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Histopathologic Diagnoses
Malignant Lesions
Invasive Lobular Carcinoma, Classic
Invasive Lobular Carcinoma, Classic
Katie M. Davis, DO; Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Invasive (infiltrating) lobular carcinoma (ILC)

            • Definitions

              • Invasive carcinoma characterized by loss of normal cell adhesion: Loss of E-cadherin expression
                • Tumor infiltrates diffusely in breast and in distant sites as single-file columns of cells or individual cells
              • Classic ILC = nuclear grade 1 or 2; most are Nottingham grade 1 or 2
              • Pleomorphic ILC (pILC) = nuclear grade 3 with pleomorphic, large, atypical nuclei
                • Most are Nottingham grade 3

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Adachi Y et al: Comparison of sentinel lymph node biopsy between invasive lobular carcinoma and invasive ductal carcinoma. Breast Cancer. 25(5):560-565, 2018
                                              2. Cohen EO et al: Screening Mammography Findings From One Standard Projection Only in the Era of Full-Field Digital Mammography and Digital Breast Tomosynthesis. AJR Am J Roentgenol. 211(2):445-451, 2018
                                              3. Ha SM et al: Breast MR imaging before surgery: Outcomes in patients with invasive lobular carcinoma by using propensity score matching. Radiology. 287(3):771-777, 2018
                                              4. Hlubocky J et al: Does the use of pretreatment MRI change the management of patients with newly diagnosed breast cancer? Breast J. 24(3):309-313, 2018
                                              5. Mamtani A et al: Lobular breast cancer: Different disease, different algorithms? Surg Oncol Clin N Am. 27(1):81-94, 2018
                                              6. Marotti JD et al: Genotype-Phenotype Correlations in Breast Cancer. Surg Pathol Clin. 11(1):199-211, 2018
                                              7. Mukhtar RA: ASO Author Reflections: Breast Conservation and Negative Margins in Invasive Lobular Carcinoma: The Impact of Oncoplastic Surgery and Shave Margins in 358 Patients. Ann Surg Oncol. ePub, 2018
                                              8. Park HL et al: Clinical utility of 18F-FDG PET/CT in low 18F-FDG-avidity breast cancer subtypes: comparison with breast US and MRI. Nucl Med Commun. 39(1):35-43, 2018
                                              9. Patel BK et al: Value Added of Preoperative Contrast-Enhanced Digital Mammography in Patients With Invasive Lobular Carcinoma of the Breast. Clin Breast Cancer. ePub, 2018
                                              10. Tsung K et al: Neoadjuvant systemic therapy in invasive lobular breast cancer: Is it indicated? Am J Surg. 215(3):509-512, 2018
                                              11. Wen HY et al: Lobular Carcinoma In Situ. Surg Pathol Clin. 11(1):123-145, 2018
                                              12. Wong SM et al: Evaluating the impact of breast density on preoperative MRI in invasive lobular carcinoma. J Am Coll Surg. 226(5):925-932, 2018
                                              13. Yeap PM et al: A comparison of the imaging features of pleomorphic and classical invasive lobular carcinoma. Breast Cancer Res Treat. ePub, 2018
                                              14. Yilmaz R et al: Stromal fibrosis: imaging features with diagnostic contribution of diffusion-weighted MRI. Br J Radiol. 91(1085):20170706, 2018
                                              15. Zhu S et al: IRS2 mutations linked to invasion in pleomorphic invasive lobular carcinoma. JCI Insight. 3(8), 2018
                                              16. Bahl M et al: Pathologic Outcomes of Architectural Distortion on Digital 2D Versus Tomosynthesis Mammography. AJR Am J Roentgenol. 209(5):1162-1167, 2017
                                              17. Cohen MA et al: Radial Scars of the Breast Encountered at Core Biopsy: Review of Histologic, Imaging, and Management Considerations. AJR Am J Roentgenol. 209(5):1168-1177, 2017
                                              18. Vriens IJH et al: Breast magnetic resonance imaging use in patients undergoing neoadjuvant chemotherapy is associated with less mastectomies in large ductal cancers but not in lobular cancers. Eur J Cancer. 81:74-80, 2017
                                              19. Bansal GJ et al: Selective magnetic resonance imaging (MRI) in invasive lobular breast cancer based on mammographic density: does it lead to an appropriate change in surgical treatment? Br J Radiol. 89(1060):20150679, 2016
                                              20. Fujii T et al: Clinical Significance of 18F-FDG-PET in Invasive Lobular Carcinoma. Anticancer Res. 36(10):5481-5485, 2016
                                              21. Al-Baimani K et al: Invasive Pleomorphic Lobular Carcinoma of the Breast: Pathologic, Clinical, and Therapeutic Considerations. Clin Breast Cancer. 15(6):421-5, 2015
