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Invasive Lobular Carcinoma of the Breast: Mammographic Characteristics and Computer-aided Detection¹

¹ From the Susan G. Komen Breast Center, Baylor University Medical Center, Dallas, Tex (W.P.E., L.L.); the Department of Radiology, University of British Columbia, Vancouver, Canada (L.J.W.B.); and R2 Technology, Sunnyvale, Calif (K.F.O., R.A.C.). From the 2000 RSNA scientific assembly. Received June 13, 2001; revision requested August 6; final revision received March 15, 2002; accepted March 25. Address correspondence to W.P.E., UT Southwestern Center for Breast Care, 5323 Harry Hines Blvd, Dallas, TX 75390-8585 (e-mail: phil.evans@utsouthwestern.edu).

PURPOSE: To characterize the mammographic appearance of invasive lobular carcinoma in a large series of screening-detected consecutive breast cancers and to evaluate the ability of a computer-aided detection system to mark these carcinomas.

MATERIALS AND METHODS: Investigators used the Breast Imaging Reporting and Data System lexicon to characterize lesions as part of a retrospective review of 90 screening mammographic examinations that led to biopsy-proved diagnosis of 94 invasive lobular carcinoma lesions. The 40 available prior mammographic examinations (obtained 9–24 months earlier) were also reviewed to characterize any visible findings. The results of a computer-aided detection analysis were compared with the images, and the sensitivity of the algorithm was calculated for correct detection of the lesions.

RESULTS: Fifty-six (60%) of 94 lesions manifested as masses, of which 40 (71%) were described as irregular and spiculated; 20 (21%) of 94, as architectural distortions; and the remainder, 18 (20%), as either asymmetric densities or calcifications. On the screening mammograms showing biopsy-proved cancers, the sensitivity of the computer-aided detection system was 86 (91%) of 94 lesions. Thirty-one of the 40 prior mammograms showed retrospectively visible findings, and 24 (77%) of 31 were marked by the computer-aided detection system.

CONCLUSION: Spiculated masses and architectural distortions are the predominant appearances of invasive lobular carcinoma, and a computer-aided detection system correctly marked a high percentage of invasive lobular carcinoma lesions.

© RSNA, 2002

Index terms: Breast neoplasms, diagnosis, 00.111, 00.1299 • Breast neoplasms, radiography, 00.111 • Breast radiography, 00.111 • Computers, diagnostic aid

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