Clinicopathological Features and Outcomes Comparing Patients With Invasive Ductal and Lobular Breast Cancer.
Journal
Journal of the National Cancer Institute
ISSN: 1460-2105
Titre abrégé: J Natl Cancer Inst
Pays: United States
ID NLM: 7503089
Informations de publication
Date de publication:
14 11 2022
14 11 2022
Historique:
received:
07
02
2022
revised:
16
06
2022
accepted:
03
08
2022
pubmed:
15
10
2022
medline:
18
11
2022
entrez:
14
10
2022
Statut:
ppublish
Résumé
There is increasing interest in better understanding the biology and clinical presentation of invasive lobular cancer (ILC), which is the most common special histological subtype of breast cancer. Limited large contemporary data sets are available allowing comparison of clinicopathologic features between ILC and invasive ductal cancer (IDC). The Great Lakes Breast Cancer Consortium was formed to compare clinical behavior of ILC (n = 3617) and IDC (n = 30 045) from 33 662 patients treated between 1990 and 2017 at 3 large clinical centers. We used Kaplan-Meier analysis, Cox proportional hazards modeling, and propensity score matching to evaluate treatment differences and outcomes. All statistical testing used 2-sided P values. Compared with IDC, patients with ILC were more frequently diagnosed at later stages and with more lymph node involvement (corrected P < .001). Estrogen receptor-positive ILCs were of lower grade (grade 1 and 2: 90% in ILC vs 72% in IDC) but larger in size (T3 and 4: 14.3% in ILC vs 3.4% in IDC) (corrected P < .001), and since 1990, the mean ILC size detected at diagnosis increased yearly. Patients with estrogen receptor (ER)-positive ILC underwent statistically significantly more mastectomies compared with ER-positive IDC (57% vs 46%). Using Kaplan-Meier analysis, patients with ER-positive ILC had statistically significantly worse disease-free survival and overall survival than ER-positive IDC although 6 times more IDCs were classified as high risk by OncotypeDx Breast Recurrence Score assay. This large, retrospective, collaborative analysis with 3 clinical centers identified meaningful differences in clinicopathological features between ILC and IDC, providing further evidence that these are 2 different entities requiring different clinical management.
Sections du résumé
BACKGROUND
There is increasing interest in better understanding the biology and clinical presentation of invasive lobular cancer (ILC), which is the most common special histological subtype of breast cancer. Limited large contemporary data sets are available allowing comparison of clinicopathologic features between ILC and invasive ductal cancer (IDC).
METHODS
The Great Lakes Breast Cancer Consortium was formed to compare clinical behavior of ILC (n = 3617) and IDC (n = 30 045) from 33 662 patients treated between 1990 and 2017 at 3 large clinical centers. We used Kaplan-Meier analysis, Cox proportional hazards modeling, and propensity score matching to evaluate treatment differences and outcomes. All statistical testing used 2-sided P values.
RESULTS
Compared with IDC, patients with ILC were more frequently diagnosed at later stages and with more lymph node involvement (corrected P < .001). Estrogen receptor-positive ILCs were of lower grade (grade 1 and 2: 90% in ILC vs 72% in IDC) but larger in size (T3 and 4: 14.3% in ILC vs 3.4% in IDC) (corrected P < .001), and since 1990, the mean ILC size detected at diagnosis increased yearly. Patients with estrogen receptor (ER)-positive ILC underwent statistically significantly more mastectomies compared with ER-positive IDC (57% vs 46%). Using Kaplan-Meier analysis, patients with ER-positive ILC had statistically significantly worse disease-free survival and overall survival than ER-positive IDC although 6 times more IDCs were classified as high risk by OncotypeDx Breast Recurrence Score assay.
CONCLUSIONS
This large, retrospective, collaborative analysis with 3 clinical centers identified meaningful differences in clinicopathological features between ILC and IDC, providing further evidence that these are 2 different entities requiring different clinical management.
