[Lobular cancer transformation of the female breast. Mammography diagnosis and clinical relevance].

Lobular cancerisation was diagnosed in 101 women between 1976 and 1980. Calcification in the mammograms and follow-up without mastectomy were analysed. Therapy was simple biopsy, because the term lobular cancerisation was not established at that time. Surgery was done at the University Clinic for Women and the Elim Hospital at Hamburg. Retrospective analysis of the specimens was performed at the Department of Gynaecological Histopathology of the Hamburg University Clinic. Mammograms were available in 72 cases, showing calcifications in 40 cases. It was impossible to match the calcifications in the mammograms and the histological slides. Hence, a further 23 cases from 1980 to 1990 were analysed, suffering from lobular cancerisation and ductal carcinoma in situ (DCIS). Comparing 13 mammograms showing calcifications, with large-area scans, only two showed corresponding calcifications. Based on these data a specific diagnosis of lobular cancerisation by mammography is impossible. The follow-up of 88 patients with breast-preserving surgery and lobular cancerisation showed ipsilateral invasive carcinoma in three cases (0.35% in a total of 100 follow-up years), ipsilateral DCIS 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 cancerisation.