A comparison of the imaging features of pleomorphic and classical invasive lobular carcinoma

Phey Ming Yeap (Lead / Corresponding author), Andrew Evans, Colin A. Purdie, Lee B. Jordan, Sarah J. Vinnicombe

Research output: Contribution to journalArticle

  • 1 Citations

Abstract

Purpose: Pleomorphic invasive lobular carcinoma (pILC) is a distinct morphological variant of ILC with a poorer prognosis than classical ILC (cILC). The aim of this study was to ascertain whether the conventional imaging appearances of the two entities differ.

Methods: A single-center retrospective review of conventional imaging was undertaken in 150 consecutive patients with histopathologically confirmed ILC (38 pILC; 112 cILC) between April 2010 and July 2015. Mammographic and sonographic findings were evaluated using the BI-RADS lexicon by a radiologist blinded to pathology, and the findings in the two groups were compared. The degree of discrepancy between imaging and pathological sizing in the two groups was evaluated.

Results: Lesions were mammographically occult in 11% of pILC and 14% of cILC (p = 0.56). On mammography, skin or trabecular thickening and microcalcification were commoner in pILC than cILC (13% vs. 1%, p < 0.01; 25% vs. 5%, p < 0.01). Architectural distortion was more frequent in cILC than pILC (26% vs. 9%, p = 0.01). On ultrasound, pILC more frequently exhibited mixed echogenicity (28% vs. 13%; p = 0.04), skin thickening, subcutaneous or parenchymal edema (8% vs. 0%; p = 0.02), echogenic surrounding fat (33% vs. 9%; p < 0.01), and posterior acoustic enhancement (10% vs. 1%; p = 0.02) than cILC. CILC was more frequently manifested as a focal area of altered echogenicity (24% vs. 8%; p = 0.04). Mean elastography stiffness was higher for pILC (174.8 vs. 124.6 kPa; p = 0.02). Imaging-pathological size disparity was similar for both subtypes.

Conclusion: There are differences in the imaging features between pILC and cILC which reflect the more aggressive nature of pILC.

LanguageEnglish
Pages381-389
Number of pages9
JournalBreast Cancer Research and Treatment
Volume172
Issue number2
Early online date9 Aug 2018
DOIs
Publication statusPublished - Nov 2018

Fingerprint

Lobular Carcinoma
Elasticity Imaging Techniques
Calcinosis
Skin
Mammography
Acoustics
Edema
Fats
Pathology

Keywords

  • Breast
  • Lobular carcinoma
  • Mammography
  • Pathology
  • Ultrasound

Cite this

Yeap, Phey Ming ; Evans, Andrew ; Purdie, Colin A. ; Jordan, Lee B. ; Vinnicombe, Sarah J. / A comparison of the imaging features of pleomorphic and classical invasive lobular carcinoma. In: Breast Cancer Research and Treatment. 2018 ; Vol. 172, No. 2. pp. 381-389.
@article{0157ec1a078246e49133f8d197df66c7,
title = "A comparison of the imaging features of pleomorphic and classical invasive lobular carcinoma",
abstract = "Purpose: Pleomorphic invasive lobular carcinoma (pILC) is a distinct morphological variant of ILC with a poorer prognosis than classical ILC (cILC). The aim of this study was to ascertain whether the conventional imaging appearances of the two entities differ.Methods: A single-center retrospective review of conventional imaging was undertaken in 150 consecutive patients with histopathologically confirmed ILC (38 pILC; 112 cILC) between April 2010 and July 2015. Mammographic and sonographic findings were evaluated using the BI-RADS lexicon by a radiologist blinded to pathology, and the findings in the two groups were compared. The degree of discrepancy between imaging and pathological sizing in the two groups was evaluated.Results: Lesions were mammographically occult in 11{\%} of pILC and 14{\%} of cILC (p = 0.56). On mammography, skin or trabecular thickening and microcalcification were commoner in pILC than cILC (13{\%} vs. 1{\%}, p < 0.01; 25{\%} vs. 5{\%}, p < 0.01). Architectural distortion was more frequent in cILC than pILC (26{\%} vs. 9{\%}, p = 0.01). On ultrasound, pILC more frequently exhibited mixed echogenicity (28{\%} vs. 13{\%}; p = 0.04), skin thickening, subcutaneous or parenchymal edema (8{\%} vs. 0{\%}; p = 0.02), echogenic surrounding fat (33{\%} vs. 9{\%}; p < 0.01), and posterior acoustic enhancement (10{\%} vs. 1{\%}; p = 0.02) than cILC. CILC was more frequently manifested as a focal area of altered echogenicity (24{\%} vs. 8{\%}; p = 0.04). Mean elastography stiffness was higher for pILC (174.8 vs. 124.6 kPa; p = 0.02). Imaging-pathological size disparity was similar for both subtypes.Conclusion: There are differences in the imaging features between pILC and cILC which reflect the more aggressive nature of pILC.",
keywords = "Breast, Lobular carcinoma, Mammography, Pathology, Ultrasound",
author = "Yeap, {Phey Ming} and Andrew Evans and Purdie, {Colin A.} and Jordan, {Lee B.} and Vinnicombe, {Sarah J.}",
year = "2018",
month = "11",
doi = "10.1007/s10549-018-4914-8",
language = "English",
volume = "172",
pages = "381--389",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer Verlag",
number = "2",

}

A comparison of the imaging features of pleomorphic and classical invasive lobular carcinoma. / Yeap, Phey Ming (Lead / Corresponding author); Evans, Andrew; Purdie, Colin A.; Jordan, Lee B.; Vinnicombe, Sarah J.

