Aims and objectives
Invasive lobular carcinoma (ILC) is the second most common cause of invasive carcinoma.
ILC is characterised,
by small round cells which invade the stroma in a ‘single file pattern’ resulting in linear strands.
There is no destruction of anatomical structure or fibrous reaction so a mass lesion is not always formed.
The conventional radiological detection of ILC is therefore difficult and patients often present with advanced disease.
ILC tumors are usually of a low histological grade and tend to have less lymph node...
Methods and materials
An electronic search of MEDLINE/PubMed using the following key words was performed: ‘invasive lobular carcinoma’,
‘breast magnetic resonance imaging’.
The following limits were applied: English Language and Humans.
All studies investigating the impact of breast MRI on preoperative assessment and subsequent surgical management of ILC were included in the narrative synthesis.
This included retrospective and prospective cohort studies.
Study selection was performed jointly by the authors and disagreements were resolved by discussion.
The search was performed in July 2017.
Study selection is summarised in the flow chart below:
The search retrieved 236 publications and the final selection list consisted of 32 papers.
Following thorough review of the 32 included papers the following codes and themes were generated and are detailed further in the discussion section:
bMRI is the most accurate modality for assessing tumour size.
Average bMRI-pathology size correlation is 0.86.
bMRI identifies multifocal disease which may not be visible on standard mammography or ultrasonography.
Preoperative bMRI is associated with increased mastectomy rates.
bMRI adds additional information in the preoperative assessment of pathologically confirmed ILC by providing the most accurate radiological tumour size assessment and identifying multifocal or multicentric disease.
These findings directly impacts on initial surgical management by potentially increasing primary mastectomy rates.
bMRI potentially has a role in identifying patients suitable for breast conserving surgery (unifocal disease) and mastectomy (multifocal disease).
Bilateral lesions require histological confirmation prior to treatment.
Further studies are required to aid patient selection for bMRI and characterise surgical outcomes following initial treatment.
Breast MRI in Invasive Lobular Carcinoma: A Useful Investigation in Surgical Planning?
ILC: Breast J. 2016 Mar-Apr;22(2):143-50.
Epub 2016 Feb 3.