Mixed invasive ductal lobular carcinoma is clinically and pathologically more similar to invasive lobular than ductal carcinoma.
Journal
British journal of cancer
ISSN: 1532-1827
Titre abrégé: Br J Cancer
Pays: England
ID NLM: 0370635
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
received:
14
02
2022
accepted:
19
12
2022
revised:
02
12
2022
pmc-release:
05
01
2024
pubmed:
6
1
2023
medline:
15
3
2023
entrez:
5
1
2023
Statut:
ppublish
Résumé
Mixed invasive ductal lobular carcinoma (mDLC) remains a poorly understood subtype of breast cancer composed of coexisting ductal and lobular components. We sought to describe clinicopathologic characteristics and determine whether mDLC is clinically more similar to invasive ductal carcinoma (IDC) or invasive lobular carcinoma (ILC), using data from patients seen at the University of Pittsburgh Medical Center. We observed a higher concordance in clinicopathologic characteristics between mDLC and ILC, compared to IDC. There is a trend for higher rates of successful breast-conserving surgery after neoadjuvant chemotherapy in patients with mDLC compared to patients with ILC, in which it is known to be lower than in those with IDC. Metastatic patterns of mDLC demonstrate a propensity to develop in sites characteristic of both IDC and ILC. A meta-analysis evaluating mDLC showed shared features with both ILC and IDC with significantly more ER-positive and fewer high grades in mDLC compared to IDC, although mDLCs were significantly smaller and included fewer late-stage tumours compared to ILC. These findings support clinicopathologic characteristics of mDLC driven by individual ductal vs lobular components and given the dominance of lobular pathology, mDLC features are often more similar to ILC than IDC. This study exemplifies the complexity of mixed disease.
Sections du résumé
BACKGROUND
Mixed invasive ductal lobular carcinoma (mDLC) remains a poorly understood subtype of breast cancer composed of coexisting ductal and lobular components.
METHODS
We sought to describe clinicopathologic characteristics and determine whether mDLC is clinically more similar to invasive ductal carcinoma (IDC) or invasive lobular carcinoma (ILC), using data from patients seen at the University of Pittsburgh Medical Center.
RESULTS
We observed a higher concordance in clinicopathologic characteristics between mDLC and ILC, compared to IDC. There is a trend for higher rates of successful breast-conserving surgery after neoadjuvant chemotherapy in patients with mDLC compared to patients with ILC, in which it is known to be lower than in those with IDC. Metastatic patterns of mDLC demonstrate a propensity to develop in sites characteristic of both IDC and ILC. A meta-analysis evaluating mDLC showed shared features with both ILC and IDC with significantly more ER-positive and fewer high grades in mDLC compared to IDC, although mDLCs were significantly smaller and included fewer late-stage tumours compared to ILC.
CONCLUSIONS
These findings support clinicopathologic characteristics of mDLC driven by individual ductal vs lobular components and given the dominance of lobular pathology, mDLC features are often more similar to ILC than IDC. This study exemplifies the complexity of mixed disease.
Identifiants
pubmed: 36604587
doi: 10.1038/s41416-022-02131-8
pii: 10.1038/s41416-022-02131-8
pmc: PMC10006180
doi:
Types de publication
Meta-Analysis
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1030-1039Subventions
Organisme : NCI NIH HHS
ID : P30 CA047904
Pays : United States
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature Limited.
Références
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70:7–30.
doi: 10.3322/caac.21590
pubmed: 31912902
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.
doi: 10.3322/caac.21492
pubmed: 30207593
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–49.
American Cancer Society. Breast cancer facts & figures. Atlanta, GA: The Society. p.v.
Board WCoTE. WHO Classification of Breast Tumours: WHO Classification of Tumours, 2: World Health Organization; 2019.
Sinn HP, Kreipe H. A brief overview of the WHO Classification of Breast Tumors, 4th Edition, focusing on issues and updates from the 3rd edition. Breast Care (Basel). 2013;8:149–54.
doi: 10.1159/000350774
pubmed: 24415964
Dabbs DJ, Bhargava R, Chivukula M. Lobular versus ductal breast neoplasms: the diagnostic utility of p120 catenin. Am J Surg Pathol. 2007;31:427–37.
doi: 10.1097/01.pas.0000213386.63160.3f
pubmed: 17325485
Chen Z, Yang J, Li S, Lv M, Shen Y, Wang B, et al. Invasive lobular carcinoma of the breast: a special histological type compared with invasive ductal carcinoma. PLoS One. 2017;12:e0182397.
doi: 10.1371/journal.pone.0182397
pubmed: 28863134
pmcid: 5580913
Biglia N, Maggiorotto F, Liberale V, Bounous VE, Sgro LG, Pecchio S, et al. Clinical-pathologic features, long term-outcome and surgical treatment in a large series of patients with invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC). Eur J Surg Oncol. 2013;39:455–60.
doi: 10.1016/j.ejso.2013.02.007
pubmed: 23490334
Arpino G, Bardou VJ, Clark GM, Elledge RM. Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome. Breast Cancer Res. 2004;6:R149–56.
doi: 10.1186/bcr767
pubmed: 15084238
pmcid: 400666
Oesterreich S, Nasrazadani A, Zou J, Carleton N, Onger T, Wright MD, et al. Clinicopathological features and outcomes comparing patients with invasive ductal and lobular breast cancer. J Natl Cancer Inst. 2022;114:1511–22.