Identifiants
pubmed: 36239760
pii: 6758318
doi: 10.1093/jnci/djac157
pmc: PMC9664185
doi:
Substances chimiques
Receptors, Estrogen
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1511-1522Subventions
Organisme : NCI NIH HHS
ID : F30 CA264963
Pays : United States
Organisme : Susan G. Komen
Pays : United States
Organisme : NIH HHS
ID : NCI P30CA047904
Pays : United States
Organisme : NCI NIH HHS
ID : NCI P30CA016058
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Références
Mod Pathol. 2021 Jul;34(7):1282-1296
pubmed: 33753865
Geburtshilfe Frauenheilkd. 2017 Jun;77(6):660-666
pubmed: 28757653
Ann Surg Oncol. 2020 Nov;27(12):4711-4719
pubmed: 32725525
Cancers (Basel). 2021 Jul 22;13(15):
pubmed: 34359596
Ann Oncol. 2019 Jan 1;30(1):115-123
pubmed: 30423024
Surg Oncol Clin N Am. 2018 Jan;27(1):81-94
pubmed: 29132567
J Clin Oncol. 2005 Jan 1;23(1):41-8
pubmed: 15625359
Breast Cancer Res Treat. 2015 Apr;150(2):447-55
pubmed: 25773929
Breast. 2021 Oct;59:94-101
pubmed: 34217971
J Clin Oncol. 2016 Jun 1;34(16):1872-81
pubmed: 26926684
Semin Oncol. 2019 Apr;46(2):121-132
pubmed: 31239068
NPJ Breast Cancer. 2021 Dec 21;7(1):156
pubmed: 34934058
Clin Cancer Res. 2020 Sep 1;26(17):4682-4687
pubmed: 32561662
Breast Cancer Res. 2021 Jan 7;23(1):6
pubmed: 33413533
Breast Cancer Res Treat. 2022 Jan;191(2):401-407
pubmed: 34716509
NPJ Breast Cancer. 2022 Jan 13;8(1):4
pubmed: 35027533
Breast Cancer Res. 2004;6(3):R149-56
pubmed: 15084238
Biomark Insights. 2016 Dec 11;11:139-146
pubmed: 27980389
Oncologist. 2021 Jun;26(6):e943-e953
pubmed: 33641217
Semin Cancer Biol. 2017 Jun;44:98-105
pubmed: 28400203
Clin Cancer Res. 2021 Oct 15;27(20):5688-5696
pubmed: 34376532
Clin Breast Cancer. 2020 Aug;20(4):e423-e432
pubmed: 32253134
Genome Med. 2015 Feb 02;7(1):20
pubmed: 25722745
Histopathology. 2015 Feb;66(3):409-19
pubmed: 25283075
NPJ Breast Cancer. 2019 Jun 27;5:18
pubmed: 31263747
Br J Cancer. 2013 Feb 5;108(2):285-91
pubmed: 23299541
Breast Cancer Res. 2020 Aug 11;22(1):85
pubmed: 32782013
Cancer. 2017 Aug 15;123(16):3015-3021
pubmed: 28382636
Breast. 2011 Oct;20 Suppl 3:S153-7
pubmed: 22015285
Breast Cancer Res. 2015 Feb 08;17:16
pubmed: 25757734
Ann Oncol. 2013 Feb;24(2):377-384
pubmed: 23028037
Oncotarget. 2017 Jul 19;8(43):74287-74298
pubmed: 29088785
Br J Cancer. 2005 Oct 31;93(9):1046-52
pubmed: 16175185
Breast Cancer Res Treat. 2017 Oct;165(3):757-763
pubmed: 28647915
Cancer. 2020 Nov 15;126(22):4847-4858
pubmed: 32780421
PLoS One. 2017 Sep 1;12(9):e0182397
pubmed: 28863134
Ann Oncol. 2022 Aug;33(8):769-785
pubmed: 35605746
J Clin Oncol. 2008 Jun 20;26(18):3006-14
pubmed: 18458044
BMC Cancer. 2016 Mar 25;16:248
pubmed: 27015895
Cancers (Basel). 2019 Jan 11;11(1):
pubmed: 30641862
Front Oncol. 2020 Dec 22;10:590643
pubmed: 33415073
Clin Cancer Res. 2013 May 15;19(10):2668-76
pubmed: 23575477
JAMA. 2003 Mar 19;289(11):1421-4
pubmed: 12636465
Cell. 2015 Oct 8;163(2):506-19
pubmed: 26451490
Nature. 2012 Apr 18;486(7403):346-52
pubmed: 22522925