                                              22. Conners AL et al: Direct-Conversion Molecular Breast Imaging of Invasive Breast Cancer: Imaging Features, Extent of Invasive Disease, and Comparison Between Invasive Ductal and Lobular Histology. AJR Am J Roentgenol. 205(3):W374-81, 2015
                                              23. Dossus L et al: Lobular breast cancer: incidence and genetic and non-genetic risk factors. Breast Cancer Res. 17:37, 2015
                                              24. Ishikawa MK et al: Morphologic Mimics of Invasive Lobular Carcinoma. Arch Pathol Lab Med. 139(10):1253-7, 2015
                                              25. Johnson K et al: Lobular breast cancer series: imaging. Breast Cancer Res. 17:94, 2015
                                              26. McCart Reed AE et al: Invasive lobular carcinoma of the breast: morphology, biomarkers and 'omics. Breast Cancer Res. 17:12, 2015
                                              27. Guiu S et al: Invasive lobular breast cancer and its variants: How special are they for systemic therapy decisions? Crit Rev Oncol Hematol. 92(3):235-257, 2014
                                              28. Porter AJ et al: Mammographic and ultrasound features of invasive lobular carcinoma of the breast. J Med Imaging Radiat Oncol. 58(1):1-10, 2014
                                              29. Berg WA et al: Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. JAMA. 307(13):1394-404, 2012
                                              30. Caldarella A et al: Invasive breast cancer: a significant correlation between histological types and molecular subgroups. J Cancer Res Clin Oncol. Epub ahead of print, 2012
                                              31. Iorfida M et al: Invasive lobular breast cancer: subtypes and outcome. Breast Cancer Res Treat. 133(2):713-23, 2012
                                              32. Albayrak ZK et al: Invasive lobular carcinoma of the breast: mammographic and sonographic evaluation. Diagn Interv Radiol. 17(3):232-8, 2011
                                              33. Berg WA et al: Breast cancer: comparative effectiveness of positron emission mammography and MR imaging in presurgical planning for the ipsilateral breast. Radiology. 258(1):59-72, 2011
                                              34. Hussain M et al: Management of lobular carcinoma in-situ and atypical lobular hyperplasia of the breast--a review. Eur J Surg Oncol. 37(4):279-89, 2011
                                              35. Kim SH et al: Imaging features of invasive lobular carcinoma: comparison with invasive ductal carcinoma. Jpn J Radiol. 29(7):475-82, 2011
                                              36. Mann RM et al: Comparison of enhancement characteristics between invasive lobular carcinoma and invasive ductal carcinoma. J Magn Reson Imaging. 34(2):293-300, 2011
                                              37. Wang CL et al: Positron emission mammography: correlation of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status and 18F-FDG. AJR Am J Roentgenol. 197(2):W247-55, 2011
                                              38. Ansquer Y et al: Risk of invasive breast cancer after lobular intra-epithelial neoplasia: review of the literature. Eur J Surg Oncol. 36(7):604-9, 2010
                                              39. Brogi E et al: Lobular carcinoma, not only a classic. Breast J. 16 Suppl 1:S10-4, 2010
                                              40. Carder PJ et al: Screen-detected pleomorphic lobular carcinoma in situ (PLCIS): risk of concurrent invasive malignancy following a core biopsy diagnosis. Histopathology. 57(3):472-8, 2010
                                              41. Gudlaugsson E et al: Prospective multicenter comparison of proliferation and other prognostic factors in lymph node negative lobular invasive breast cancer. Breast Cancer Res Treat. 121(1):35-40, 2010
                                              42. Mann RM: The effectiveness of MR imaging in the assessment of invasive lobular carcinoma of the breast. Magn Reson Imaging Clin N Am. 18(2):259-76, ix, 2010
                                              43. Sullivan ME et al: Lobular carcinoma in situ variants in breast cores: potential for misdiagnosis, upgrade rates at surgical excision, and practical implications. Arch Pathol Lab Med. 134(7):1024-8, 2010
                                              44. Wasif N et al: Invasive lobular vs. ductal breast cancer: a stage-matched comparison of outcomes. Ann Surg Oncol. 17(7):1862-9, 2010
                                              45. Brem RF et al: Invasive lobular carcinoma: detection with mammography, sonography, MRI, and breast-specific gamma imaging. AJR Am J Roentgenol. 192(2):379-83, 2009
                                              46. Lopez JK et al: Invasive lobular carcinoma of the breast: spectrum of mammographic, US, and MR imaging findings. Radiographics. 29(1):165-76, 2009
                                              47. Levrini G et al: MRI patterns of invasive lobular cancer: T1 and T2 features. Radiol Med. 113(8):1110-25, 2008
                                              48. Mann RM et al: MRI compared to conventional diagnostic work-up in the detection and evaluation of invasive lobular carcinoma of the breast: a review of existing literature. Breast Cancer Res Treat. 107(1):1-14, 2008
