Pathological Features and Prognosis of Lobular Carcinoma in Egyptian Breast Cancer Patients

Azim, Hamdy A.; Abdel-Malek, Raafat; Azim, Hatem A.

doi:10.2217/whe.14.48

Cited by 11 publications

(14 citation statements)

References 38 publications

(54 reference statements)

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“…In a sample of 75 lobular tumors from the I-SPY trial, Lips et al (2012) determined PAM50 subtypes and reported an RFD of 44% for Luminal A subtype among lobular compared to ductal tumors, similar to our findings [50]. Other studies using IHC have reported RFDs for Luminal A subtype among lobular compared to ductal tumors ranging from 6 to 39%, reflecting tremendous molecular variability in the tumors studied [14, 16, 19, 22, 37, 47–49, 51, 52]. Proportions of Luminal A ductal tumors were also different between IHC subtype and RNA subtype data, suggesting RNA subtyping may be important for understanding associations between intrinsic subtype and histology.…”

Section: Discussionsupporting

confidence: 83%

“…In both studies, lobular tumors were significantly more likely to be Luminal A, both IHC- and RNA-defined, and have lower frequencies of TP53 pathway defects than ductal tumors. As previously reported, we found lobular disease to be more common among older and white women [4, 6, 10, 11, 45] more likely to be low-intermediate tumor grade, larger tumor size, and diagnosed at later stage of disease [1, 4, 6, 9–11, 14, 16, 17, 19, 22–24, 33, 37, 46–50]. However, we show that the associations between lobular subtype and patient/ tumor characteristics, with the exception of TP53 status, persisted among Luminal A subtype only, suggesting that histology contributes to these observed associations even after restricting to a single, and the dominant, molecular subtype.…”

Section: Discussionsupporting

confidence: 61%

See 1 more Smart Citation

Differences in race, molecular and tumor characteristics among women diagnosed with invasive ductal and lobular breast carcinomas

Williams

Hoadley

Nichols

et al. 2019

Cancer Causes Control

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Background The dominant invasive breast cancer histologic subtype, ductal carcinoma, shows intrinsic subtype diversity. However, lobular breast cancers are predominantly Luminal A. Both histologic subtypes show distinct relationships with patient and tumor characteristics, but it is unclear if these associations remain after accounting for intrinsic subtype. Methods Generalized linear models were used to estimate relative frequency differences (RFDs) and 95% confidence intervals (95% CIs) for the associations between age, race, tumor characteristics, immunohistochemistry (IHC) and RNA-based intrinsic subtype, TP53 status, and histologic subtype in the Carolina Breast Cancer Study (CBCS, n = 3,182) and The Cancer Genome Atlas (TCGA, n = 808). Results Relative to ductal tumors, lobular tumors were significantly more likely to be Luminal A [CBCS RNA RFD: 44.9%, 95% CI (39.6, 50.1); TCGA: RFD: 50.5%, 95% CI (43.9, 57.1)], were less frequent among young (≤ 50 years) and black women, were larger in size, low grade, less frequently had TP53 pathway defects, and were diagnosed at later stages. These associations persisted among Luminal A tumors (n = 242). Conclusions While histology is strongly associated with molecular characteristics, histologic associations with age, race, size, grade, and stage persisted after restricting to Luminal A subtype. Histology may continue to be clinically relevant among Luminal A breast cancers.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 61%

Differences in race, molecular and tumor characteristics among women diagnosed with invasive ductal and lobular breast carcinomas

Williams

Hoadley

Nichols

et al. 2019

Cancer Causes Control

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“…In the multivariate analyses, the OS but not BCSS of lobular carcinoma NOS was better than infiltrating ductal carcinoma NOS. There are conflicting findings on the survival outcomes between lobular carcinoma and infiltrating ductal carcinoma in previous studies 18 - 20 . The median follow-up of our study was only 20 months.…”

