Invasive lobular carcinoma of the breast

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  • Second most common histologic type (10~15%)
  • Higher incidence of multifocality, multicentricity, and bilaterality
  • E-cadherin negative
  • Indian file appearance
  • Common cause of missed or delayed diagnosis
  • Not common desmoplastic reaction ➨ US, MR is better than MG
  • Larger at diagnosis than IDC
  • Imaging finding
    • MG : Spiculated mass (m/c), isolated architectural distortion, calcification rare
    • US : Irregular hypoechoic mass, marked posterior shadowing

An 59 year old woman presented with large right breast mass

MG) irregular spiculated high density mass with nipple retraction and associated skin thickening

USG) irregular spiculated hypoechoic mass with vessels in rim

MRI) irregular heterogenous enhancing mass with nipple retraction and delayed enhancing pattern

Other lesion in left breast ; irregular early fast and delayed washout heterogenous enhancing intraductal mass with segmental ductal dilatation
Note that invasive lobular carcinoma has tendency of multifocality, multicentricity, and bilaterality

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