Ultrasonographic findings of invasive lobular carcinoma differentiation of invasive lobular carcinoma from invasive ductal carcinoma by ultrasonography

Nonmasslike lesions on breast sonography: comparison between benign and malignant lesions

OBJECTIVES

To compare the imaging and clinical features of benign and malignant nonmasslike lesions in the breast.

METHODS

During a 2-year period at a single institution, 186 nonmasslike lesions in 158 women were pathologically confirmed through surgery or sonographically guided biopsy. The sonographic patterns (mottled, geographic, and indistinct) and distributions (focal and regional) were compared between benign and malignant lesions. The presence of sonographically visible calcifications, amount of color Doppler signals, presence of positive findings on mammography, and presence of symptoms were also compared between the two groups.

RESULTS

A total of 156 lesions (84%) were confirmed as benign and 30 (16%) as malignant. On sonography, malignant nonmasslike lesions more frequently had mottled and geographic patterns and regional distribution than benign lesions (P < .0001). Malignant lesions also more frequently had sonographically visible calcifications (40% versus 0%; P < 0.0001) and a greater amount of color Doppler signals than benign lesions (P < .0001). On mammography, malignant lesions more frequently had densities and calcifications than benign lesions (30.4% versus 7.1%; P = 0.0052; 73.9% versus 6.1%; P < .0001, respectively). Clinically, malignant lesions were more frequently palpable and accompanied by localized pain than benign lesions (50% versus 2.6%; P< .0001; 13.3% versus 0.6%; P = .0025).

CONCLUSIONS

The imaging and clinical features of malignant nonmasslike lesions differed significantly from those of benign nonmasslike lesions.

The relationship between 18F-FDG metabolic volumetric parameters and clinicopathological factors of breast cancer

OBJECTIVES

This study was conducted to evaluate the relationship between fluorine-18 fluorodeoxyglucose metabolic parameters [maximum standardized uptake value (SUV(max)), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] and clinicopathological factors of breast cancer.

METHODS

The study comprised 93 patients. A volumetric region of interest was drawn over the abnormal focal uptake of breast cancer. Spearman's rank correlation, the Kruskal-Wallis test, and receiver operating characteristic analysis were used to investigate the relationship between clinicopathological factors and metabolic parameters and determine which metabolic parameters were most highly associated with clinicopathological factors.

RESULTS

All parameters had a statistically significant relationship with pathological T stage (p-T stage), pathological N status (p-N status), pathological stage (p-stage), and triple-negative type (TN) (all P values were <0.05). There were statistically significant differences between SUV(max) and TLG in relation to lymphatic invasion, estrogen receptor, and nuclear grade (P<0.05). High MTV showed a tendency toward association with estrogen receptor negativity, but the relation did not reach the level of statistical significance (P=0.056). No statistically significant relationship was observed between MTV and lymphatic invasion or nuclear grade. In the receiver operating characteristic analysis of p-T stage and p-stage, the AUC for TLG was significantly larger than that for SUV(max) (P=0.0003 and 0.048, respectively). There were marginally significant differences between TLG and MTV in relation to p-stage (P=0.058).

CONCLUSION

TLG may reflect tumor metabolism for clinicopathological factors of breast cancer better than SUV(max) or MTV.

The invasive lobular carcinoma as a prototype luminal A breast cancer: a retrospective cohort study

BACKGROUND

Although the invasive lobular carcinoma (ILC) is the second most frequent histologic subtype in Western countries, its incidence is much lower in Asia, and its characteristics are less well known.

METHODS

We assessed the clinical characteristics and outcomes of 83 Korean patients (2.8%) with ILC for comparison with 2,833 (97.2%) with the invasive ductal carcinoma (IDC), including 1,088 (37.3%) with the luminal A subtype (LA-IDC).

RESULTS

The mean age of all patients was 48.2 years, with no significant differences among the groups. Compared to IDC, ILC showed a larger tumor size (≥ T2, 59.8% vs. 38.8%, P = 0.001), a lower histologic grade (HG 1/2, 90.4% vs. 64.4%, P < 0.001), more frequent estrogen receptor positive (90.4% vs. 64.4%, P < 0.001), progesterone receptor positive (71.1% vs. 50.1%, P < 0.001) and HER2 negative (97.5% vs. 74.6%, P < 0.001) status, and lower Ki-67 expression (10.3% ± 10.6% vs. 20.6% ± 19.8%, P < 0.001), as well as being more likely to be of the luminal A subtype (91.4% vs. 51.2%, P < 0.001). Six (7.2%) ILC and 359 (12.7%) IDC patients developed disease recurrence, with a median follow-up of 56.4 (range 4.9-136.6) months. The outcome of ILC was close to LA-IDC (HR 0.77 for recurrence, 95% CI 0.31-1.90, P = 0.57; HR 0.75 for death, 95% CI 0.18-3.09, P = 0.70) and significantly better than for the non-LA-IDC (HR 1.69 for recurrence, 95% CI 1.23-2.33, P = 0.001; HR 1.50 for death, 95% CI 0.97-2.33, P = 0.07).

CONCLUSIONS

ILC, a rare histologic type of breast cancer in Korea, has distinctive clinicopathological characteristics similar to those of LA-IDC.