Cancer Genetics and Epigenetics 2017, Vol.5, No.1, 1
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between the IDC in enhanced MRI. To evaluate the range and morphological characteristics of ILC, MRI is
superior than X-ray examination, and its sensitivity is more than 90%, but in the role of preoperative analysis
remains controversial. So, MRI is used to guide the preoperative of breast conserving surgery and assessment of
potopeerative. Ultrasonic is a better imaging examination method to judge invasive lobular carcinoma, and the
sensitivity is 68% to 68%.The patients with ILC can be found by ultrasonic, but the lesions can’t be found in the X
(Menezes et al., 2013). The sonographic appearances of the ILC and IDC ultrasound are similar, irregular shape,
and the ultrasound elastography can improve the detection rate.
Pathology Characteristics
Invasive lobular carcinoma macroscopic view: invasive lobular carcinoma’s cut is mostly gray with sclerosing and
fibrous appearance, no bleeding, calcification and yellow-white stripe generally. Histology is characterized by the
cancer cells into single line arrangement, or around the catheter and small lobe concentric circles sample
arrangement, or a single scattered diffuse, in a fibrous stroma. The cells is of small size, uniform, lack of adhesion
between each other, seldom produces a fibrous reaction. ILC has multicenter growth characteristics of multifocal,
multicenter incidence is for 9% ~ 50%, 8% ~ 19% for double side (Sinn et al., 2014). Diversity (including
multifocal, multicenter, diffuse, double side) incidence is 44.4%.
Immunohistochemical Characteristics
ILC cancer in estrogen receptor (ER) positive rate is about 90%, which is 70% ~ 80% higher than that of
infiltrating ductal carcinoma, progesterone (PR) positive rate is 60% ~ 70% (Sikora et al., 2014). Her - 2 and P53
are usually lower expresses, and Her-2 positive expression rate is lower than that of IDC. Ki67 and mitotic index
value are generally low (Dabbs et al., 2013). Another important phenotypic characteristics is that the lack
expression of calcium in the E -cadherin. And the lack of E -cadherin may be associated with CDH 1 gene
mutations (Petridis et al., 2014). E - cadherin is a transmembrane glycoprotein involved in cell adhesion, E -
cadherin expressed weaken or disappear in ILC , E - cadherin in IDC is positive (Engstrøm et al., 2015). P120 also
can be used in the identification of ILC and IDC,and the ILC p120 cytoplasmic is positive, positive capsule of
p120, p120 has become one of the invasive lobular carcinoma immunohistochemical markers (Li et al., 2014).
Clinical Outcomes
The most important prognostic factors depends on the size of the tumor and lymph node metastasis. According to
the grade of Nottingham, close to 76% invasive lobular carcinoma belongs to grade 2 (Rakha et al., 2013).
Primary diagnosis with mass are less than 3 cm, regional lymph node negative, clinical pathologic stage for phase
I, II, hormone receptor-positive, and endocrine therapy. Postoperative 5-year disease-free survival rate is higher.
Invasive lobular carcinoma was found late, aggressive, with broad transfer and proliferation tendency, therefore,
in some studies, in which compare with other invasive carcinoma with poor prognosis, whether for endocrine
therapy may be the important indexes affecting the prognosis.
Comprehensive Treatment
Treatments include local lesion surgery, radiotherapy and endocrine therapy, biological to medication or by a
combination of the above treatments application. Variety of treatment choices should be based on the tumor’s
histological characteristics, clinical and pathological features of primary tumor, axillary lymph node status, tumor
hormone receptor level, Her - 2 state, with or without detected the metastatic lesions, complications, patients' age,
menopausal status, etc.
Surgery
Surgery is one of the main treatments of breast cancer, there are many types of surgical procedure, including
modified radical mastectomy, Unilateral mastectomy + sentinel lymph node biopsy, breast-conserving surgery, etc.
Invasive lobular carcinoma’s breast-conserving surgery recurrence rate is higher, perhaps due to invasive lobular
carcinoma is multifocal and centricity (Nounou et al., 2015). Surgical choice should minimize the surgical damage,
and try our best to keep breast shape in patients with early breast cancer, but we must control strictly, in order to