                                              49. Michael M et al: Mammography, sonography and MRI for detection and characterization of invasive lobular carcinoma of the breast. Breast Dis. 30:21-30, 2008
                                              50. Orvieto E et al: Clinicopathologic characteristics of invasive lobular carcinoma of the breast: results of an analysis of 530 cases from a single institution. Cancer. 113(7):1511-20, 2008
                                              51. Caramella T et al: Value of MRI in the surgical planning of invasive lobular breast carcinoma: a prospective and a retrospective study of 57 cases: comparison with physical examination, conventional imaging, and histology. Clin Imaging. 31(3):155-61, 2007
                                              52. Watermann DO et al: Ultrasound morphology of invasive lobular breast cancer is different compared with other types of breast cancer. Ultrasound Med Biol. 31(2):167-74, 2005
                                              53. Berg WA et al: Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology. 233(3):830-49, 2004
                                              54. Fisher ER et al: Pathologic findings from the National Surgical Adjuvant Breast and Bowel Project: twelve-year observations concerning lobular carcinoma in situ. Cancer. 100(2):238-44, 2004
                                              55. Schelfout K et al: Preoperative breast MRI in patients with invasive lobular breast cancer. Eur Radiol. 14(7):1209-16, 2004
                                              56. Selinko VL et al: Role of sonography in diagnosing and staging invasive lobular carcinoma. J Clin Ultrasound. 32(7):323-32, 2004
                                              57. Wheeler DT et al: Tubulolobular carcinoma of the breast: an analysis of 27 cases of a tumor with a hybrid morphology and immunoprofile. Am J Surg Pathol. 28(12):1587-93, 2004
                                              58. Evans WP et al: Invasive lobular carcinoma of the breast: mammographic characteristics and computer-aided detection. Radiology. 225(1):182-9, 2002
                                              59. Qayyum A et al: MR imaging features of infiltrating lobular carcinoma of the breast: histopathologic correlation. AJR Am J Roentgenol. 178(5):1227-32, 2002
                                              60. Cawson JN et al: Invasive lobular carcinoma: sonographic features of cancers detected in a BreastScreen Program. Australas Radiol. 45(1):25-30, 2001
                                              61. Weinstein SP et al: MR imaging of the breast in patients with invasive lobular carcinoma. AJR Am J Roentgenol. 176(2):399-406, 2001
                                              62. Avril N et al: Breast imaging with positron emission tomography and fluorine-18 fluorodeoxyglucose: use and limitations. J Clin Oncol. 18(20):3495-502, 2000
                                              63. Chapellier C et al: Ultrasonography of invasive lobular carcinoma of the breast: sonographic patterns and diagnostic value: report of 102 cases. Clin Imaging. 24(6):333-6, 2000
                                              64. Harvey JA et al: Apparent ipsilateral decrease in breast size at mammography: a sign of infiltrating lobular carcinoma. Radiology. 214(3):883-9, 2000
                                              65. Butler RS et al: Sonographic evaluation of infiltrating lobular carcinoma. AJR Am J Roentgenol. 172(2):325-30, 1999
                                              66. Pointon KS et al: Ultrasound findings in pure invasive lobular carcinoma of the breast: comparison with matched cases of invasive ductal carcinoma of the breast. Breast. 8(4):188-90, 1999
                                              67. Rodenko GN et al: MR imaging in the management before surgery of lobular carcinoma of the breast: correlation with pathology. AJR Am J Roentgenol. 167(6):1415-9, 1996
                                              68. Paramagul CP et al: Invasive lobular carcinoma: sonographic appearance and role of sonography in improving diagnostic sensitivity. Radiology. 195(1):231-4, 1995
                                              69. Helvie MA et al: Invasive lobular carcinoma. Imaging features and clinical detection. Invest Radiol. 28(3):202-7, 1993
                                              70. Krecke KN et al: Invasive lobular carcinoma of the breast: mammographic findings and extent of disease at diagnosis in 184 patients. AJR Am J Roentgenol. 161(5):957-60, 1993
                                              71. Le Gal M et al: Mammographic features of 455 invasive lobular carcinomas. Radiology. 185(3):705-8, 1992
                                              72. Hilleren DJ et al: Invasive lobular carcinoma: mammographic findings in a 10-year experience. Radiology. 178(1):149-54, 1991
                                              73. Sickles EA: The subtle and atypical mammographic features of invasive lobular carcinoma. Radiology. 178(1):25-6, 1991
