Lymph-node metastases in invasive lobular carcinoma are different from those in ductal carcinoma of the breast

Fernández, B. Díaz; Paish, Emma C.; Green, Andrew; Lee, Andrew H.S.; Macmillan, R. Douglas; Ellis, Ian O.; Rakha, Emad A.

doi:10.1136/jclinpath-2011-200151

Cited by 51 publications

(47 citation statements)

References 58 publications

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“…Almost 30% of clinically node negative cases in this analysis had positive SLN and 43.3% (n=13) of those had additional lymph node involvement in the non-SLNs. One of the few studies comparing axillary node involvement and the ratio of metastatic/dissected axillary nodes between ILC and IDC reported a mean of 4.2 vs 2.12 lymph node metastasis for the grade-matched ILC and IDC respectively (12). With similar grade distribution (grade II>grade III>grade I), our report revealed a mean metastatic axillary node of 2.5.…”

Section: Discussionsupporting

confidence: 60%

“…Although conflicting results exist on axillary metastasis of ILC, most studies conclude that they appear to be more in number and greater in size than IDC (7,12). Almost 30% of clinically node negative cases in this analysis had positive SLN and 43.3% (n=13) of those had additional lymph node involvement in the non-SLNs.…”

Section: Discussionmentioning

confidence: 80%

“…The c-erb-b2 expression is quite uncommon, and proliferation index, illustrated by Ki67 stain, is lower. These cells are also reluctant to make lymphovascular invasion (8)(9)(10)(11)(12). Patients in this study represented a high ER and PR expression, 98.1% and 87.7% respectively.…”

Section: Discussionmentioning

confidence: 97%

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Sentinel Lymph Node Metastasis in Invasive Lobular Carcinoma of the Breast

Güven

Kültüroğlu

Gülçelik

et al. 2018

Eur J Breast Health

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Objective: Invasive lobular carcinoma (ILC) of the breast makes up 5 to 15 percent of all invasive breast cancers. It has distinctive clinical and histopathological features when compared to invasive ductal carcinoma (IDC). This study intends to describe factors influencing sentinel lymph node (SLN) positivity in patients with "pure" ILC. Materials and Methods:Data of 105 patients, who were treated at a tertiary oncology center, with lobular carcinoma of the breast that were subjected to SLN biopsy was probed retrospectively. Patients were categorized as ≤60 and >60 years of age, positive or negative for estrogen receptor and progesterone, tumor grade I, II and III, Ki67≤15% and >30%, lymphovascular invasion presence and the presence of multicentricity and multifocality.Results: Mean age at the time of diagnosis was 52 (38-81). Mean tumor size was 2.7 cm (0.7-13cm). Univariate analyses revealed a significant relationship between tumor size (≤2 cm vs >2cm) and metastasis in the SLN. This relation kept its significance in multivariate analyses. (p=0.013). Conclusion:With so many different characteristics from IDC, ILC is mostly a uniform tumor. In this study, tumor size was the only independent clinical parameter that was found related to SLN metastases.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 80%

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Sentinel Lymph Node Metastasis in Invasive Lobular Carcinoma of the Breast

Güven

Kültüroğlu

Gülçelik

et al. 2018

Eur J Breast Health

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“…It is also important to note that invasive micropapillary carcinomas show a high frequency of LVI regardless of the proportion of micropapillary components in the invasive tumour [31] suggesting an intrinsic biological feature of this tumour type that promotes the development of LVI. Contrasting this, invasive lobular carcinoma (ILC) is known to show a low frequency of LVI, even when LVI was detected using lymphatic endothelial-specific biomarkers [32], despite having equal frequency of nodal involvement and a tendency to metastasise to more nodes than grade-matched invasive ductal carcinoma [33]. The disproportionate balance between the metastatic rate and the frequency of morphologically detected LVI in ILC could be explained by the discohesive single-cell infiltration pattern of ILC with the inherited loss of E-cadherin resulting in intratumoural or peritumoural intravasation of single small uniform cells rather than the easily identifiable cohesive clusters of invasive ductal carcinoma cells.…”

Section: Tumour Histological Features and LVImentioning

confidence: 99%

Molecular Mechanisms Underlying Lymphovascular Invasion in Invasive Breast Cancer

et al. 2015

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Lymphovascular invasion (LVI), the presence of malignant cells within lymphovascular channels, is a crucial step in the invasion-metastasis cascade. LVI, when identified morphologically in the peritumoural area, is regarded as an indicator of metastatic potential and is strongly associated with a poor prognosis in many solid tumours, including breast cancer (BC). Although molecular mechanisms associated with the development of LVI have been extensively studied, details of driver genes, and molecular pathways and mechanisms involved in its development in BC, remain poorly defined. Although invasive BC cells have the ability to invade surrounding stroma, only those that can interact with endothelial cells, penetrate the vascular wall and withstand the intravascular stress will develop LVI and complete metastatic dissemination. Identification of additional molecular events associated with LVI in the primary tumour and characterisation of the contribution of the tumour micro-environment to modulating biological processes leading to LVI in BC remain a challenging task. This stems not only from the complexity of the molecular alterations in the primary tumour and the interactions with different components of its micro-environment but also from the subjective nature of LVI assessment in human BC. In this review, we discuss the clinicopathological features and the current knowledge of the molecular mechanisms underlying LVI in BC.

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“…This histologic distinction is not an independent prognostic factor for patient outcome [41-43]. Allowing for variants, in general invasive lobular carcinoma is associated with a higher nodal stage (13.1 vs. 4.5%), higher absolute number of positive nodes, and higher ratio of positive nodes than invasive ductal carcinoma [44]. This is not associated with a significant difference in regional recurrence rates or overall patient survival.…”

Section: Resultsmentioning

confidence: 99%

Fine-Needle Aspiration Biopsy Management of the Axilla in Primary Breast Carcinoma

2019

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Context: Fine-needle aspiration biopsy (FNAB) is frequently used to stage the axilla preoperatively in patients with primary breast carcinoma. In the light of the ACOSOG-Z0011 and AMAROS trials that specified sentinel lymph node biopsy as an inclusion criterion, the role of FNAB in axillary staging is changing. Objective: This article will review the diagnostic accuracy of FNAB in staging of the axilla in patients with primary breast carcinoma. The efficacy of axillary FNAB compared with core-needle biopsy will be evaluated. The evolving approach to staging of the axilla, in the light of ACOSOG-Z0011 and AMAROS trials, will be discussed. Data Sources: Data were sourced from published peer-reviewed articles in PubMed (US National Library of Medicine) and published guidelines including the European Guidelines for Quality Assurance in Breast Cancer and those from the European Society of Medical Oncology (ESMO), Union for International Cancer (UICC), American Society of Clinical Oncology (ASCO), and the American Society of Breast Surgeons. Conclusions: FNAB of the axilla is almost 100% specific with a sensitivity between 40 and 90%. A positive FNAB reduces the need for a second axillary procedure by up to 20% with reduced morbidity and cost. The recent ACOSOG-Z0011 and AMAROS trials have reduced the use of FNAB axilla in American protocols, but it remains the standard of care in Europe.

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Lymph-node metastases in invasive lobular carcinoma are different from those in ductal carcinoma of the breast

Cited by 51 publications

References 58 publications

Sentinel Lymph Node Metastasis in Invasive Lobular Carcinoma of the Breast

Sentinel Lymph Node Metastasis in Invasive Lobular Carcinoma of the Breast

Molecular Mechanisms Underlying Lymphovascular Invasion in Invasive Breast Cancer

Fine-Needle Aspiration Biopsy Management of the Axilla in Primary Breast Carcinoma

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