54 Pleomorphic Invasive Lobular Carcinoma: Multimodality Imaging Findings in Cases From the University of Rochester Medical Center

Background

Pleomorphic invasive lobular carcinoma (pILC) is a rare and aggressive morphologic variant of invasive lobular carcinoma (ILC), accounting for less than 1% of all breast cancers. Prognosis in patients with pILC is poor due to aggressive biologic behavior. Although characterized by a greater degree of cellular pleomorphism histopathologically, it can be difficult to differentiate pILC from classic ILC based on imaging findings.

Learning Objectives

1. Describe mammographic findings of pILC, which can include calcifications only, masses with calcifications, architectural distortions, masses/focal asymmetry, axillary lymph node morphology, or skin and nipple findings.

2. Describe sonographic findings of pILC, which can include calcifications only, masses only, masses with calcifications, internal vascularity, or axillary lymph node morphology and size.

3. Describe MRI findings of pILC, which can include masses, contrast enhancement patterns of masses, non-mass contrast enhancement, visualized lymph node morphology, and size.

Abstract Content

This pictorial review presents a comprehensive imaging spectrum of pILC using mammography, ultrasound, and MRI from cases diagnosed at the University of Rochester Medical Center. As we navigate through these 13 cases, we highlight the variable imaging presentations of pILC.

Conclusion

This review aims to highlight the variable presentations of pILC in an effort to support timely interdisciplinary diagnosis and management of this uncommon, but clinically significant, breast cancer variant.