Results of a worldwide survey on the currently used histopathological diagnostic criteria for invasive lobular breast cancer

Pedro Luis Fernández, Maxim De Schepper, Anne Vincent-Salomon, Matthias Christgen, Karen Van Baelen, François Richard, Hitoshi Tsuda, Sasagu Kurozumi, Maria Jose Brito, Gabor Cserni, Stuart Schnitt, Denis Larsimont, Janina Kulka, Paula Rodríguez-Martínez, Ana Aula Olivar, Cristina Melendez, Mieke Van Bockstal, Aniko Kovacs, Zsuzsanna Varga, Jelle WesselingRohit Bhargava, Pia Boström, Camille Franchet, Blessing Zambuko, Gustavo Matute, Sophie Mueller, Anca Berghian, Emad Rakha, Paul J. van Diest, Steffi Oesterreich, Patrick W. B. Derksen, Giuseppe Floris, Christine Desmedt

Research output: Contribution to journalArticleResearchpeer-review

10 Citations (Scopus)


Invasive lobular carcinoma (ILC) represents the second most common subtype of breast cancer (BC), accounting for up to 15% of all invasive BC. Loss of cell adhesion due to functional inactivation of E-cadherin is the hallmark of ILC. Although the current world health organization (WHO) classification for diagnosing ILC requires the recognition of the dispersed or linear non-cohesive growth pattern, it is not mandatory to demonstrate E-cadherin loss by immunohistochemistry (IHC). Recent results of central pathology review of two large randomized clinical trials have demonstrated relative overdiagnosis of ILC, as only ~60% of the locally diagnosed ILCs were confirmed by central pathology. To understand the possible underlying reasons of this discrepancy, we undertook a worldwide survey on the current practice of diagnosing BC as ILC. A survey was drafted by a panel of pathologists and researchers from the European lobular breast cancer consortium (ELBCC) using the online tool SurveyMonkey®. Various parameters such as indications for IHC staining, IHC clones, and IHC staining procedures were questioned. Finally, systematic reporting of non-classical ILC variants were also interrogated. This survey was sent out to pathologists worldwide and circulated from December 14, 2020 until July, 1 2021. The results demonstrate that approximately half of the institutions use E-cadherin expression loss by IHC as an ancillary test to diagnose ILC and that there is a great variability in immunostaining protocols. This might cause different staining results and discordant interpretations. As ILC-specific therapeutic and diagnostic avenues are currently explored in the context of clinical trials, it is of importance to improve standardization of histopathologic diagnosis of ILC diagnosis.
Original languageEnglish
Pages (from-to)1812-1820
Number of pages9
JournalModern Pathology
Publication statusPublished - 2022


  • Pathology
  • Breast cancer


Dive into the research topics of 'Results of a worldwide survey on the currently used histopathological diagnostic criteria for invasive lobular breast cancer'. Together they form a unique fingerprint.

Cite this