|
|
| |
| Lobular Carcinoma of the Breast: Clinical, Epidemiological, Anatomopathological and Therapeutic Profile (About 40 Cases)
Download PDF
|
M. Alami Merrouni, M. Benchaaboun, M. Bendahhou Idrissi, K. Saoud, N. Mamouni, S. Errarhay, C. Bouhchikhi, A. Banani
|
Abstract:
Breast cancer is considered the leading cancer in women worldwide, with an increasing incidence, posing a real challenge for diagnosis and adequate management in developing countries. Currently, knowledge of its histological types, histoprognostic grades, and anatomoclinical stages increasingly influence its management. It is crucial to study the various types of breast cancer to refine therapeutic indications and improve survival rates, including lobular carcinoma, whose incidence has been rising in recent years. Invasive Lobular Carcinoma (ILC) represents 5 to 15% of breast cancers, making it the second most frequent histological type after invasive ductal carcinoma. In comparison to ductal carcinomas, in situ or invasive, lobular carcinomas, in situ or invasive, stand out due to diagnostic, therapeutic, and evolutionary peculiarities. Its uniqueness lies in the difficulty of clinical and mammographic diagnosis, its anatomopathological appearance, and its mode of proliferation, with a different metastatic dissemination pattern compared to invasive ductal carcinoma. The aim of our study is to specify the epidemiological, histological, clinical, paraclinical, therapeutic, and prognostic characteristics of lobular breast cancer based on our initial experience and a review of the literature. This is a retrospective study conducted at the Department of Obstetrics and Gynecology I of Hassan II University Hospital in Fez over a 4-year period from January 1, 2018, to December 31, 2022. We collected a total of 30 cases of women with invasive lobular carcinoma. The most affected age group was between 40 and 50 years, with an average age of 55.4 years. In 37.5% of cases, ILC was diagnosed at a late stage. The most frequent reason for consultation was the discovery of a nodule in 82.5% of cases, most often located in the upper outer quadrant (35%). In the majority of cases, it was the classical histological type, with a low Scarf-Bloom and Richardson (SBR II) grade (80%). Radical surgery, such as the Patey procedure, was performed in 82.5% of patients. Lymph node dissection was positive in 22 patients. Neoadjuvant chemotherapy was administered in 12 cases (30%), adjuvant chemotherapy in 15 cases (37.5%), and palliative chemotherapy in metastatic cases. Other adjuvant treatments included radiotherapy in 27 cases (65%), adjuvant hormone therapy in 34 cases (85%), and adjuvant targeted therapy in 6 cases (15%). The outcome was marked by 5 cases of metastases (pulmonary, bone, and hepatic), with 3 resulting in death. Invasive lobular carcinoma of the breast remains rare, with a unique clinical-pathological profile. Its clinical and radiological diagnosis is challenging. Currently, its treatment and prognosis do not differ from that of invasive ductal carcinomas.
|
|
|
| | |