                                              74. DiCostanzo D et al: Prognosis in infiltrating lobular carcinoma. An analysis of "classical" and variant tumors. Am J Surg Pathol. 14(1):12-23, 1990
                                              75. Mendelson EB et al: Infiltrating lobular carcinoma: mammographic patterns with pathologic correlation. AJR Am J Roentgenol. 153(2):265-71, 1989
                                              76. Dixon JM et al: Infiltrating lobular carcinoma of the breast: an evaluation of the incidence and consequence of bilateral disease. Br J Surg. 70(9):513-6, 1983
                                              77. Dixon JM et al: Infiltrating lobular carcinoma of the breast. Histopathology. 6(2):149-61, 1982
                                              78. Newstead GM et al. Dynamic breast MR imaging: comparison of kinetic and morphologic characteristics of malignant lesions by tumor type and grade. In: Proceedings of the RSNA. 2005 (abstract no. SSM01-05).
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Invasive (infiltrating) lobular carcinoma (ILC)

                                                        • Definitions

                                                          • Invasive carcinoma characterized by loss of normal cell adhesion: Loss of E-cadherin expression
                                                            • Tumor infiltrates diffusely in breast and in distant sites as single-file columns of cells or individual cells
                                                          • Classic ILC = nuclear grade 1 or 2; most are Nottingham grade 1 or 2
                                                          • Pleomorphic ILC (pILC) = nuclear grade 3 with pleomorphic, large, atypical nuclei
                                                            • Most are Nottingham grade 3

                                                        IMAGING

                                                        • General Features

                                                          • Mammographic Findings

                                                            • Ultrasonographic Findings

                                                              • MR Findings

                                                                • Nuclear Medicine Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Adachi Y et al: Comparison of sentinel lymph node biopsy between invasive lobular carcinoma and invasive ductal carcinoma. Breast Cancer. 25(5):560-565, 2018
                                                                                          2. Cohen EO et al: Screening Mammography Findings From One Standard Projection Only in the Era of Full-Field Digital Mammography and Digital Breast Tomosynthesis. AJR Am J Roentgenol. 211(2):445-451, 2018
                                                                                          3. Ha SM et al: Breast MR imaging before surgery: Outcomes in patients with invasive lobular carcinoma by using propensity score matching. Radiology. 287(3):771-777, 2018
                                                                                          4. Hlubocky J et al: Does the use of pretreatment MRI change the management of patients with newly diagnosed breast cancer? Breast J. 24(3):309-313, 2018
                                                                                          5. Mamtani A et al: Lobular breast cancer: Different disease, different algorithms? Surg Oncol Clin N Am. 27(1):81-94, 2018
                                                                                          6. Marotti JD et al: Genotype-Phenotype Correlations in Breast Cancer. Surg Pathol Clin. 11(1):199-211, 2018
                                                                                          7. Mukhtar RA: ASO Author Reflections: Breast Conservation and Negative Margins in Invasive Lobular Carcinoma: The Impact of Oncoplastic Surgery and Shave Margins in 358 Patients. Ann Surg Oncol. ePub, 2018
                                                                                          8. Park HL et al: Clinical utility of 18F-FDG PET/CT in low 18F-FDG-avidity breast cancer subtypes: comparison with breast US and MRI. Nucl Med Commun. 39(1):35-43, 2018
                                                                                          9. Patel BK et al: Value Added of Preoperative Contrast-Enhanced Digital Mammography in Patients With Invasive Lobular Carcinoma of the Breast. Clin Breast Cancer. ePub, 2018
                                                                                          10. Tsung K et al: Neoadjuvant systemic therapy in invasive lobular breast cancer: Is it indicated? Am J Surg. 215(3):509-512, 2018
                                                                                          11. Wen HY et al: Lobular Carcinoma In Situ. Surg Pathol Clin. 11(1):123-145, 2018
                                                                                          12. Wong SM et al: Evaluating the impact of breast density on preoperative MRI in invasive lobular carcinoma. J Am Coll Surg. 226(5):925-932, 2018
