Lobular vs Ductal Carcinoma: Staging Nuances

Different growth patterns

Invasive ductal carcinoma is the most common type and forms a mass. Invasive lobular carcinoma spreads in single files, often making it harder to see on imaging and palpation.

Staging implications

• Lobular tumors may be multifocal or bilateral more often, widening the field to image.
• Both use the same AJCC TNM framework, but lobular disease can underestimate extent clinically.
• Receptor status differs: lobular tumors are more often hormone-receptor positive and HER2-negative.

Planning takeaway

Because lobular disease can be subtle, staging imaging and pathology review need to be thorough before settling on a surgical plan.