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Cancers canalaires et lobulaires : Quelles sont les différences pour l’anatomo-cyto-pathologiste ?

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Cancer du sein

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Conclusion

Bien que les carcinomes canalaires et lobulaires soient les deux formes les plus fréquentes de cancer infiltrant du sein, d’agressivité sensiblement comparable, ils s’opposent sur de nombreux points. Ainsi, la forme lobulaire voit son incidence augmentée par l’exposition aux différents traitements hormonaux. L’infiltration du tissu mammaire qu’elle occasionne est majeure, dépassant souvent les estimations cliniques et radiologiques, à l’origine des tailles importantes observées. Ses caractéristiques biologiques sont celles d’une tumeur bien différenciée, faible taux de prolifération, forte expression pour les récepteurs hormonaux, absence d’anomalie de la p53, de la voie d’apoptose ou d’hyperexpression d’Her2. Les sites métastatiques diffèrent également avec une prédilection pour les séreuses (péritoine, méninges) pour la forme lobulaire. Enfin, il semblerait que cette forme réponde moins bien à la chimiothérapie que la forme canalaire en néo-adjuvant (33, 34). Toutes ces différences inciteraient à développer des attitudes thérapeutiques et des modalités de surveillance différentes.

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  1. Service de pathologie, Centre René-Huguenin, 35, rue Dailly, 92210, Saint-Cloud

    J. -M. Guinebretière

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  1. J. -M. Guinebretière
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© 2006 Springer-Verlag France, Paris

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Guinebretière, J.M. (2006). Cancers canalaires et lobulaires : Quelles sont les différences pour l’anatomo-cyto-pathologiste ?. In: Cancer du sein. Springer, Paris. https://doi.org/10.1007/2-287-31109-2_9

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  • DOI: https://doi.org/10.1007/2-287-31109-2_9

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-25174-0

  • Online ISBN: 978-2-287-31109-3

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