Invasive Lobular Carcinoma of the Breast: The Use of Radiological Appearance to Classify Tumor Subtypes for Better Prediction of Long-Term Outcome

Abstract

We compared the survival of women diagnosed with invasive lobular carcinoma subtypes prior to and during the mammography screening era to determine the impact of early detection and treatment in an early phase upon survival according to tumor subtypes. Using mammographic tumor features, we classified 428 consecutive invasive lobular carcinoma cases of the breast into four subgroups according to their mammographic tumor features. Life-table-based survival curves and adjusted survival curves with the accelerated failure time method were plotted to demonstrate the 14-year follow-up survival outcome with adjustment for tumor size, node status, histologic malignancy grade, tumor focality and treatment. Survival of invasive lobular carcinoma subtypes was substantially improved as a result of early detection through mammography screening and treatment in an early phase, except for the subtype presenting as architectural distortion on the mammogram, even with the use of modern therapeutic methods. There is a clear need to further develop diagnostic and management strategies to decrease mortality from the diffusely infiltrating special subtype of invasive lobular carcinoma.