Infiltrating lobular carcinoma of the breast detected by screening

This study was a retrospective analysis of all patients with invasive lobular breast cancer who presented to the University Hospital Nijmegen between 1980 and 1990, with follow-up to December 1992. A comparison was made between the invasive lobular carcinomas detected by breast cancer screening and those detected outside the screening project.

The total number of patients with breast cancer during this interval was 937, of whom 136 (14.5 per cent) had pure infiltrating lobular carcinoma (ILC). Breast cancer screening identified a total of 158 patients with infiltrating breast carcinoma of whom 20 (12.7 per cent) had ILC. Outside the screening programme a total of 116 patients with ILC were diagnosed during the same interval.

The 2- and 5- and 10-year disease-free survival rate in the screen-detected group was 100, 100 and 89 per cent respectively. For the group outside the screening programme this was 88.4, 74.3 and 72.5 per cent respectively (P = 0.04). No patient in the screen-detected group died from breast cancer during follow-up, whereas the 2- and 5- and 10-year breast cancer survival rate for the group detected outside the screening programme was 96.5, 89.1 and 70.6 per cent respectively (P = 0.06).

Between 10 and 15 per cent of patients with invasive lobular breast cancer can be detected by breast screening. These patients have a favourable outcome compared with those who have ILC detected outside the screening programme.