Invasive Lobular vs. Ductal Breast Cancer: A Stage-Matched Comparison of Outcomes
- 17 February 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in Annals of Surgical Oncology
- Vol. 17 (7), 1862-1869
- https://doi.org/10.1245/s10434-010-0953-z
Abstract
Invasive lobular breast cancer (ILC) is less common than invasive ductal breast cancer (IDC), more difficult to detect mammographically, and usually diagnosed at a later stage. Does delayed diagnosis of ILC affect survival? We used a national registry to compare outcomes of patients with stage-matched ILC and IDC.Query of the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) tumor registry identified 263,408 women diagnosed with IDC or ILC between 1993 and 2003. Survival of patients matched by T and N stage was compared using Kaplan-Meier curves and log-rank analysis.When compared with IDC, ILC was more likely to be >2 cm (43.1 vs. 32.6%; P < 0.001), lymph node positive (36.8 vs. 34.4%; P < 0.001), and ER positive (93.1 vs. 75.6%; P < 0.001). The 5-year disease-specific survival (DSS) was significantly better for patients with ILC than for those with IDC, before (90 vs. 88%; P < 0.001) and after matching for stage T1N0 (98 vs. 96%; P < 0.001), T2N0 (94 vs. 88%; P < 0.001), and T3N0 (92 vs. 83%, P < 0.001). The 5-year DSS for patients with nodal metastasis of ILC vs. IDC was 89% vs. 88% (P = NS) for stage T1N1, 81 vs. 73% (P < 0.001) for T2N1, and 72 vs. 56% (P < 0.001) for T3N1. Multivariate analysis identified a 14% survival benefit for ILC (hazard ratio 0.86, 95% confidence interval 0.80-0.92).Stage-matched prognosis is better for patients with ILC than for those with IDC. Our findings support a different biology for ILC and are important for counseling and risk stratification.Keywords
This publication has 31 references indexed in Scilit:
- Invasive Lobular Carcinoma Classic Type: Response to Primary Chemotherapy and Survival OutcomesJournal of Clinical Oncology, 2005
- Infiltrating lobular carcinoma—a comparison of diagnosis, management and outcome with infiltrating duct carcinomaThe Breast, 2004
- Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcomeBreast Cancer Research, 2004
- E-cadherin and loss of heterozygosity at chromosome 16 in breast carcinogenesis: different genetic pathways in ductal and lobular breast cancer?Breast Cancer Research, 2001
- Changing incidence rate of invasive lobular breast carcinoma among older womenCancer, 2000
- Simultaneous loss of E-cadherin and catenins in invasive lobular breast cancer and lobular carcinomain situThe Journal of Pathology, 1997
- Invasive lobular carcinoma of the breast: mammographic findings and extent of disease at diagnosis in 184 patients.American Journal of Roentgenology, 1993
- Mammographic features of 455 invasive lobular carcinomas.Radiology, 1992
- Invasive lobular carcinoma of the breast: incidence and variantsHistopathology, 1979
- The pathology of invasive breast cancerA Syllabus Derived from Findings of the National Surgical Adjuvant Breast Project (Protocol No. 4)Cancer, 1975