This high power view shows the cytologic features of lobular carcinoma.
The cells have oval to round nuclei and may be "signet ring" (arrows) with a vacuole of mucin forming the hole in the center of a ring and the nucleus bulgin to form the seal or stone in the ring.
The linear pattern of infiltration is also known as "indian filing".
|Infiltrating Lobular Carcinoma|
Between 3-14% of invasive carcinomas of the breast depending on microscopic criteria for diagnosis
More common in older women with breast cancer
Present as palpable or mammographic mass, but some because of little desmoplasia may be very subtle
Bilaterality ranges from 6-28%
Neoplasms spread to axillary lymph nodes and then disseminate to peritoneal surfaces, meninges, ovaries and uterus in a somewhat different pattern than ductal carcinoma, similar to the pattern in signet ring carcinoma of the gastrointestinal tract
Therapy dependent on stage with treatment similar to that with invasive duct carcinoma
Usually low grade, estrogen and progesterone receptor positive and Her2/neu negative.
Loss of region of chromosome 16 that includes genes for cell adhesion molecule e-cadherin
For more information on prognosis and treatment, consult the NCI web site.
|General Gross Description|
Mass may be firm to hard or not readily palpable or visible
May be detected mammographically, although microcalcifications are uncommon
|General Micro Description|
Neoplastic cells infiltrate in small linear groups: "Indian file"
Circle around preexisting benign ducts forming a "target"
Some variants are recognized with solid, tubulolobular 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.
Robbins and Cotran: Pathologic Basis of Disease, 7th ed., 2005, pp. 1144-45.