Background: Invasive lobular carcinoma (ILC) is more difficult to detect clinically and with conventional imaging than other types of breast cancer [1]. Compared with invasive ductal cancers (IDC), ILC commonly presents as multifocal disease [1]. Compounding the difficulty in imaging detection of ILC is the issue of breast density. Many studies have confirmed the relationship between high mammographic density (MD) and reduced mammographic sensitivity [2]. MD is itself a risk factor for breast cancer [3]. The National Institute for Health and Care Excellence (NICE) recommend...

Retrospective study. All patients who had histopathological analysis of a surgical specimen of ILC in NHS Grampian in 2016/17 were reviewed (screening and symptomatic patients). Pre-operative conventional imaging of mammogram and ultrasound followed by MRI was standard protocol. Additional findings on MRI were investigated via second look ultrasound +/- biopsy and some patients required MRI guided biopsy. Twenty eight patients were excluded as they did not have imaging as per protocol and / or imaging and reports were not available to view. All MRI scans...

73 patients were identified, mean age was 59.9 years, age range 41-79 years. 41 patients (56.2%) were from screening, 31 patients (42.5%) were from the symptomatic service and 1 patient (1.4%) was on Family History Surveillance. Breast density via BI-RADS 4th edition is shown in Figure 1. 26 patients (35.6%) had additional disease in either breast. 25 (34.2%) patients had additional disease in the ipsilateral malignant breast. In total 3 patients (4.1%) had contralateral malignancy, these patients had BI-RADS density of 2, 3 and 4,...

Discussion: In our study 28.8% of patients were in the higher density group (BI-RADS 3 or 4), comparable to recent data from an urban screening centre in the UK which found that 32% of women had heterogeneously dense breasts [2]. A meta-analysis of MRI use in ILC found that in 32% of patients there were additional ipsilateral lesions and contralateral malignancy in 7% [5]. Our findings are similar with additional ipsilateral lesions in 28.8% and contralateral malignancy in 4.1%. Additional disease was seen in all...

S. D. Gawley; Aberdeen/UK - nothing to disclose A. Nandakumar; Aberdeen/UK - nothing to disclose Y. Masannat; Aberdeen/UK - nothing to disclose E. Husain; Aberdeen/UK - nothing to disclose T. Gagliardi; London/UK - nothing to disclose

1.Johnson K, Sarma D and Hwang ES. Lobular breast cancer series: imaging. Breast Cancer Research 2015;17(1):94. 2.Vinnicombe SJ. Breast density: why all the fuss? Clin Radiol 2018;73(4):334-57. 3. Boyd NF, Guo H, Martin LJ et al. Mammographic density and the risk and detection of breast cancer. N Engl J Med 2007;356(3):227-36. 4. NICE. Early and locally advanced breast cancer: diagnosis and management. NICE guideline [NG101]. Published date: July 2018. Available at: www.nice.org.uk/guidance/ng101 5.Mann RM, Hoogeveen YL, Blickman JG et al. MRI compared to conventional diagnostic...