Archives of Gynecology and Obstetrics

, Volume 279, Issue 1, pp 23–28

Survival analysis between patients with invasive ductal and invasive lobular breast cancer

  • Darius Dian
  • Hannes Herold
  • Ioannis Mylonas
  • Christoph Scholz
  • Wolfgang Janni
  • Harald Sommer
  • Klaus Friese
Original Article

Abstract

Objective

Differences in overall survival (OS) and disease-free survival (DFS) between patients with invasive ductal (IDC) and invasive lobular breast cancer (ILC) are controversial.

Study design

The study population was selected from a database of 5,689 female patients with invasive breast cancer. In order to focus on the impact of tumour histology, all primary metastatic patients and patients with adjuvant chemotherapy or anti-hormonal treatment were excluded. Only patients with pure invasive lobular and invasive ductal histology were included.

Results

Multivariate survival analyses of 2,058 eligible patients confirmed tumour histology as an independent prognostic factor for OS in invasive breast cancer (p = 0.046) but not for DFS (p = 0.599). Kaplan–Meier survival analysis of OS between IDC and ILC patients showed a statistically significantly better OS for patients with ILC (p = 0.0302). DFS was not statistically different (p = 0.6659) between IDC and ILC. Univariate survival analyses of tumour size, tumour grading and nodal status in our study population were highly statistically significant for OS and DFS (p < 0.0000).

Conclusion

Patients in our study population with ILC have significantly better OS than patients with IDC. Differences in DFS are not statistically significant.

