Clinical presentation and surgical management of invasive lobular carcinoma of the breast.

Invasive lobular carcinoma is the second most common histological type of breast cancer and differs from invasive ductal carcinoma also in some clinical features. Multifocal or multicentric as well as contralateral diseases are more frequently found among patients with lobular carcinoma. Tumor size at diagnosis is larger than in patients with ductal carcinoma due to diagnostic challenges associated with lobular histology. For surgical management, breast conserving surgery followed by radiotherapy offers equal local control as mastectomy. Controversy however exists regarding risk for positive margins and subsequent need for second operations. Axillary staging can be safely performed by sentinel node biopsy if lymph nodes are clinically negative, even in multifocal or multicentric disease.