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Review

Lobular Breast Cancer: Histomorphology and Different Concepts of a Special Spectrum of Tumors

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Institute of Pathology, Hannover Medical School, Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
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Department of Pathology, University of Szeged, 6725 Szeged, Hungary
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Department of Pathology, Bács-Kiskun County Teaching Hospital, 6000 Kecskemét, Hungary
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Department of Pathology, UZ Leuven Gasthuisberg Campus, Universitair Ziekenhuis Leuven, Pathology, Herestraat 49, 3000 Leuven, Belgium
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Department of Medical Sciences, University of Turin, 10124 Turin, Italy
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Unit of Pathology, Candiolo Cancer Institute, FPO IRCCS, 10060 Candiolo, Italy
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Department of Diagnostic and Theranostic Medicine, Department of Pathology, Institute Curie, PSL-Research University, 26 rue d’Ulm, 75005 Paris, France
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Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
*
Authors to whom correspondence should be addressed.
Academic Editor: Jos Jonkers
Cancers 2021, 13(15), 3695; https://doi.org/10.3390/cancers13153695
Received: 20 May 2021 / Revised: 15 July 2021 / Accepted: 18 July 2021 / Published: 22 July 2021
Invasive lobular breast cancer (ILC) is a special type of breast cancer (BC) that was first described in 1941. The diagnosis of ILC is made by microscopy of tumor specimens, which reveals a distinct morphology. This review recapitulates the developments in the microscopic assessment of ILC from 1941 until today. We discuss different concepts of ILC, provide an overview on ILC variants, and highlight advances which have contributed to a better understanding of ILC as a special histologic spectrum of tumors.
Invasive lobular breast cancer (ILC) is the most common special histological type of breast cancer (BC). This review recapitulates developments in the histomorphologic assessment of ILC from its beginnings with the seminal work of Foote and Stewart, which was published in 1941, until today. We discuss different concepts of ILC and their implications. These concepts include (i) BC arising from mammary lobules, (ii) BC growing in dissociated cells and single files, and (iii) BC defined as a morpho-molecular spectrum of tumors with distinct histological and molecular characteristics related to impaired cell adhesion. This review also provides a comprehensive overview of ILC variants, their histomorphology, and differential diagnosis. Furthermore, this review highlights recent advances which have contributed to a better understanding of the histomorphology of ILC, such as the role of the basal lamina component laminin, the molecular specificities of triple-negative ILC, and E-cadherin to P-cadherin expression switching as the molecular determinant of tubular elements in CDH1-deficient ILC. Last but not least, we provide a detailed account of the tumor microenvironment in ILC, including tumor infiltrating lymphocyte (TIL) levels, which are comparatively low in ILC compared to other BCs, but correlate with clinical outcome. The distinct histomorphology of ILC clearly reflects a special tumor biology. In the clinic, special treatment strategies have been established for triple-negative, HER2-positive, and ER-positive BC. Treatment specialization for patients diagnosed with ILC is just in its beginnings. Accordingly, ILC deserves greater attention as a special tumor entity in BC diagnostics, patient care, and cancer research. View Full-Text
Keywords: LCIS; LIN; pleomorphic; solid; tubulolobular; HER2; beta-catenin; p120-catenin LCIS; LIN; pleomorphic; solid; tubulolobular; HER2; beta-catenin; p120-catenin
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MDPI and ACS Style

Christgen, M.; Cserni, G.; Floris, G.; Marchio, C.; Djerroudi, L.; Kreipe, H.; Derksen, P.W.B.; Vincent-Salomon, A. Lobular Breast Cancer: Histomorphology and Different Concepts of a Special Spectrum of Tumors. Cancers 2021, 13, 3695. https://doi.org/10.3390/cancers13153695

AMA Style

Christgen M, Cserni G, Floris G, Marchio C, Djerroudi L, Kreipe H, Derksen PWB, Vincent-Salomon A. Lobular Breast Cancer: Histomorphology and Different Concepts of a Special Spectrum of Tumors. Cancers. 2021; 13(15):3695. https://doi.org/10.3390/cancers13153695

Chicago/Turabian Style

Christgen, Matthias, Gábor Cserni, Giuseppe Floris, Caterina Marchio, Lounes Djerroudi, Hans Kreipe, Patrick W.B. Derksen, and Anne Vincent-Salomon. 2021. "Lobular Breast Cancer: Histomorphology and Different Concepts of a Special Spectrum of Tumors" Cancers 13, no. 15: 3695. https://doi.org/10.3390/cancers13153695

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