                                                                                          13. Yeap PM et al: A comparison of the imaging features of pleomorphic and classical invasive lobular carcinoma. Breast Cancer Res Treat. ePub, 2018
                                                                                          14. Yilmaz R et al: Stromal fibrosis: imaging features with diagnostic contribution of diffusion-weighted MRI. Br J Radiol. 91(1085):20170706, 2018
                                                                                          15. Zhu S et al: IRS2 mutations linked to invasion in pleomorphic invasive lobular carcinoma. JCI Insight. 3(8), 2018
                                                                                          16. Bahl M et al: Pathologic Outcomes of Architectural Distortion on Digital 2D Versus Tomosynthesis Mammography. AJR Am J Roentgenol. 209(5):1162-1167, 2017
                                                                                          17. Cohen MA et al: Radial Scars of the Breast Encountered at Core Biopsy: Review of Histologic, Imaging, and Management Considerations. AJR Am J Roentgenol. 209(5):1168-1177, 2017
                                                                                          18. Vriens IJH et al: Breast magnetic resonance imaging use in patients undergoing neoadjuvant chemotherapy is associated with less mastectomies in large ductal cancers but not in lobular cancers. Eur J Cancer. 81:74-80, 2017
                                                                                          19. Bansal GJ et al: Selective magnetic resonance imaging (MRI) in invasive lobular breast cancer based on mammographic density: does it lead to an appropriate change in surgical treatment? Br J Radiol. 89(1060):20150679, 2016
                                                                                          20. Fujii T et al: Clinical Significance of 18F-FDG-PET in Invasive Lobular Carcinoma. Anticancer Res. 36(10):5481-5485, 2016
                                                                                          21. Al-Baimani K et al: Invasive Pleomorphic Lobular Carcinoma of the Breast: Pathologic, Clinical, and Therapeutic Considerations. Clin Breast Cancer. 15(6):421-5, 2015
                                                                                          22. Conners AL et al: Direct-Conversion Molecular Breast Imaging of Invasive Breast Cancer: Imaging Features, Extent of Invasive Disease, and Comparison Between Invasive Ductal and Lobular Histology. AJR Am J Roentgenol. 205(3):W374-81, 2015
                                                                                          23. Dossus L et al: Lobular breast cancer: incidence and genetic and non-genetic risk factors. Breast Cancer Res. 17:37, 2015
                                                                                          24. Ishikawa MK et al: Morphologic Mimics of Invasive Lobular Carcinoma. Arch Pathol Lab Med. 139(10):1253-7, 2015
                                                                                          25. Johnson K et al: Lobular breast cancer series: imaging. Breast Cancer Res. 17:94, 2015
                                                                                          26. McCart Reed AE et al: Invasive lobular carcinoma of the breast: morphology, biomarkers and 'omics. Breast Cancer Res. 17:12, 2015
                                                                                          27. Guiu S et al: Invasive lobular breast cancer and its variants: How special are they for systemic therapy decisions? Crit Rev Oncol Hematol. 92(3):235-257, 2014
                                                                                          28. Porter AJ et al: Mammographic and ultrasound features of invasive lobular carcinoma of the breast. J Med Imaging Radiat Oncol. 58(1):1-10, 2014
                                                                                          29. Berg WA et al: Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. JAMA. 307(13):1394-404, 2012
                                                                                          30. Caldarella A et al: Invasive breast cancer: a significant correlation between histological types and molecular subgroups. J Cancer Res Clin Oncol. Epub ahead of print, 2012
                                                                                          31. Iorfida M et al: Invasive lobular breast cancer: subtypes and outcome. Breast Cancer Res Treat. 133(2):713-23, 2012
                                                                                          32. Albayrak ZK et al: Invasive lobular carcinoma of the breast: mammographic and sonographic evaluation. Diagn Interv Radiol. 17(3):232-8, 2011
                                                                                          33. Berg WA et al: Breast cancer: comparative effectiveness of positron emission mammography and MR imaging in presurgical planning for the ipsilateral breast. Radiology. 258(1):59-72, 2011
