The Challenges of Lobular Carcinomas from a Surgeon’s Point of View

• Published in: Clinical breast cancer 2024-12, Vol.24 (8), p.e645-e654
• Main Author: Riis, Margit L.H.
• Format: Article
• Language: English
• Subjects: Breast cancer surgery; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Carcinoma, Lobular - pathology; Carcinoma, Lobular - surgery; Challenges in surgical management; Female; Humans; Lobular breast cancer; Margins of Excision; Mastectomy; Mastectomy, Segmental; Prognosis; Sentinel Lymph Node Biopsy; Surgeons; Therapy response
• ISSN: 1526-8209; 1938-0666; 1938-0666
• DOI: 10.1016/j.clbc.2024.06.007

Invasive lobular breast cancer (ILC) presents unique challenges and considerations in the realm of surgical management. Characterized by its distinct histological features, including the loss of E-cadherin expression and dys-cohesive growth pattern, ILC often poses diagnostic and therapeutic dilemmas for clinicians. This abstract explores the surgical landscape of ILC, focusing on its epidemiology, clinical presentation, diagnostic modalities, and surgical interventions. Emphasizing the importance of individualized treatment strategies, this narrative delves into the nuances of surgical decision-making, including the role of breast-conserving surgery versus mastectomy, axillary staging, and the significance of margin status. Additionally, advancements in surgical techniques, such as oncoplastic approaches and sentinel lymph node biopsy, are examined in the context of optimizing oncologic outcomes and preserving cosmesis. Through a comprehensive review of current literature and clinical guidelines, this overview aims to provide a nuanced understanding of the surgical considerations inherent to the management of invasive lobular breast cancer.