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Invasive ductal carcinoma with lobular features: a comparison study to invasive ductal and invasive lobular carcinomas of the breast

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Abstract

Invasive ductal carcinoma with lobular features (IDC-L) is not recognized as a distinct subtype of breast cancer, and its clinicopathologic features and outcomes are unknown. In this retrospective study, we focused on characterization of clinicopathologic features and outcomes of IDC-L and compared them to invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC). 183 cases of IDC-L from 1996 to 2011 were compared with 1,499 cases of IDC and 375 cases of ILC. Available slides of IDC-L (n = 150) were reviewed to quantify the lobular component (≤20, 21–50, 51–80, >80 %), defined as small cells individually dispersed, arranged in linear cords, or in loose aggregates without the formation of tubules or cohesive nests. E-cadherin immunostain was performed to confirm ductal origin. Compared to IDC, IDC-L was more likely to have lower histologic grade (p < 0.001), be positive for estrogen receptor (96 vs. 70 %; p < 0.0001) and progesterone receptor (84 vs. 57 %; p < 0.0001), and less likely to overexpress HER-2/neu (12 vs. 23 %; p = 0.001). Despite these favorable prognostic features, IDC-L had a higher frequency of nodal metastases (51 vs. 34 %; p < 0.0001) and a worse 5-year disease-free survival than IDC (hazard ratio = 0.454; p = 0.0004). ILC and IDC-L had similar clinicopathologic features and outcomes. The proportion of the lobular component in IDC-L had no impact on the size, nodal status, stage, or outcome. Our data suggest that although IDC-L may be a variant of IDC, with >90 % of cases being E-cadherin positive, the clinical and biological characteristics are more similar to that of ILC.

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Acknowledgments

The authors gratefully acknowledge the UMHS Cancer Center Research Histology & Immunoperoxidase Lab for performing the E-cadherin immunostains and Steven C. Smith, M.D., Ph.D. for his assistance in the preparation of Fig. 2.

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The authors have no disclosures or conflict of interest.

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Authors and Affiliations

  1. Department of Pathology, University of Michigan Health System, 1500 E. Medical Center Dr., 2G340, Ann Arbor, MI, 48109, USA

    David P. Arps, Celina G. Kleer & Judy C. Pang

  2. Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA

    Patrick Healy & Lili Zhao

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  1. David P. Arps
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  2. Patrick Healy
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  3. Lili Zhao
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  4. Celina G. Kleer
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  5. Judy C. Pang
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Correspondence to Judy C. Pang.

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Arps, D.P., Healy, P., Zhao, L. et al. Invasive ductal carcinoma with lobular features: a comparison study to invasive ductal and invasive lobular carcinomas of the breast. Breast Cancer Res Treat 138, 719–726 (2013). https://doi.org/10.1007/s10549-013-2493-2

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  • DOI: https://doi.org/10.1007/s10549-013-2493-2

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