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Invasive lobular vs. ductal breast cancer: a stage-matched comparison of outcomes.
Ann Surg Oncol. 2010 Jul; 17(7):1862-9.AS

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

Authors+Show Affiliations

John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20162457

Citation

Wasif, Nabil, et al. "Invasive Lobular Vs. Ductal Breast Cancer: a Stage-matched Comparison of Outcomes." Annals of Surgical Oncology, vol. 17, no. 7, 2010, pp. 1862-9.
Wasif N, Maggard MA, Ko CY, et al. Invasive lobular vs. ductal breast cancer: a stage-matched comparison of outcomes. Ann Surg Oncol. 2010;17(7):1862-9.
Wasif, N., Maggard, M. A., Ko, C. Y., & Giuliano, A. E. (2010). Invasive lobular vs. ductal breast cancer: a stage-matched comparison of outcomes. Annals of Surgical Oncology, 17(7), 1862-9. https://doi.org/10.1245/s10434-010-0953-z
Wasif N, et al. Invasive Lobular Vs. Ductal Breast Cancer: a Stage-matched Comparison of Outcomes. Ann Surg Oncol. 2010;17(7):1862-9. PubMed PMID: 20162457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Invasive lobular vs. ductal breast cancer: a stage-matched comparison of outcomes. AU - Wasif,Nabil, AU - Maggard,Melinda A, AU - Ko,Clifford Y, AU - Giuliano,Armando E, Y1 - 2010/02/17/ PY - 2009/11/11/received PY - 2010/2/18/entrez PY - 2010/2/18/pubmed PY - 2010/9/30/medline SP - 1862 EP - 9 JF - Annals of surgical oncology JO - Ann. Surg. Oncol. VL - 17 IS - 7 N2 - BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. SN - 1534-4681 UR - https://www.unboundmedicine.com/medline/citation/20162457/Invasive_lobular_vs__ductal_breast_cancer:_a_stage_matched_comparison_of_outcomes_ L2 - https://dx.doi.org/10.1245/s10434-010-0953-z DB - PRIME DP - Unbound Medicine ER -