Invasive Lobular Carcinoma: A Review of Imaging Modalities with Special Focus on Pathology Concordance

Pereslucha, Alicia M; Wenger, Danielle M.; Morris, Michael; Aydi, Zeynep Bostanci

doi:10.3390/healthcare11050746

Cited by 13 publications

(12 citation statements)

References 141 publications

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“…The most common radiological findings are an irregular mass with type 2 enhancement, followed by non-mass lesions with different patterns. The increased sensitivity of MRI has improved the detection rate of ILC and the diagnosis of synchronous and multifocal lesions, which improves surgical planning [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Metastatic Occult Primary Lobular Breast Cancer: A Case Report

Pouptsis,

Cano Gimeno,

Martinez Rubio

et al. 2024

Cureus

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Breast cancer is the most common malignancy diagnosed in women. Invasive lobular breast cancer (ILC) is the second most common histologic subtype after invasive ductal carcinoma. Metastatic occult primary breast cancer, although rare, is a well-known clinical entity that usually presents with axillary lymphadenopathy without a detectable breast tumour. A perimenopausal woman in her 50s presented with abdominal pain, fatigue, and weight loss. Imaging showed peritoneal carcinomatosis with ascites, ovarian masses, and a lesion in the ascending colon. Gastric and colon biopsies showed infiltration from lobular breast cancer. Diagnostic workup, including mammography, breast ultrasound, and breast MRI, showed no evidence of breast pathology or axillary lymphadenopathy. First-line treatment with goserelin, letrozole, and palbociclib commenced with clinical improvement and radiological response. This case illustrates the challenges faced by clinicians in the diagnosis and treatment of lobular breast cancer without an identifiable primary lesion or axillary lymphadenopathy.

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Section: Discussionmentioning

confidence: 99%

Metastatic Occult Primary Lobular Breast Cancer: A Case Report

Pouptsis,

Cano Gimeno,

Martinez Rubio

et al. 2024

Cureus

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“…Compared with the more common IDC, ILC has differing genetic, molecular, and pathologic features 68 . Due to the lack of E-cadherin, ILC grows in a noncohesive single-file linear pattern, which can be difficult to image with mammography, ultrasound, MRI, or FDG PET 69 . Both ILC and low-grade IDC are less likely to show distant disease sites with FDG avidity (Fig.…”

Section: Estrogen Receptor–targeted Imagingmentioning

confidence: 99%

“…Both ILC and low-grade IDC are less likely to show distant disease sites with FDG avidity (Fig. 3) 24,69,70 ; however, ILC is almost always ER-positive 68,71 . Data from small studies support potential utility of FES PET imaging for invasive lobular breast cancer, but more research is needed 36,72,73 …”

Section: Estrogen Receptor–targeted Imagingmentioning

confidence: 99%

Molecular Imaging of Steroid Receptors in Breast Cancer

Keigley,

Fowler,

O'Brien

et al. 2024

Cancer J

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Steroid receptors regulate gene expression for many important physiologic functions and pathologic processes. Receptors for estrogen, progesterone, and androgen have been extensively studied in breast cancer, and their expression provides prognostic information as well as targets for therapy. Noninvasive imaging utilizing positron emission tomography and radiolabeled ligands targeting these receptors can provide valuable insight into predicting treatment efficacy, staging whole-body disease burden, and identifying heterogeneity in receptor expression across different metastatic sites. This review provides an overview of steroid receptor imaging with a focus on breast cancer and radioligands for estrogen, progesterone, and androgen receptors.

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“…While mammography is the standard for breast cancer screening and is the first-line modality for most diagnostic breast evaluations, its sensitivity relies on the detection of morphologic changes that may not be evident with ILC ( 3 ). Mammographically, ILC typically presents as a mass or with subtle findings, such as architectural distortion or a low-density asymmetry that may only be seen in one view in up to 35% of cases ( 6 , 8–13 ).…”

Section: Introductionmentioning

confidence: 99%

Breast Radiologists’ Perceptions on the Detection and Management of Invasive Lobular Carcinoma: Most Agree Imaging Beyond Mammography Is Warranted

Coffey,

Berg,

Dodelzon

et al. 2024

Journal of Breast Imaging

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Objective To determine breast radiologists’ confidence in detecting invasive lobular carcinoma (ILC) on mammography and the perceived need for additional imaging in screening and preoperative settings. Methods A 16-item anonymized survey was developed, and IRB exemption obtained, by the Society of Breast Imaging (SBI) Patient Care and Delivery Committee and the Lobular Breast Cancer Alliance. The survey was emailed to 2946 radiologist SBI members on February 15, 2023. The survey recorded demographics, perceived modality-specific sensitivity for ILC to the nearest decile, and opinions on diagnosing ILC in screening and staging imaging. Five-point Likert scales were used (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree). Results Response rate was 12.4% (366/2946). Perceived median (interquartile range) modality-specific sensitivities for ILC were MRI 90% (80–90), contrast-enhanced mammography 80% (70–90), molecular breast imaging 80% (60–90), digital breast tomosynthesis 70% (60–80), US 60% (50–80), and 2D mammography 50% (30–60). Only 25% (85/340) respondents were confident in detecting ILC on screening mammography in dense breasts, while 67% (229/343) were confident if breasts were nondense. Most agreed that supplemental screening is needed to detect ILC in women with dense breasts (272/344, 79%) or a personal history of ILC (248/341, 73%), with 34% (118/334) indicating that supplemental screening would also benefit women with nondense breasts. Most agreed that additional imaging is needed to evaluate extent of disease in women with newly diagnosed ILC, regardless of breast density (dense 320/329, 97%; nondense 263/329, 80%). Conclusion Most breast radiologists felt that additional imaging beyond mammography is needed to more confidently screen for and stage ILC.

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Invasive Lobular Carcinoma: A Review of Imaging Modalities with Special Focus on Pathology Concordance

Cited by 13 publications

References 141 publications

Metastatic Occult Primary Lobular Breast Cancer: A Case Report

Metastatic Occult Primary Lobular Breast Cancer: A Case Report

Molecular Imaging of Steroid Receptors in Breast Cancer

Breast Radiologists’ Perceptions on the Detection and Management of Invasive Lobular Carcinoma: Most Agree Imaging Beyond Mammography Is Warranted

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