LAUSR

I read with great interest the article by El-Hage et al in which patients with invasive lobular carcinoma (ILC) were retrospectively reviewed. They reported that among the 481 patients with ILC, 74 (15.4%) were diagnosed with metastases after a median follow-up of 46 months. Among these 74 patients, 41.9% had metastases in atypical sites. Five patients were diagnosed with histologically confirmed gastric metastases of ILC. However, authors did not reveal strict definition of ILC. Since some cases with ILC also carry features of infiltrative ductal carcinoma (IDC) so called “mixed type,” the definition of cases with ILC may be important whether they are pure ILC or mixed type. We evaluated 358 consecutive patients with breast cancer presenting at Hacettepe University Cancer Instiute, Ankara, Turkey. Among them, 17 (4.7%) patients had a diagnosis of pure ILC. Twenty (5.5%) cases with mixed-type histology (ILC + IDC) were identified. Since metastatic patterns of pure ILC or mixed type breast cancers may be different, it is imperative to exclude any mixed ductal/lobular cancers from any data set of putative lobular cancers.