                                                                                          34. Hussain M et al: Management of lobular carcinoma in-situ and atypical lobular hyperplasia of the breast--a review. Eur J Surg Oncol. 37(4):279-89, 2011
                                                                                          35. Kim SH et al: Imaging features of invasive lobular carcinoma: comparison with invasive ductal carcinoma. Jpn J Radiol. 29(7):475-82, 2011
                                                                                          36. Mann RM et al: Comparison of enhancement characteristics between invasive lobular carcinoma and invasive ductal carcinoma. J Magn Reson Imaging. 34(2):293-300, 2011
                                                                                          37. Wang CL et al: Positron emission mammography: correlation of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status and 18F-FDG. AJR Am J Roentgenol. 197(2):W247-55, 2011
                                                                                          38. Ansquer Y et al: Risk of invasive breast cancer after lobular intra-epithelial neoplasia: review of the literature. Eur J Surg Oncol. 36(7):604-9, 2010
                                                                                          39. Brogi E et al: Lobular carcinoma, not only a classic. Breast J. 16 Suppl 1:S10-4, 2010
                                                                                          40. Carder PJ et al: Screen-detected pleomorphic lobular carcinoma in situ (PLCIS): risk of concurrent invasive malignancy following a core biopsy diagnosis. Histopathology. 57(3):472-8, 2010
                                                                                          41. Gudlaugsson E et al: Prospective multicenter comparison of proliferation and other prognostic factors in lymph node negative lobular invasive breast cancer. Breast Cancer Res Treat. 121(1):35-40, 2010
                                                                                          42. Mann RM: The effectiveness of MR imaging in the assessment of invasive lobular carcinoma of the breast. Magn Reson Imaging Clin N Am. 18(2):259-76, ix, 2010
                                                                                          43. Sullivan ME et al: Lobular carcinoma in situ variants in breast cores: potential for misdiagnosis, upgrade rates at surgical excision, and practical implications. Arch Pathol Lab Med. 134(7):1024-8, 2010
                                                                                          44. Wasif N et al: Invasive lobular vs. ductal breast cancer: a stage-matched comparison of outcomes. Ann Surg Oncol. 17(7):1862-9, 2010
                                                                                          45. Brem RF et al: Invasive lobular carcinoma: detection with mammography, sonography, MRI, and breast-specific gamma imaging. AJR Am J Roentgenol. 192(2):379-83, 2009
                                                                                          46. Lopez JK et al: Invasive lobular carcinoma of the breast: spectrum of mammographic, US, and MR imaging findings. Radiographics. 29(1):165-76, 2009
                                                                                          47. Levrini G et al: MRI patterns of invasive lobular cancer: T1 and T2 features. Radiol Med. 113(8):1110-25, 2008
                                                                                          48. Mann RM et al: MRI compared to conventional diagnostic work-up in the detection and evaluation of invasive lobular carcinoma of the breast: a review of existing literature. Breast Cancer Res Treat. 107(1):1-14, 2008
                                                                                          49. Michael M et al: Mammography, sonography and MRI for detection and characterization of invasive lobular carcinoma of the breast. Breast Dis. 30:21-30, 2008
                                                                                          50. Orvieto E et al: Clinicopathologic characteristics of invasive lobular carcinoma of the breast: results of an analysis of 530 cases from a single institution. Cancer. 113(7):1511-20, 2008
                                                                                          51. Caramella T et al: Value of MRI in the surgical planning of invasive lobular breast carcinoma: a prospective and a retrospective study of 57 cases: comparison with physical examination, conventional imaging, and histology. Clin Imaging. 31(3):155-61, 2007
                                                                                          52. Watermann DO et al: Ultrasound morphology of invasive lobular breast cancer is different compared with other types of breast cancer. Ultrasound Med Biol. 31(2):167-74, 2005
                                                                                          53. Berg WA et al: Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology. 233(3):830-49, 2004
                                                                                          54. Fisher ER et al: Pathologic findings from the National Surgical Adjuvant Breast and Bowel Project: twelve-year observations concerning lobular carcinoma in situ. Cancer. 100(2):238-44, 2004
