Surgical management of lobular carcinoma from a national screening program: a retrospective analysis

To compare the surgical outcomes of women diagnosed with invasive ductal and lobular carcinoma of the breast.

The role of Breast Conserving Surgery (BCS) for invasive cancers of the breast is well established; however its role for invasive lobular carcinoma is less well defined. Concerns exist regarding the need for re-excision of margins and the eventual need for mastectomy in women with Invasive Lobular Carcinoma (ILC) compared with Ductal Carcinoma (IDC). In this study we compare the surgical results of these two groups examining BCS from a national breast cancer screening program.

Analysis of mammographically detected ILC and IDC tumours obtained from the national breast cancer screening program of the Republic of Ireland (BreastCheck) was performed. BreastCheck offers biannual screening mammograms to women throughout the Republic of Ireland between 50 and 65 years of age. We examined and pooled the data across 4 screening zones from 2005 to 2010.

We observed similar success rates and trends in both the ILC and IDC groups where BCS was attempted. Patients selected for BCS with ILC were statistically more likely to have successful surgery compared with IDC as tumour size increased. There however was no statistical difference in a pooled analysis of successful treatment across all tumour sizes in comparing the two groups. We conclude that BCS is an appropriate and acceptable treatment option for women diagnosed with ILC.