Invasive Lobular Carcinoma Classic Type: Response to Primary Chemotherapy and Survival Outcomes
- 1 January 2005
- journal article
- clinical trial
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 23 (1), 41-48
- https://doi.org/10.1200/jco.2005.03.111
Abstract
To investigate the impact of histologic type invasive lobular carcinoma (ILC) versus invasive ductal carcinoma (IDC) on response to primary chemotherapy (PC) and long-term outcome. The study included 1,034 patients with stage II and III breast cancer who participated in six clinical trials of PC at our institution between 1985 and 2002. One hundred twenty-two patients (12%) had ILC and 912 (88%) had IDC. All patients received anthracycline-based PC, and 346 patients (33.5%) also received a taxane as part of PC. Pathologic complete response (pCR) was defined as no evidence of invasive disease in the breast and axillary lymph nodes. The median patient age was 48 years (range, 18 to 79 years). Patients with ILC tended to be older (median age, 53 years v 47 years for patients with IDC) and have more hormone-receptor–positive tumors (92% v 62%; P < .001), lower nuclear grade (nuclear grade 3, 16% v 56%; P < .001), and higher stage at diagnosis (10% v 0% with stage IIIB or IIIC disease; P < .001). Patients with ILC were less likely to have a pCR (3% v 15%; P < .001) and had a larger number of involved axillary lymph nodes (41% v 26% had > 3 involved nodes; P = .001). At a median follow-up time of 70 months, ILC patients tended to have longer recurrence-free survival (P = .004) and overall survival (P = .001). ILC is characterized by lower rates of pathologic response to PC but better long-term outcomes compared to IDC. pCR might not be a prognostic indicator for this group of patients.Keywords
This publication has 32 references indexed in Scilit:
- Technology updateBreast Cancer Research, 2002
- Infiltrating lobular carcinoma of the breast: Clinicopathologic analysis of 975 cases with reference to data on conservative therapy and metastatic patternsCancer, 1996
- Metastatic pattern of infiltrating lobular carcinoma of the breast: An autopsy studyJournal of Surgical Oncology, 1991
- Invasive lobular carcinomas of the breast – the prognosis of histopathological subtypesBritish Journal of Cancer, 1989
- A comparison of the metastatic pattern of infiltrating lobular carcinoma and infiltrating duct carcinoma of the breastBritish Journal of Cancer, 1984
- The World Health Organization Histological Typing of Breast Tumors—Second EditionAmerican Journal of Clinical Pathology, 1982
- Infiltrating lobular carcinoma of the breastHistopathology, 1982
- 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
- Histologic variants of infiltrating lobular carcinoma of the breastHuman Pathology, 1975