Lamovec J, Bracko M. Metastatic pattern of infiltrating lobular carcinoma of the breast: an autopsy study. J Surg Oncol. 1991;48:28–33.
doi: 10.1002/jso.2930480106
pubmed: 1653879
Mathew A, Rajagopal PS, Villgran V, Sandhu GS, Jankowitz RC, Jacob M, et al. Distinct pattern of metastases in patients with invasive lobular carcinoma of the breast. Geburtshilfe Frauenheilkd. 2017;77:660–6.
doi: 10.1055/s-0043-109374
pubmed: 28757653
pmcid: 5489406
Bharat A, Gao F, Margenthaler JA. Tumor characteristics and patient outcomes are similar between invasive lobular and mixed invasive ductal/lobular breast cancers but differ from pure invasive ductal breast cancers. Am J Surg. 2009;198:516–9.
doi: 10.1016/j.amjsurg.2009.06.005
pubmed: 19800459
Sastre-Garau X, Jouve M, Asselain B, Vincent-Salomon A, Beuzeboc P, Dorval T, et al. Infiltrating lobular carcinoma of the breast. Clinicopathologic analysis of 975 cases with reference to data on conservative therapy and metastatic patterns. Cancer. 1996;77:113–20.
doi: 10.1002/(SICI)1097-0142(19960101)77:1<113::AID-CNCR19>3.0.CO;2-8
pubmed: 8630916
Rakha EA, Gill MS, El-Sayed ME, Khan MM, Hodi Z, Blamey RW, et al. The biological and clinical characteristics of breast carcinoma with mixed ductal and lobular morphology. Breast Cancer Res Treat. 2009;114:243–50.
doi: 10.1007/s10549-008-0007-4
pubmed: 18404368
Xiao Y, Ma D, Ruan M, Zhao S, Liu XY, Jiang YZ, et al. Mixed invasive ductal and lobular carcinoma has distinct clinical features and predicts worse prognosis when stratified by estrogen receptor status. Sci Rep. 2017;7:10380.
doi: 10.1038/s41598-017-10789-x
pubmed: 28871133
pmcid: 5583173
Arps DP, Healy P, Zhao L, Kleer CG, Pang JC. Invasive ductal carcinoma with lobular features: a comparison study to invasive ductal and invasive lobular carcinomas of the breast. Breast Cancer Res Treat. 2013;138:719–26.
doi: 10.1007/s10549-013-2493-2
pubmed: 23535842
pmcid: 3906642
Duraker N, Hot S, Akan A, Nayir PO. A comparison of the clinicopathological features, metastasis sites and survival outcomes of invasive lobular, invasive ductal and mixed invasive ductal and lobular breast carcinoma. Eur J Breast Health. 2020;16:22–31.
doi: 10.5152/ejbh.2019.5004
pubmed: 31912010
pmcid: 6939713
Phipps AI, Li CI, Kerlikowske K, Barlow WE, Buist DS. Risk factors for ductal, lobular, and mixed ductal-lobular breast cancer in a screening population. Cancer Epidemiol Biomark Prev. 2010;19:1643–54.
doi: 10.1158/1055-9965.EPI-10-0188
Metzger-Filho O, Ferreira AR, Jeselsohn R, Barry WT, Dillon DA, Brock JE, et al. Mixed invasive ductal and lobular carcinoma of the breast: prognosis and the importance of histologic grade. Oncologist. 2019;24:e441–9.
doi: 10.1634/theoncologist.2018-0363
pubmed: 30518616
Suryadevara A, Paruchuri LP, Banisaeed N, Dunnington G, Rao KA. The clinical behavior of mixed ductal/lobular carcinoma of the breast: a clinicopathologic analysis. World J Surg Oncol. 2010;8:51.
doi: 10.1186/1477-7819-8-51
pubmed: 20565965
pmcid: 2904770
Tubiana-Hulin M, Stevens D, Lasry S, Guinebretiere JM, Bouita L, Cohen-Solal C, et al. Response to neoadjuvant chemotherapy in lobular and ductal breast carcinomas: a retrospective study on 860 patients from one institution. Ann Oncol. 2006;17:1228–33.
doi: 10.1093/annonc/mdl114
pubmed: 16740599
Truin W, Vugts G, Roumen RM, Maaskant-Braat AJ, Nieuwenhuijzen GA, van der Heiden-van der Loo M. et al. Differences in response and surgical management with neoadjuvant chemotherapy in invasive lobular versus ductal breast cancer. Ann Surg Oncol. 2016;23:51–7.
