LOBULAR CANCERIZATION OF THE FEMALE BREAS T - MAMMOGRAPHY AND CLINICAL IMPLICATIONS

Lobular cancerisation was diagnosed in 101 women between 1976 and 1980 . Calcification in the mammograms and follow-up without mastectomy wer e analysed. Therapy was simple biopsy, because the term lobular cancer isation was not established at that time. Surgery was done at the Univ ersity Clinic for Woman and the Elim Hospital at Hamburg. Retrospectiv e analysis of the specimens was performed at the Department of Gynaeco logical Histopathology of the Hamburg University Clinic. Mammograms we re available in 72 cases, showing calcifications in 40 cases. It was i mpossible to match the calcifications in the mammograms and in the his tological slides. Hence, a further 23 cases from 1980 to 1990 were ana lysed, suffering from lobular cancerisation and ductal carcinoma in si tu (DCIS). Comparing 13 mammograms showing calcifications, with large- area scans, only two showed corresponding calcifications. Based on the se data a specific diagnosis of lobular cancerisation by mammography i s impossible. The follow-up of 88 patients with breast-preserving surg ery and lobular cancerisation showed ipsilateral invasive carcinoma in three cases (0.35% in a total of 100 follow-up years), ipsilateral DC IS in five, and contralateral invasive breast cancer in one case. The therapy of lobular cancerisation should depend on the coexisting DCIS. There is no additional risk of local recurrence by lobular cancerisat ion.