In: Breast Cancer Research and Treatment, Vol. 172, No. 2, 11.2018, p. 381-389.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A comparison of the imaging features of pleomorphic and classical invasive lobular carcinoma

AU - Yeap, Phey Ming

AU - Evans, Andrew

AU - Purdie, Colin A.

AU - Jordan, Lee B.

AU - Vinnicombe, Sarah J.

PY - 2018/11

Y1 - 2018/11

N2 - Purpose: Pleomorphic invasive lobular carcinoma (pILC) is a distinct morphological variant of ILC with a poorer prognosis than classical ILC (cILC). The aim of this study was to ascertain whether the conventional imaging appearances of the two entities differ.Methods: A single-center retrospective review of conventional imaging was undertaken in 150 consecutive patients with histopathologically confirmed ILC (38 pILC; 112 cILC) between April 2010 and July 2015. Mammographic and sonographic findings were evaluated using the BI-RADS lexicon by a radiologist blinded to pathology, and the findings in the two groups were compared. The degree of discrepancy between imaging and pathological sizing in the two groups was evaluated.Results: Lesions were mammographically occult in 11% of pILC and 14% of cILC (p = 0.56). On mammography, skin or trabecular thickening and microcalcification were commoner in pILC than cILC (13% vs. 1%, p < 0.01; 25% vs. 5%, p < 0.01). Architectural distortion was more frequent in cILC than pILC (26% vs. 9%, p = 0.01). On ultrasound, pILC more frequently exhibited mixed echogenicity (28% vs. 13%; p = 0.04), skin thickening, subcutaneous or parenchymal edema (8% vs. 0%; p = 0.02), echogenic surrounding fat (33% vs. 9%; p < 0.01), and posterior acoustic enhancement (10% vs. 1%; p = 0.02) than cILC. CILC was more frequently manifested as a focal area of altered echogenicity (24% vs. 8%; p = 0.04). Mean elastography stiffness was higher for pILC (174.8 vs. 124.6 kPa; p = 0.02). Imaging-pathological size disparity was similar for both subtypes.Conclusion: There are differences in the imaging features between pILC and cILC which reflect the more aggressive nature of pILC.

AB - Purpose: Pleomorphic invasive lobular carcinoma (pILC) is a distinct morphological variant of ILC with a poorer prognosis than classical ILC (cILC). The aim of this study was to ascertain whether the conventional imaging appearances of the two entities differ.Methods: A single-center retrospective review of conventional imaging was undertaken in 150 consecutive patients with histopathologically confirmed ILC (38 pILC; 112 cILC) between April 2010 and July 2015. Mammographic and sonographic findings were evaluated using the BI-RADS lexicon by a radiologist blinded to pathology, and the findings in the two groups were compared. The degree of discrepancy between imaging and pathological sizing in the two groups was evaluated.Results: Lesions were mammographically occult in 11% of pILC and 14% of cILC (p = 0.56). On mammography, skin or trabecular thickening and microcalcification were commoner in pILC than cILC (13% vs. 1%, p < 0.01; 25% vs. 5%, p < 0.01). Architectural distortion was more frequent in cILC than pILC (26% vs. 9%, p = 0.01). On ultrasound, pILC more frequently exhibited mixed echogenicity (28% vs. 13%; p = 0.04), skin thickening, subcutaneous or parenchymal edema (8% vs. 0%; p = 0.02), echogenic surrounding fat (33% vs. 9%; p < 0.01), and posterior acoustic enhancement (10% vs. 1%; p = 0.02) than cILC. CILC was more frequently manifested as a focal area of altered echogenicity (24% vs. 8%; p = 0.04). Mean elastography stiffness was higher for pILC (174.8 vs. 124.6 kPa; p = 0.02). Imaging-pathological size disparity was similar for both subtypes.Conclusion: There are differences in the imaging features between pILC and cILC which reflect the more aggressive nature of pILC.

KW - Breast

KW - Lobular carcinoma

KW - Mammography

KW - Pathology

KW - Ultrasound

U2 - 10.1007/s10549-018-4914-8

DO - 10.1007/s10549-018-4914-8

M3 - Article

VL - 172

SP - 381

EP - 389

JO - Breast Cancer Research and Treatment

T2 - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 2

ER -