Locoregional Considerations for Invasive Lobular Carcinoma

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Research

Background:

• Invasive lobular carcinoma (ILC) is the second most common type of invasive breast cancer, presenting unique challenges in locoregional management.
• Current literature review focuses on optimizing surgical and systemic treatment approaches for ILC patients.

Purpose of the Study:

• To summarize recent advancements in the locoregional management of invasive lobular carcinoma.
• To review current evidence on breast surgery, axillary staging, and neoadjuvant therapy for ILC.

Main Methods:

• Systematic literature review of recent studies on ILC management.
• Analysis of data regarding breast conservation, margin status, axillary surgery, and neoadjuvant treatment efficacy.

Main Results:

• Breast conservation therapy is safe for ILC, though high positive margin rates can be mitigated by shave margins and oncoplastic techniques.
• Evidence for de-escalating axillary surgery in ILC is insufficient; sentinel lymph node biopsy is generally recommended.
• Neoadjuvant chemotherapy shows potential for improving breast conservation and increasing nodal complete response in select ILC patients.

Conclusions:

• Locoregional management of ILC requires tailored approaches due to its distinct biological and clinical characteristics.
• Further ILC-specific research is crucial to refine treatment guidelines and address existing knowledge gaps.