also showed E-CD is useful in differ-entiate Pleomorphic Lobular carcinoma
from IDC.12 Bratthauer et al.
of Cases Percentage DCIS 1 0.87 INFILTRATING DUCT CARCINOMA 79 68.7 LOBULAR CARCINOMA
9 7.84 MEDULLARY CARCINOMA 15 13.04 PHYLLODE TUMOR WITH MALIGNANT CHANGE 4 3.47 PHYLLODE TUMOR WITH BORDERLINE CHANGE 1 0.87 SMALL CELL CARCINOMA 2 1.73 MAMMARY CARCINOMA WITH NEUROENDOCRINE 1 0.87 DIFFERENTIATION PAGETS 1 0.87 SPINDLE CELL TUMOR WITH 1 0.87 BORDERLINE CHANGE SCHIRROUS CARCINOMA 1 0.87 TOTAL 115 100% Graph.
We also queried institutions with regard to which specific lesions they report margin status for, and the results are summarized in Table 8: 778 of 786 respondents (99%) report margins for IC, 783 of 792 (99%) report margins for DCIS, 455 of 723 (63%) report margins for classical lobular carcinoma
in situ (LOS), 635 of 723 (88%) report margins for pleomorphic LCIS, 423 of 723 (59%) report margins for other types of "variant" LCIS, 302 of 723 (42%) report margins for atypical ductal hyperplasia (ADH), and 487 of 723 (67%) report margins for "ADH bordering on DCIS."
In the other study, HER-2 positivity was limited to invasive breast carcinomas of the ductal type and among lobular carcinomas
, HER-2 positivity was observed only in the pleomorphic type and not in the classic type tumours.
Both invasive lobular carcinoma
and tumors with an extensive component of DCIS are often underestimated by mammography.
Nor is lobular carcinoma
in situ (LCIS) simply a risk factor for invasive breast cancer, as has been the traditional view.
In particular, the best course of action for "risk factor" diagnoses like atypical lobular hyperplasia or lobular carcinoma
in situ, which constituted most of the findings, is even less clear.
Others reviewed 200 RMs and found that 8% had lobular carcinoma
in situ, all being older than 40 years.12 Still others showed invasive breast cancer in 20%, DCIS in 14%, lobular carcinoma
in situ in 3% of patients in a series of 110 patients.13
Abnormalities (such as lobular carcinoma
in situ, atypical ductal hyperplasia, and other precancerous lesions) may demonstrate MRI enhancement.
In 1998 this landmark trial demonstrated that tamoxifen reduced the incidence of invasive breast cancer by 49% and of noninvasive cancer--ductal carcinoma in situ and lobular carcinoma
in situ--by 50%.
When present, lobular neoplasia, encompassing ALH and lobular carcinoma
in situ (LCIS), is often multifocal and bilateral.
Invasive lobular carcinoma
, which is the second most common in female breast cancer, is much less common in MBC.