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Infiltrating lobular carcinoma of the breast: tumor
characteristics and clinical outcome
Grazia Arpino, Valerie J. Bardou, Gary M. Clark, and Richard M. Elledge
Introduction: Invasive lobular carcinoma (ILC) comprises
approximately 10% of breast cancers and appears to have
a distinct biology. Because it is less common than infiltrating
ductal carcinoma (IDC), few data have been reported that
address the biologic features of ILC in the context of
their clinical outcome.
In the present study we undertook
an extensive comparison of ILC and IDC using a large database
to provide a more complete and reliable assessment of
their biologic phenotypes and clinical behaviors.
Results: In comparison with IDC, ILC was significantly more likely
to occur in older patients, to be larger in size, to be
estrogen and progesterone receptor positive, to have lower
S-phase fraction, to be diploid, and to be HER-2, p53,
and epidermal growth factor receptor negative.
It was
more common for ILC than for IDC to metastasize to the
gastrointestinal tract and ovary. The incidence of contralateral
breast cancer was higher for ILC patients than for IDC
patients (20.9% versus 11.2%; P < 0.0001).
Breast preservation
was modestly less frequent in ILC patients than in IDC
patients. The 5-year disease-free survival was 85.7% for
ILC and 83.5% for IDC (P = 0.13).
The 5-year overall survival
was 85.6% for ILC and 84.1% for IDC (P = 0.64).
Conclusion: Despite the fact that the biologic phenotype of ILC is
quite favorable, these patients do not have better clinical
outcomes than do patients with IDC.
At present, management
decisions should be based on individual patient and tumor
biologic characteristics, and not on lobular histology.
Breast Cancer Res 2004, 6:R149-R156 (DOI 10.1186/bcr767)
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