Absence of lobular carcinoma in situ is a poor prognostic marker in invasive lobular carcinoma.

To determine if the outcomes of patients with ILC co-occurring with LCIS are similar to pure ILC and if the presence of LCIS is a prognostic factor for ILC. In an observational, population-based investigation using data from the MD Anderson breast cancer prospectively collected electronic database, we analysed patients with a diagnosis of stage I-III ILC. Patients were divided into two groups: those with ILC with co-occurring ipsilateral LCIS (ILC + LCIS) and those with pure ILC without a histologically detected co-occurring ipsilateral LCIS (ILC alone). We obtained data on demographics, pathologic tumour size (pT), pathologic lymph node (pN) involvement, estrogen (ER), progesterone (PR) receptor status, HER2 status, Ki67, treatment received, distant recurrence-free and overall survival (DRFS, OS). We identified 4217 patients with stage I-III ILC treated at MD Anderson between 1966 and 2021. 45% of cases (n = 1881) had co-existing LCIS. Statistically and numerically, ILC alone tended to associate with pT4 and pN3 stage (P < 0.001), ER/PR negativity (P = 0.0002), HER2 positivity (P = 0.010), higher Ki67 (P = 0.005), non-classical ILC subtype (P = 0.04) and more exposure to neoadjuvant chemotherapy (P = 0.0002) compared to the ILC + LCIS group. The median follow-up time was 6.5 years. Patients with ILC + LCIS had better median DRFS (16.8 versus 10.1 years, Hazard ratio [HR] 0.55, 95% confidence interval [CI] 0.50-0.60, P < 0.0001) and better median OS (18.9 versus 13.7 years, HR 0.62, 95% CI 0.56-0.69; P < 0.0001). Multivariate analysis showed the absence of LCIS to be an independent poor prognostic factor along with a higher pT stage and higher pN stage for DRFS and OS. The findings of this study suggests that the absence of ipsilateral LCIS with ILC is an independent poor prognostic factor and that further studies are warranted to understand this phenomenon.

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Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Jason A. Mouabbi: Consulting fees from GE Healthcare, Genentech, BostonGene, and Cardinal Health. Gabriel Hortobagyi: Consultant to AstraZeneca, Blueprint Medicines, Novartis and Seagen. Amy Hassan: Consulting fees for AIM Specialty Health, Oncology Pathways Program. Debasish Tripathy: Research support from Novartis and Pfizer. Consulting fees from Novartis, Pfizer, and AstraZeneca. Rachel M. Layman: Research support from Pfizer, Eli Lilly, Novartis, Pfizer, Puma, Zentalis, and Celcuity. Consulting fees from Pfizer, Eli Lilly, Novartis, and Celcuity. The following authors: Akshara Singareeka Raghavendra, Roland L. Bassett, Jr, Matthias Christgen, Azadeh Nasrazadani, Lavinia Middleton, Mediget Teshome have no conflict of interest to declare.