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Invasive Lobular Carcinoma

Etiology: • Unknown

Pathogenesis: • Unknown • ? BRCA1 mutations

Epidemiology: • Between 3-14% of invasive carcinomas of the breast depending on microscopic criteria for diangosis • More common in older women with breast cancer

General Gross Description: • Mass may be firm to hard or not readily palpable or visible • May be detected mammographically, although microcalcifications are uncommon

General Microscopic Description: • Neoplastic cells infiltrate in small linear groups "Indian file" • Circle around preexisting benign ducts forming a "target" • Some variants are recognized with solid, tubulolubular or alveolar patterns • Intracytoplasmic lumens may be identified by electron microscopy • Mucin vacuoles creating a signet ring appearance with a nucleus pressed against the cytoplasmic membrane by a large mucin vacuole may be seen.

Clinical Correlations: • Bilaterality ranges from 6-28% • Neoplasms spread to axillary lymph nodes and then disseminate to lungs, liver, and bone • Therapy dependent on stage with treatment similar to that with invasive duct carcinoma

References: • Rosen PP, Oberman H. Tumors of the Mammary Gland. AFIP, Washington, 1993, pp. 168-175.