Infiltrating lobular carcinoma of the breast

Dixon, JM; Anderson, Thomas; Page, David L.; Lee, D.; Duffy, S W

doi:10.1111/j.1365-2559.1982.tb02712.x

Cited by 222 publications

(116 citation statements)

References 19 publications

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“…Further, the differences in stage, tumour size, and lymph node status observed here may reflect differences in the utility of screening approaches to detect different histologic types of cancer. For example, it is well known that lobular tumours are more difficult to detect with mammography compared to ductal tumours, and this is thought to be primarily due to the fact that lobular tumours tend to grow as linear strands or sheets of cancer cells rather than as more discrete masses, explaining why they are more likely to be diagnosed at a more advanced stage (Davis et al, 1979;Dixon et al, 1982;Silverstein et al, 1994;Yeatman et al, 1995). Thus, currently, available breast cancer screening tools appear to be relatively less or relatively more effective in detecting different histopathologic types of breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of different histologic types of breast cancer

2005

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Breast cancer is a heterogeneous disease, though little is known about some of its rarer forms, including certain histologic types. Using Surveillance, Epidemiology, and End Results Program data on 135 157 invasive breast cancer cases diagnosed from 1992 to 2001, relationships between nine histologic types of breast cancer and various tumour characteristics were assessed. Among women aged 50 -89 years at diagnosis, lobular and ductal/lobular carcinoma cases were more likely to be diagnosed with stage III/IV, X5.0 cm, and node-positive tumours compared to ductal carcinoma cases. Mucinous, comedo, tubular, and medullary carcinomas were less likely to present at an advanced stage. Lobular, ductal/lobular, mucinous, tubular, and papillary carcinomas were less likely, and comedo, medullary, and inflammatory carcinomas were more likely to be oestrogen receptor (ER) negative/progesterone receptor (PR) negative and high grade (notably, 68.2% of medullary carcinomas were ERÀ/PRÀ vs 19.3% of ductal carcinomas). In general, similar differences were observed among women diagnosed at age 30 -49 years. Inflammatory carcinomas are associated with more aggressive tumour phenotypes, and mucinous, tubular, and papillary tumours are associated with less aggressive phenotypes. The histologic types of breast cancer studied here differ greatly in their clinical presentations, and the differences in their hormone receptor profiles and grades point to their likely different aetiologies. British Journal of Cancer (2005) Although breast cancer remains the most commonly diagnosed cancer among women in the United States (US) and worldwide, it is a heterogeneous disease. Breast cancer can be categorized in several ways, including based on its clinical features, its expression of tumour markers, and its histologic type. The two most common histologic types of invasive breast cancer are ductal and lobular carcinomas, accounting for approximately 75 and 15% of all cases in the US, respectively (Li et al, 2003a). Interest in lobular carcinoma in particular has recently been piqued by data indicating that incidence rates of lobular carcinoma are increasing more rapidly than are rates of ductal carcinoma in the US. Specifically, lobular rates have increased by 65% from 1987 to 1999, while rates of ductal carcinoma have increased only by 3% (Li et al, 2003a). Studies also suggest that lobular carcinomas are more likely than ductal carcinomas to be hormone receptor positive (Arpino et al, 2004;Korhonen et al, 2004). This difference may partly explain why seven studies have consistently observed that combined oestrogen and progestin postmenopausal hormone use is more strongly related to lobular carcinoma risk than to ductal carcinoma risk (Li et al, 2000(Li et al, , 2003bChen et al, 2002;Newcomb et al, 2002;Daling et al, 2003;Newcomer et al, 2003).While several studies have now examined the clinical, pathologic, and epidemiologic differences between ductal and lobular carcinomas, much less is known about the rarer histologic types of breast cancer,...

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of different histologic types of breast cancer

2005

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“…These include, the solid variant, 10 the alveolar variant, 3 the tubulo-lobular variant, 11 the signet ring variant, 12 the histiocytoid variant 13 and a mixed subgroup. 12 The mixed subgroup, in Dixon et al's 12 original paper, was recognized when an invasive lobular carcinoma was comprised of a mixture of variants or when the invasive lobular carcinoma had a classic growth pattern, but the degree of nuclear pleomorphism was greater than that seen in the classic subgroup. Eusebi et al 14 described the clinical outcome in a group of cases he termed 'pleomorphic lobular carcinoma' which had the growth pattern of classic invasive lobular carcinoma but showed at least a moderate degree of nuclear pleomorphism.…”

