disease was present in the axillary lymph nodes in 21% of the patients, and sonographic examination of the nodal basins resulted in a change of clinical staging from N0 to N1 in 75% and from N1 to N0 in 30% of the cases. Multicentricity/multifocality was identified sonographically and proved by FNA in 21% of patients. Conclusions Sonography has a much higher sensitivity than mammography in detecting ILC and therefore is an important adjunctive tool in the diagnosis of this form of cancer. Routine examination of node-bearing areas in patients with ILC proved useful in refining the disease staging. © 2004 Wiley Periodicals, Inc. J Clin Ultrasound 32:323,332, 2004 [source] Challenges to interpretation of breast MRIJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 6 2001Karen Kinkel MD Abstract This review describes the current knowledge and challenges of lesion interpretation with MRI of the breast according to different image interpretation strategies. Particular emphasis is given to patient- and tumor-related factors that influence image interpretation. The impacts of the menstrual cycle, prior surgery, radiation therapy, and chemotherapy are summarized. Particular enhancement features of ductal carcinoma in situ (DCIS) or invasive lobular carcinoma are described. Finally, an adequate diagnosis at MRI of the breast should take into account the results of the patient's history, physical examination, and all imaging tests performed before MRI. J. Magn. Reson. Imaging 2001;13:821,829. © 2001 Wiley-Liss, Inc. [source] Lymphoepithelioma-like carcinoma of the breastAPMIS, Issue 6 2002A newly recognized subtype of lobular carcinoma Lymphoepithelioma-like carcinoma (LELC) of the breast is a rare, newly recognized subtype of breast carcinoma. Distinction from medullary carcinoma is important because of the difference in biologic behavior of these two neoplasms and LELC of the breast is regarded as an unusual form of lobular carcinoma. We present the case of a 56-year-old female with a breast mass measuring 2 cm in diameter, which was diagnosed as invasive lobular carcinoma with LELC pattern. This is the ninth case reported in the English literature and to the best of our knowledge the first one with lymph node metastasis. [source] Role of magnetic resonance imaging in the diagnosis and single-stage surgical resection of invasive lobular carcinoma of the breast,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 10 2002K. Munot Background: Conventional imaging with mammography and ultrasonography has a low sensitivity for diagnosis and a tendency to underestimate the extent of invasive lobular carcinoma (ILC) of the breast. The aim was to determine whether magnetic resonance imaging (MRI) had any advantages for the characterization of ILC. Methods: Twenty patients with histologically proven ILC underwent preoperative imaging with MRI. MRI was performed to aid detection of malignancy in six patients with a clinically suspicious presentation but normal or indeterminate imaging on mammography and ultrasonography. In 14 patients MRI was performed to determine tumour extent. Results: MRI accurately identified malignancy in five of six patients with normal or indeterminate conventional imaging. In seven of 14 patients in whom MRI was performed to determine tumour extent, it provided significant additional information. These included four patients in whom conventional imaging grossly underestimated tumour size, two patients in whom MRI identified an unsuspected contralateral breast tumour and one patient in whom MRI predicted tumour invasion of the pectoral muscle. The correlation between tumour size on histological examination was better with MRI (r = 0·967) than with mammography (r = 0·663) and ultrasonography (r = 0·673). Conclusion: MRI can provide considerable additional information in the detection and characterization of ILC. © 2002 British Journal of Surgery Society Ltd [source] The role of cytokeratins 20 and 7 and estrogen receptor analysis in separation of metastatic lobular carcinoma of the breast and metastatic signet ring cell carcinoma of the gastrointestinal tractAPMIS, Issue 7-8 2000TIBOR Tot Metastatic signet ring cell carcinomas of unknown primary site can represent a clinical problem. Gastrointestinal signet ring cell carcinomas and invasive lobular carcinomas of the breast are the most common sources of these metastases. Immunohistochemical algorithms have been successfully used in the search for the unknown primary adenocarcinomas. In the present study a series of primary invasive lobular breast carcinomas (79 cases) and their metastases and a series of gastrointestinal signet ring cell carcinomas (22 primary and 13 metastases) were stained with monoclonal antibodies for cytokeratin (CK) 20 and CK7 and for estrogen receptors (ER). The staining was evaluated as negative (no staining), focally (less than 10% of the tumor cells stained) or diffusely positive. All the primary and metastatic gastrointestinal signet ring cell carcinomas proved to be CK20 positive, while only 2/79 (3%) of the primary and 1/21 metastatic lobulr carcinomas (5%) stained positively for this CK. None of the gastrointestinal carcinomas and the majority of the lobular carcinomas expressed ER. The majority of the tumors were CK7+. Using CK20 alone, 33 of 34 metastases could be properly classified as gastrointestinal (CK20+) or mammary (CK20-). ER identified 31/34 of breast cancer metastases. By combining the results of CK20 and ER staining all the metastases could be properly classified as the CK20+/ER- pattern identified all the gastrointestinal tumors. [source] | ||||||||||