                                                                                          55. Schelfout K et al: Preoperative breast MRI in patients with invasive lobular breast cancer. Eur Radiol. 14(7):1209-16, 2004
                                                                                          56. Selinko VL et al: Role of sonography in diagnosing and staging invasive lobular carcinoma. J Clin Ultrasound. 32(7):323-32, 2004
                                                                                          57. Wheeler DT et al: Tubulolobular carcinoma of the breast: an analysis of 27 cases of a tumor with a hybrid morphology and immunoprofile. Am J Surg Pathol. 28(12):1587-93, 2004
                                                                                          58. Evans WP et al: Invasive lobular carcinoma of the breast: mammographic characteristics and computer-aided detection. Radiology. 225(1):182-9, 2002
                                                                                          59. Qayyum A et al: MR imaging features of infiltrating lobular carcinoma of the breast: histopathologic correlation. AJR Am J Roentgenol. 178(5):1227-32, 2002
                                                                                          60. Cawson JN et al: Invasive lobular carcinoma: sonographic features of cancers detected in a BreastScreen Program. Australas Radiol. 45(1):25-30, 2001
                                                                                          61. Weinstein SP et al: MR imaging of the breast in patients with invasive lobular carcinoma. AJR Am J Roentgenol. 176(2):399-406, 2001
                                                                                          62. Avril N et al: Breast imaging with positron emission tomography and fluorine-18 fluorodeoxyglucose: use and limitations. J Clin Oncol. 18(20):3495-502, 2000
                                                                                          63. Chapellier C et al: Ultrasonography of invasive lobular carcinoma of the breast: sonographic patterns and diagnostic value: report of 102 cases. Clin Imaging. 24(6):333-6, 2000
                                                                                          64. Harvey JA et al: Apparent ipsilateral decrease in breast size at mammography: a sign of infiltrating lobular carcinoma. Radiology. 214(3):883-9, 2000
                                                                                          65. Butler RS et al: Sonographic evaluation of infiltrating lobular carcinoma. AJR Am J Roentgenol. 172(2):325-30, 1999
                                                                                          66. Pointon KS et al: Ultrasound findings in pure invasive lobular carcinoma of the breast: comparison with matched cases of invasive ductal carcinoma of the breast. Breast. 8(4):188-90, 1999
                                                                                          67. Rodenko GN et al: MR imaging in the management before surgery of lobular carcinoma of the breast: correlation with pathology. AJR Am J Roentgenol. 167(6):1415-9, 1996
                                                                                          68. Paramagul CP et al: Invasive lobular carcinoma: sonographic appearance and role of sonography in improving diagnostic sensitivity. Radiology. 195(1):231-4, 1995
                                                                                          69. Helvie MA et al: Invasive lobular carcinoma. Imaging features and clinical detection. Invest Radiol. 28(3):202-7, 1993
                                                                                          70. Krecke KN et al: Invasive lobular carcinoma of the breast: mammographic findings and extent of disease at diagnosis in 184 patients. AJR Am J Roentgenol. 161(5):957-60, 1993
                                                                                          71. Le Gal M et al: Mammographic features of 455 invasive lobular carcinomas. Radiology. 185(3):705-8, 1992
                                                                                          72. Hilleren DJ et al: Invasive lobular carcinoma: mammographic findings in a 10-year experience. Radiology. 178(1):149-54, 1991
                                                                                          73. Sickles EA: The subtle and atypical mammographic features of invasive lobular carcinoma. Radiology. 178(1):25-6, 1991
                                                                                          74. DiCostanzo D et al: Prognosis in infiltrating lobular carcinoma. An analysis of "classical" and variant tumors. Am J Surg Pathol. 14(1):12-23, 1990
                                                                                          75. Mendelson EB et al: Infiltrating lobular carcinoma: mammographic patterns with pathologic correlation. AJR Am J Roentgenol. 153(2):265-71, 1989
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