Section: Discussionmentioning

confidence: 99%

Invasive lobular carcinoma: to grade or not to grade

et al. 2005

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Grading of invasive ductal carcinoma of no special type using the Nottingham combined histologic grading system provides independent prognostic information. The prognostic utility of grading invasive lobular carcinomas, however, has not been fully elucidated. In addition, the relationship between grade in invasive lobular carcinomas and expression of predictive biomarkers is less certain. The purpose of this study was to correlate histologic grade in invasive lobular carcinoma with known prognostic and predictive markers. All primary resections for invasive mammary carcinomas diagnosed in Mount Sinai Hospital, Toronto, between the years 1996 and 2002 were reviewed (n ¼ 1053). Of these cases, 50 were pure invasive lobular carcinoma (incidence 4.7%). The median age at diagnosis was 64 years. These tumors were graded using the Nottingham combined histologic grading system and analyzed for estrogen receptor, progesterone receptor, HER2/neu and E-cadherin expression. Tumor grade was correlated with tumor size (P ¼ 0.03), and the American Joint Committee on Cancer nodal status (P ¼ 0.05). Assessment of the individual components of grade showed that the mitotic score was highly correlated with tumor size (P ¼ 0.02), lymph node positivity (P ¼ 0.02) and overall American Joint Committee on Cancer stage (P ¼ 0.01). Estrogen receptor and progesterone receptor were highly expressed irrespective of the grade of tumor. HER2/neu protein overexpression and E-cadherin protein expression was absent in all invasive lobular carcinomas studied. We conclude that pure invasive lobular carcinoma is uncommon and occurs predominantly in postmenopausal women. Increasing tumor grade is correlated with median tumor size and the American Joint Committee on Cancer nodal stage, but not correlated with the expression of estrogen receptor, progesterone receptor, E-cadherin or HER2/neu protein overexpression.

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“…At present, it is generally accepted that LCIS is present in 60-70% of all ILC cases and that the presence of LCIS is by no means mandatory for the correct diagnosis of ILC (Dixon et al, 1982). Fechner (1972) described ductal epithelial involvement, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…There is general agreement that patients with ISC have significantly better prognosis than those with IDC or ILC, but there is still controversy as to whether the prognoses of IDC and ILC differ (Howell and Harris, 1985;DiCostanzo et al, 1990;Sastre-Garau et al, 1996). The studies performed to solve this issue have mostly been based on a small number of patients, and relatively few reports including more than 100 cases have been published so far (Dixon et al, 1982;DiCostanzo et al, 1990;du Toit et al, 1991;Silverstein et al, 1994). Moreover, only a few reports are based on a well-defined cohort, and there is little data available comparing long-term survival of patients with ILC with that of patients with IDC (Sastre-Garau et al, 1996).…”

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confidence: 99%

Invasive lobular carcinoma of the breast has better short- and long-term survival than invasive ductal carcinoma

Toikkanen

Pylkkänen²,

Joensuu³

1997

Br J Cancer

145

105

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Invasive lobular carcinoma of the breast has better short-and long-term survival than invasive ductal carcinoma S Toikkanen', L Pylkkanen2and H Joensuu3Departments of 'Pathology and 2Oncology, University Central Hospital of Turku, Kiinamyllynkatu 10, FIN-20520 Turku, Finland; 3Department of Oncology, University Central Hospital of Helsinki, Haartmaninkatu 4, Helsinki, Finland Summary The outcome and prognostic factors of 217 women with invasive lobular carcinoma (ILC) and those of 1121 women with invasive ductal carcinoma (IDC) of the breast were compared. The patients were followed up for 10-43 years. Women with ILC had axillary nodal metastases less frequently than those with IDC (43% vs 53%, P= 0.02), although there was no difference in the primary tumour size between the groups. ILCs were more frequently of low grade, had lower mitotic counts and had less tumour necrosis. Furthermore, ILCs had lower Sphase fractions and were more often DNA diploid in flow cytometric analysis than IDCs (P < 0.0001 for all comparisons). The 5-and 30-year corrected survival rates of women with ILC were 78% and 50%, respectively, compared with 63% and 37% for women with IDC (P = 0.001). Small pTl NOMO ILCs (n = 41) had 100% 1 0-year and 83% 20-year corrected survival rates. In a multivariate analysis, a large primary tumour size, the presence of axillary nodal metastases, a high mitotic count and the presence of tumour necrosis all had an independent prognostic value in ILC. We conclude that ILC is associated with better survival than IDC.

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Infiltrating lobular carcinoma of the breast

Cited by 222 publications

References 19 publications

Clinical characteristics of different histologic types of breast cancer

Clinical characteristics of different histologic types of breast cancer

Invasive lobular carcinoma: to grade or not to grade

Invasive lobular carcinoma of the breast has better short- and long-term survival than invasive ductal carcinoma

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