A lady presented with breast carcinoma. On investigation, it is noticed that other breast is also involved. Likely histological subtype is: March 2012
## **Core Concept**
The question tests knowledge of breast cancer histological subtypes and their characteristics, particularly in the context of bilaterality. Breast cancer can present in various histological subtypes, each with distinct features and clinical implications.
## **Why the Correct Answer is Right**
The correct answer, **D. Lobular carcinoma**, is associated with a higher incidence of bilaterality and multicentricity compared to other subtypes like ductal carcinoma. Lobular carcinoma, especially invasive lobular carcinoma (ILC), often presents as multifocal or bilateral disease. This is because ILC can diffusely infiltrate the breast tissue, making it harder to detect by clinical examination or imaging. The histological diagnosis of lobular carcinoma is based on the presence of small, uniform cells that infiltrate the breast tissue in a single-file pattern.
## **Why Each Wrong Option is Incorrect**
- **Option A:** Ductal carcinoma (not specified but commonly referred to as invasive ductal carcinoma or IDC) is the most common type of breast cancer but is less likely to present bilaterally compared to lobular carcinoma.
- **Option B:** Medullary carcinoma is a rare subtype of breast cancer known for its well-defined borders, high lymphocytic infiltrate, and often, a better prognosis. It is not particularly known for bilaterality.
- **Option C:** Tubular carcinoma is another subtype of breast cancer characterized by its excellent prognosis due to its low grade and favorable biological features. It typically presents as a small, unifocal tumor and is not commonly associated with bilaterality.
## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that **invasive lobular carcinoma (ILC) is the second most common type of breast cancer after invasive ductal carcinoma and is more likely to be bilateral and multicentric**. ILC can be challenging to detect by physical examination and imaging due to its diffuse growth pattern. This highlights the importance of thorough histological examination in cases of suspected breast cancer, especially when bilaterality is observed.
## **Correct Answer: D. Lobular carcinoma**