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Invasive lobular carcinoma of the breast: response to hormonal therapy and outcomes.
Eur J Cancer. 2008 Jan; 44(1):73-83.EJ

Abstract

Invasive lobular carcinoma (ILC) comprises approximately 5-15% of breast cancers and appears to have a distinct biology. It is less common than invasive ductal carcinoma (IDC) and few large studies have addressed its biologic characteristics and behaviour with respect to long-term clinical outcome and response to adjuvant therapy.

METHODS

This study is based on a large and well-characterised consecutive series of invasive breast carcinomas with a long-term follow-up (up to 25 years). This series included 415 (8%) patients with pure ILC and 2901 (55.7%) with IDC (not otherwise specified) identified from a consecutive cohort of 5680 breast tumours presented to our Breast Unit that were treated in a similar conventional manner. Clinicopathological, therapy and outcome information as well as data on a large panel of biomarkers were available.

RESULTS

Compared to IDC, patients with ILC tended to be older and present with tumours which are more frequently lower grade (typically, grade 2 [84%]), hormone-receptor positive (86% compared to 61% in IDC), of larger size, and with the absence of vascular invasion. A higher frequency of ILC was placed in the good Nottingham Prognostic Index group (40% compared to 21% in IDC). ILC showed indolent but progressive behavioural characteristics with nearly linear survival curves which crossed those of IDC after approximately 10years of follow-up, thus eventually exhibiting a worse long-term outcome. Importantly, ILC showed a better response to adjuvant hormonal therapy (HT) with improvement in survival in patients who received HT compared with matched patients with IDC.

CONCLUSION

ILC is a distinct entity of breast cancer that responds well to adjuvant HT. These data add important clinical information for assessing the long-term benefits of adjuvant HT use in ILC.

Authors+Show Affiliations

Department of Histopathology, School of Molecular Medical Sciences, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18035533

Citation

Rakha, Emad A., et al. "Invasive Lobular Carcinoma of the Breast: Response to Hormonal Therapy and Outcomes." European Journal of Cancer (Oxford, England : 1990), vol. 44, no. 1, 2008, pp. 73-83.
Rakha EA, El-Sayed ME, Powe DG, et al. Invasive lobular carcinoma of the breast: response to hormonal therapy and outcomes. Eur J Cancer. 2008;44(1):73-83.
Rakha, E. A., El-Sayed, M. E., Powe, D. G., Green, A. R., Habashy, H., Grainge, M. J., Robertson, J. F., Blamey, R., Gee, J., Nicholson, R. I., Lee, A. H., & Ellis, I. O. (2008). Invasive lobular carcinoma of the breast: response to hormonal therapy and outcomes. European Journal of Cancer (Oxford, England : 1990), 44(1), 73-83.
Rakha EA, et al. Invasive Lobular Carcinoma of the Breast: Response to Hormonal Therapy and Outcomes. Eur J Cancer. 2008;44(1):73-83. PubMed PMID: 18035533.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Invasive lobular carcinoma of the breast: response to hormonal therapy and outcomes. AU - Rakha,Emad A, AU - El-Sayed,Maysa E, AU - Powe,Desmond G, AU - Green,Andrew R, AU - Habashy,Hany, AU - Grainge,Matthew J, AU - Robertson,John F R, AU - Blamey,Roger, AU - Gee,Julia, AU - Nicholson,Robert I, AU - Lee,Andrew H S, AU - Ellis,Ian O, Y1 - 2007/11/26/ PY - 2007/07/01/received PY - 2007/09/05/revised PY - 2007/10/09/accepted PY - 2007/11/24/pubmed PY - 2008/4/15/medline PY - 2007/11/24/entrez SP - 73 EP - 83 JF - European journal of cancer (Oxford, England : 1990) JO - Eur. J. Cancer VL - 44 IS - 1 N2 - UNLABELLED: Invasive lobular carcinoma (ILC) comprises approximately 5-15% of breast cancers and appears to have a distinct biology. It is less common than invasive ductal carcinoma (IDC) and few large studies have addressed its biologic characteristics and behaviour with respect to long-term clinical outcome and response to adjuvant therapy. METHODS: This study is based on a large and well-characterised consecutive series of invasive breast carcinomas with a long-term follow-up (up to 25 years). This series included 415 (8%) patients with pure ILC and 2901 (55.7%) with IDC (not otherwise specified) identified from a consecutive cohort of 5680 breast tumours presented to our Breast Unit that were treated in a similar conventional manner. Clinicopathological, therapy and outcome information as well as data on a large panel of biomarkers were available. RESULTS: Compared to IDC, patients with ILC tended to be older and present with tumours which are more frequently lower grade (typically, grade 2 [84%]), hormone-receptor positive (86% compared to 61% in IDC), of larger size, and with the absence of vascular invasion. A higher frequency of ILC was placed in the good Nottingham Prognostic Index group (40% compared to 21% in IDC). ILC showed indolent but progressive behavioural characteristics with nearly linear survival curves which crossed those of IDC after approximately 10years of follow-up, thus eventually exhibiting a worse long-term outcome. Importantly, ILC showed a better response to adjuvant hormonal therapy (HT) with improvement in survival in patients who received HT compared with matched patients with IDC. CONCLUSION: ILC is a distinct entity of breast cancer that responds well to adjuvant HT. These data add important clinical information for assessing the long-term benefits of adjuvant HT use in ILC. SN - 0959-8049 UR - https://www.unboundmedicine.com/medline/citation/18035533/Invasive_lobular_carcinoma_of_the_breast:_response_to_hormonal_therapy_and_outcomes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-8049(07)00804-0 DB - PRIME DP - Unbound Medicine ER -