Background: ILC is less common than IDC and is usually diagnosed at a later stage Purpose:The aim of our study was to investigate different clinico-biological behavior associated to ILC compared to IDC and to evaluate implications on survival outcomes Methods: We analyzed data from 3749 consecutive cases of IBC treated from 1995 to 2008 and classified as ILC, IDC and mixed/other. Relationships with clinical-pathological variables and the impact of ILC/IDC types on Event Free Survival (EFS), Overall Survival (OS) and Post-Progression Survival (PPS) were analyzed. Results: We have identified 445 ILC BC (12%), 3021 IDC (80.5%), 149 mixed (3.9%) and 134 other histotypes (3.6%). Median age was 61 (25-97) years. ILC presented a significantly (p<0.001) larger tumor size (T≥2: 46% vs 34%) and more frequent axilla involvement (43% vs 37%) compared to IDC. It was usually associated with intermediate grade, low ki67, positive ER and negative HER2 status. Mastectomy was more frequently required for ILC (45%) than IDC (37%). Adjuvant hormonal (± previous chemo) therapy was more frequently given (77 vs 64%) to ILC pts due to higher ER expression than IDC. At a median follow up of 77 (0-272) months (ms), there were not significant differences in EFS (81.4 vs 82.1%, p=0.7) and OS (82.8 vs 84.6%; p=0.19) between ILC vs IDC. Local and Distant Relapses were 15 (3.3%) and 50 (11.2%) in ILC vs 179 (5.9%) and 225 (7.4%) in IDC; preferential sites of first distant relapses were similar in both histotypes. Contralateral and second tumors were 9 (2%) and 22 (5%) in ILC vs 84 (2.8%) and 174 (5.7%) in IDC. Median time to first event was 38.3 ms in ILC vs 35.23 in IDC. PPS was 16.5 ms (0-100) in ILC compared to 22.2 (0-187) in IDC. Prognosis in term of OS was consistently worse for ILC pts, compared to IDC, when considering the luminal A (86.9 vs 93.5%; p=0.003), luminal C (70.4 vs 88.5%; p=0.028) and in triple negative subgroups (50 vs 73.1%; p=0.021). No difference in OS was seen for age, size, hormonal and nodal status, except in N>3 ILC pts, in whom a trend of worse prognosis (55.6 vs 60.2%) was observed. Conclusions: ILC pts did not show in our series a better outcome than IDC pts, despite a quite favorable biological pattern.
Invasive lobular (ILC) versus invasive ductal (IDC) breast cancer (BC): Clinical-pathologic features and clinical outcomes in monoinstitutional series
Eccher, Claudio;
2012-01-01
Abstract
Background: ILC is less common than IDC and is usually diagnosed at a later stage Purpose:The aim of our study was to investigate different clinico-biological behavior associated to ILC compared to IDC and to evaluate implications on survival outcomes Methods: We analyzed data from 3749 consecutive cases of IBC treated from 1995 to 2008 and classified as ILC, IDC and mixed/other. Relationships with clinical-pathological variables and the impact of ILC/IDC types on Event Free Survival (EFS), Overall Survival (OS) and Post-Progression Survival (PPS) were analyzed. Results: We have identified 445 ILC BC (12%), 3021 IDC (80.5%), 149 mixed (3.9%) and 134 other histotypes (3.6%). Median age was 61 (25-97) years. ILC presented a significantly (p<0.001) larger tumor size (T≥2: 46% vs 34%) and more frequent axilla involvement (43% vs 37%) compared to IDC. It was usually associated with intermediate grade, low ki67, positive ER and negative HER2 status. Mastectomy was more frequently required for ILC (45%) than IDC (37%). Adjuvant hormonal (± previous chemo) therapy was more frequently given (77 vs 64%) to ILC pts due to higher ER expression than IDC. At a median follow up of 77 (0-272) months (ms), there were not significant differences in EFS (81.4 vs 82.1%, p=0.7) and OS (82.8 vs 84.6%; p=0.19) between ILC vs IDC. Local and Distant Relapses were 15 (3.3%) and 50 (11.2%) in ILC vs 179 (5.9%) and 225 (7.4%) in IDC; preferential sites of first distant relapses were similar in both histotypes. Contralateral and second tumors were 9 (2%) and 22 (5%) in ILC vs 84 (2.8%) and 174 (5.7%) in IDC. Median time to first event was 38.3 ms in ILC vs 35.23 in IDC. PPS was 16.5 ms (0-100) in ILC compared to 22.2 (0-187) in IDC. Prognosis in term of OS was consistently worse for ILC pts, compared to IDC, when considering the luminal A (86.9 vs 93.5%; p=0.003), luminal C (70.4 vs 88.5%; p=0.028) and in triple negative subgroups (50 vs 73.1%; p=0.021). No difference in OS was seen for age, size, hormonal and nodal status, except in N>3 ILC pts, in whom a trend of worse prognosis (55.6 vs 60.2%) was observed. Conclusions: ILC pts did not show in our series a better outcome than IDC pts, despite a quite favorable biological pattern.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
