Lobular Carcinoma of the Female Breast

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Abstract
All slides from 1,436 cases of carcinoma of the breast seen at the George Washington University Hospital since April, 1948, were examined. Forty cases showing only in situ lobular carcioma are not included in this paper, 32 of these having been presented previously. In an initial survey of the material, 142 cases having terminal duct or lobular component or both were separated from 1,396 cases of carcinoma of the breast (10.2%). These cases were re-examined, and by rigid and stringent criteria, 73 cases representing "pure" infiltrating lobular carcinoma were established. This is probably the largest group of infiltrating lobular carcinomas reported to date, and represents about 5% of the cancers examined in this series. In 72 of these 73 cases, histologic evidence of "early," antecedent, in situ lobular carcinoma was found. Once invasion of breast stroma has taken place, the sequence is similar to that in the more frequent carcinomas of duct origin. Patterns of lobular carcinoma of the breast occur more frequently than previously supposed. Recommendations for treatment, depending on whether the tumor is non-infiltrating or infiltrating, are discussed. Additional cases of progression from in situ lobular to infiltrating lobular breast cancer are presented. Residual in situ lobular in 72 of 73 cases of "pure" infiltrating lobular carcinoma of the female breast indicates that they form a continuum. When diagnosed it should be treated promptly to forestall (where possible) the sequence of events reported in this paper.