doi: 10.1245/s10434-015-4603-3
pubmed: 25980321
Petrelli F, Barni S. Response to neoadjuvant chemotherapy in ductal compared to lobular carcinoma of the breast: a meta-analysis of published trials including 1,764 lobular breast cancer. Breast Cancer Res Treat. 2013;142:227–35.
doi: 10.1007/s10549-013-2751-3
pubmed: 24177758
Friedman J, Hastie T, Tibshirani R. Regularization paths for generalized linear models via coordinate descent. J Stat Softw. 2010;33:1–22.
doi: 10.18637/jss.v033.i01
pubmed: 20808728
pmcid: 2929880
Viechtbauer W. Conducting meta-analyses in R with the metafor Package. J Stat Softw. 2010;36:1–48.
doi: 10.18637/jss.v036.i03
Lopez JK, Bassett LW. Invasive lobular carcinoma of the breast: spectrum of mammographic, US, and MR imaging findings. Radiographics. 2009;29:165–76.
doi: 10.1148/rg.291085100
pubmed: 19168843
Wenzel C, Bartsch R, Hussian D, Pluschnig U, Altorjai G, Zielinski CC, et al. Invasive ductal carcinoma and invasive lobular carcinoma of breast differ in response following neoadjuvant therapy with epidoxorubicin and docetaxel + G-CSF. Breast Cancer Res Treat. 2007;104:109–14.
doi: 10.1007/s10549-006-9397-3
pubmed: 17061042
Cocquyt VF, Blondeel PN, Depypere HT, Praet MM, Schelfhout VR, Silva OE, et al. Different responses to preoperative chemotherapy for invasive lobular and invasive ductal breast carcinoma. Eur J Surg Oncol. 2003;29:361–7.
doi: 10.1053/ejso.2002.1404
pubmed: 12711290
Pestalozzi BC, Zahrieh D, Mallon E, Gusterson BA, Price KN, Gelber RD, et al. Distinct clinical and prognostic features of infiltrating lobular carcinoma of the breast: combined results of 15 International Breast Cancer Study Group clinical trials. J Clin Oncol. 2008;26:3006–14.
doi: 10.1200/JCO.2007.14.9336
pubmed: 18458044
Adachi Y, Ishiguro J, Kotani H, Hisada T, Ichikawa M, Gondo N, et al. Comparison of clinical outcomes between luminal invasive ductal carcinoma and luminal invasive lobular carcinoma. BMC Cancer. 2016;16:248.
doi: 10.1186/s12885-016-2275-4
pubmed: 27015895
pmcid: 4807554
Dabbs DJ, editor. Breast pathology. 1st ed. Philadelphia, PA: Elsevier; 2012.
Rosen P, editor. Breast pathology. 3rd ed. United Kingdom: Wolters Kluwer Health; 2009.
Collins SJSaL, editor. Biopsy interpretation of the breast. 2nd ed. United States: Wolters Kluwer Health; 2009.
Lawton TJ, editor. Breast Cambridge illustrated surgical pathology. 1st ed. United Kingdom: Cambridge University Press; 2009.
Engstrom MJ, Opdahl S, Vatten LJ, Haugen OA, Bofin AM. Invasive lobular breast cancer: the prognostic impact of histopathological grade, E-cadherin and molecular subtypes. Histopathology. 2015;66:409–19.
doi: 10.1111/his.12572
pubmed: 25283075
Yang LY, Yang LP, Zhu B. Clinicopathological characteristics and survival outcomes of invasive lobular carcinoma in different races. Oncotarget. 2017;8:74287–98.
doi: 10.18632/oncotarget.19396
pubmed: 29088785
pmcid: 5650340
Weiser R, Polychronopoulou E, Hatch SS, Haque W, Ghani HA, He J, et al. Adjuvant chemotherapy in patients with invasive lobular carcinoma and use of the 21-gene recurrence score: A National Cancer Database analysis. Cancer. 2022;128:1738–47.
doi: 10.1002/cncr.34127
pubmed: 35137951
Felts JL, Zhu J, Han B, Smith SJ, Truica CI. An analysis of oncotype DX recurrence scores and clinicopathologic characteristics in invasive lobular breast cancer. Breast J. 2017;23:677–86.
doi: 10.1111/tbj.12751
pubmed: 28097781
Hanna MG, Bleiweiss IJ, Nayak A, Jaffer S. Correlation of oncotype DX recurrence score with histomorphology and immunohistochemistry in over 500 patients. Int J Breast Cancer. 2017;2017:1257078.
doi: 10.1155/2017/1257078
pubmed: 28168058
pmcid: 5266836
Wang J, He ZY, Dong Y, Sun JY, Zhang WW, Wu SG. The distribution and outcomes of the 21-gene recurrence score in T1-T2N0 estrogen receptor-positive breast cancer with different histologic subtypes. Front Genet. 2018;9:638.
doi: 10.3389/fgene.2018.00638
pubmed: 30619463
pmcid: 6304349