Section: Discussionmentioning

confidence: 93%

The Clinicopathological Features and Survival Outcomes of Different Histological Subtypes in Triple-negative Breast Cancer

et al. 2018

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Purpose: To determine the clinicopathological features and survival outcomes of triple-negative breast cancer (TNBC) according to different histological subtypes.Methods: Using the Surveillance, Epidemiology, and End Results database, we included TNBC cases in 2010-2013. The effect of histological subtype on breast cancer-specific survival (BCSS) and overall survival (OS) were analyzed using univariate and multivariate analyses.Results: A total of 19,900 patients were identified. Infiltrating ductal carcinoma not otherwise specified accounted for 91.6% of patients, followed by metaplastic carcinoma (2.7%), medullary carcinoma (1.4%), mixed lobular-ductal carcinoma (1.4%), lobular carcinoma (1.3%), apocrine carcinoma (1.0%), and adenoid cystic carcinoma (0.6%). Medullary carcinoma was more frequently poorly/undifferentiated. Significantly more lobular carcinoma, mixed lobular-ductal carcinoma, and metaplastic carcinoma patients had larger tumors. Adenoid cystic carcinoma, metaplastic carcinoma, medullary carcinoma, and apocrine carcinoma were more frequently node-negative. Lobular carcinoma (16.0%) and mixed lobular-ductal carcinoma (10.4%) more frequently had distant stage at initial diagnosis. Histologic subtype was an independent prognostic factor of BCSS and OS. Compared with infiltrating ductal carcinoma, medullary carcinoma and apocrine carcinoma had better BCSS and OS, while mixed lobular-ductal carcinoma and metaplastic carcinoma had worse survival. Adenoid cystic carcinoma survival was not significantly different from that of infiltrating ductal carcinoma.Conclusions: TNBC histological subtypes have different clinicopathological characteristics and survival outcomes. Medullary carcinoma and apocrine adenocarcinoma have excellent prognosis; mixed lobular-ductal carcinoma and metaplastic carcinoma are the most aggressive subtypes.

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“…Classic ILC was reported to have a better prognosis than IDC [36]. A retrospective analysis by Azimet al showed that ILC was associated with better disease-free survival[37]. Recently, another study compared the clinical outcomes between luminal IDC and luminal ILC, and found that luminal ILC had a worse outcome[38].…”

Section: Discussionmentioning

confidence: 99%

Invasive lobular carcinoma of the breast: A special histological type compared with invasive ductal carcinoma

et al. 2017

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The clinical outcomes and therapeutic strategies for infiltrating ductal carcinoma (IDC) and infiltrating lobular carcinoma (ILC) are not uniform. The primary objectives of this study were to identify the differences in the clinical characteristics and prognoses between ILC and IDC, and identify the high-risk population based on the hormone receptor status and metastasis sites. The Surveillance, Epidemiology, and End Results Program database was searched and patients diagnosed with ILC or IDC from 1990 to 2013 were identified. In total,796,335 patients were analyzed, including 85,048 withILC (10.7%) and 711,287 withIDC (89.3%). The ILC group was correlatedwith older age, larger tumor size, later stage, lower grade, metastasis disease(M1) disease, and greater counts ofpositive lymph nodesandestrogen-receptor-positive (ER)/progesterone receptor-positive (PR) positive nodes. The overall survival showed an early advantage for ILC but a worse outcome after 5 years. Regarding the disease-specific survival, the IDC cohort had advantages over the ILC group, both during the early years and long-term. In hormone status and metastasis site subgroup analyses, the ER+/PR+ subgroup had the best survival, while the ER+/PR- subgroup had the worst outcome, especially the ILC cohort. ILC and IDC had different metastasis patterns. The proportion of bone metastasis was higher in the ILC group (91.52%) than that in the IDC (76.04%), and the ILC group was more likely to have multiple metastasis sites. Survival analyses showed patients with ILC had a higher risk of liver metastasis (disease-specific survival[DSS]; P = 0.046), but had a better overall survival than the bone metastasis group (P<0.0001). We concluded that the long-term prognosis for ILC was poorer than that for IDC, and the ER+/PR- subgroup had the worst outcome. Therefore, the metastasis pattern and prognosis must be seriously evaluated, and a combination of endocrine therapy and chemotherapy should be considered.

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Pathological Features and Prognosis of Lobular Carcinoma in Egyptian Breast Cancer Patients

Abstract: ILC has distinct biologic and prognostic features that may warrant different therapeutic approaches.

Cited by 11 publications

References 38 publications

Differences in race, molecular and tumor characteristics among women diagnosed with invasive ductal and lobular breast carcinomas

Differences in race, molecular and tumor characteristics among women diagnosed with invasive ductal and lobular breast carcinomas

The Clinicopathological Features and Survival Outcomes of Different Histological Subtypes in Triple-negative Breast Cancer

Invasive lobular carcinoma of the breast: A special histological type compared with invasive ductal carcinoma

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