Abstract
The limitations of mammography in the detection and evaluation of invasive lobular carcinoma (ILC) have long been recognized, presenting real clinical challenges in treatment planning for these tumors. However, advances in mammography, ultrasound, and magnetic resonance imaging present opportunities to improve the diagnosis and preoperative assessment of ILC. The evidence supporting the performance of each imaging modality will be reviewed, specifically as it relates to the pathology of ILC and its subtypes. Further, we will discuss emerging technologies that may be employed to enhance the detection rate and ultimately result in more effective screening and staging of ILC.
Highlights
Invasive lobular carcinomas (ILCs) are the second most prevalent subtype of invasive breast cancer after invasive ductal cancer (IDC), accounting for 5 to 15 % of new breast cancer diagnoses [1,2,3]
ILC commonly presents as multifocal disease, and some series report a higher incidence of bilateral breast cancer, this finding has not been consistently demonstrated across all studies
Routine preoperative magnetic resonance imaging (MRI) for all breast cancers is not recommended, it should be considered in the setting of newly diagnosed ILC in order to better define the extent of disease
Summary
Invasive lobular carcinomas (ILCs) are the second most prevalent subtype of invasive breast cancer after invasive ductal cancer (IDC), accounting for 5 to 15 % of new breast cancer diagnoses [1,2,3]. ILC commonly presents as multifocal disease, and some series report a higher incidence of bilateral breast cancer, this finding has not been consistently demonstrated across all studies. When breast tissue is described as heterogeneous or extremely dense, the sensitivity of mammography for the detection of invasive tumors can be as low as 30 to 48 % [16, 17].
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