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

Abstract

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.

Prognostic value of morphology and hormone receptor status in breast cancer – a population-based study

“…The morphology categories special type and comedocarcinoma were associated with lower RERs of death than infiltracting ductal carcinoma (Table 5). The special type category includes, tubular, mucinous and papillary histotypes, which were reported to have good prognoses in a previous population-based study (Li et al, 2003), and in other studies (Cooper et al, 1978;Fisher et al, 1980;Wargotz and Silverberg, 1988;Ellis et al, 1992;Silverstein et al, 1994;Pedersen et al, 1995;Reinfuss et al, 1995;Toikkanen et al, 1997;Diab et al, 1999). Comedocarcinoma also had a relatively good prognosis in a previous study (Li et al, 2003).…”

Securin is overexpressed in breast cancer

“…This result may in part be explained by the histology of lobular carcinoma, which is characterized by abundant fibrous tissue, that is diffusely infiltrated by uniform, small round cells, which typically exhibit lower mitotic activities than invasive ductal carcinomas, and the lower securin expression that we observed, may simply reflect lower tumor proliferative rates. [26][27][28] A further explanation for the comparatively lower securin expression seen in lobular carcinomas compared to ductal carcinomas was that two-thirds of the lobular carcinomas exhibited a low degree of nuclear pleomorphism and only one tumor was markedly pleomorphic.…”

The biological and clinical characteristics of breast carcinoma with mixed ductal and lobular morphology

“…In addition, it has been reported that ILC is less responsive to chemotherapy [3,21], lacks potential benefit of HER2 targeted therapy [16,17], being typically HER2 negative, but is more often HR positive and responsive to adjuvant hormonal therapy (HT) [11,22,23]. Reported prognosis of ILC varies and has been reported to be worse [1,9,[24][25][26][27], no different [17,[28][29][30][31][32], or better [6] than that with IDC.…”