Keywords

Breast cancer Ductal Lobular Survival 

References

  1. 1.
    Li CI, Anderson BO, Daling JR, Moe RE (2003) Trends in incidence rates of invasive lobular and ductal breast carcinoma. JAMA 289:1421–1424PubMedCrossRefGoogle Scholar
  2. 2.
    Martinez V, Azzopardi JG (1979) Invasive lobular carcinoma of the breast: incidence and variants. Histopathology 3:467–488PubMedCrossRefGoogle Scholar
  3. 3.
    Veronesi U, Salvadori B, Luini A, Banfi A, Zucali R, Del Vecchio M, Saccozzi R, Beretta E, Boracchi P, Farante G et al (1990) Conservative treatment of early breast cancer, long-term results of 1,232 cases treated with quadrantectomy, axillary dissection, and radiotherapy. Ann Surg 221:250–259Google Scholar
  4. 4.
    Sastre-Garau X, Jouve M, Asselain B, Vincent-Salomon A, Beuzeboc P, Dorval T, Durand JC, Fourquet A, Pouillart P (1996) Infiltrating lobular carcinoma of the breast clinicopathologic analysis of 975 cases with reference to data on conservative therapy and metastatic patterns. Cancer 77(1):113–120PubMedCrossRefGoogle Scholar
  5. 5.
    Verkooijen HM, Fioretta G, Vlastos G, Morabia A, Schubert H, Sappino AP, Pelte MF, Schafer P, Kurtz J, Bouchardy C (2003) Important increase of invasive lobular breast cancer incidence in Geneva, Switzerland. Int J Cancer 104(6):778–781PubMedCrossRefGoogle Scholar
  6. 6.
    Daling JR, Malone KE, Doody DR, Voigt LF, Bernstein L, Coates RJ, Marchbanks PA, Norman SA, Weiss LK, Ursin G et al (2002) Relation of regimens of combined hormone replacement therapy to lobular, ductal, and other histologic types of breast carcinoma. Cancer 95(12):2455–2464PubMedCrossRefGoogle Scholar
  7. 7.
    Silverstein MJ, Lewinsky BS, Waisman JR, Gierson ED, Colburn WJ, Senofsky GM, Gamagami P (1994) Infiltrating lobular carcinoma. Is it different from infiltrating duct carcinoma? Cancer 73:1673–1677PubMedCrossRefGoogle Scholar
  8. 8.
    Kurtz JM, Jaquemier J, Torhorst J, Spitalier JM, Amalric R, Hunig R, Walther E, Harder F, Almendra A, Brandone H et al (1989) Conservative therapy for breast cancers other than infiltrating duct carcinoma. Cancer 63(8):1630–1635PubMedCrossRefGoogle Scholar
  9. 9.
    Mate TP, Carter D, Fischer DB, Hartman PV, McKhann C, Merino M, Prosnitz LR, Weissberg JB (1986) A clinical and histopathologic analysis of the results of conservation surgery and radiation therapy in stage I and II breast carcinoma. Cancer 58:1995–2002PubMedCrossRefGoogle Scholar
  10. 10.
    Korkolis DP, Tsoli E, Fouskakis D, Yiotis J, Koullias GJ, Giannapopoulos D, Papalambros E, Nikiteas NI, Spiliopoulou CA, Patsouris E, Asimacopoulos P, Gorgoulis VG (2004) Tumor histology and stage but not p53, Her2-neu or cathepsin-D expression are independent prognostic factors in breast cancer. Anticancer Res 24(3b):2061–2068Google Scholar
  11. 11.
    Li CI, Moe RE, Daling JR (2003) Risk of mortality by histologic type of breast cancer among women aged 50 to 79 years. Arch Intern Med 163(18):2149–2153PubMedCrossRefGoogle Scholar
  12. 12.
    Fondrinier E, Guerin O, Lorimier G (1997) A comparison of metastatic patterns of invasive ductal and lobular carcinomas of the breast: result of a matched study. Bull Cancer 84:1101–1107PubMedGoogle Scholar
  13. 13.
    Winchester DJ, Mencj HR, Winchester DP (1997) The National Cancer Data Base Report on the results of a large non-randomised comparison of breast preservation and modified radical mastectomy. Cancer 80:162–167PubMedCrossRefGoogle Scholar
  14. 14.
    Salvadori B, Biganzoli E, Veronesi P, Saccozzi R, Rilke F (1997) Conservative surgery for infiltrating lobular breast carcinoma. Br J Surg 84:106–109PubMedCrossRefGoogle Scholar
  15. 15.
    Chung MA, Cole B, Wanebo HJ, Bland KI, Chang HR (1997) Optimal surgical treatment of invasive lobular carcinoma. Ann Surg Oncol 4(7):545–550PubMedCrossRefGoogle Scholar
  16. 16.
    Arpino G, Bardou V, Clark GM, Elledge RM (2004) Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome. Breast Cancer Res 6(3):R149–R156PubMedCrossRefGoogle Scholar
  17. 17.
    Molland JG, Donnellan M, Janu NC, Carmalt HL, Kenneddy CW, Gillett DJ (2004) Infiltrating lobular carcinoma—a comparison of diagnosis, management and outcome with infiltrating duct carcinoma. Breast 13:389–396PubMedCrossRefGoogle Scholar
  18. 18.
    Korhonen T, Huhtala K, Holli K (2004) A comparison of the biological and clinical features of invasive lobular and ductal carcinomas of the breast. Breast Cancer Res Treat 85:23–29PubMedCrossRefGoogle Scholar
  19. 19.
    Santiago RJ, Harris EE, Quin L, Hwang WT, Solin LJ (2005) Similar long-term results of breast-conservation treatment for stage I and II invasive lobular carcinoma compared with invasive ductal carcinoma of the breast: the University of Pennsylvania experience. Cancer 103(12):2447–2454PubMedCrossRefGoogle Scholar
  20. 20.
    Mersin H, Yildrim E, Gulben K, Berberoglou U (2003) Is invasive lobular carcinoma different from invasive ductal carcinoma? Eur J Surg Oncol 29(4):390–395PubMedCrossRefGoogle Scholar
  21. 21.
    du Toit RS, Locker AP, Ellis IO, Elston CW, Nicholson RI, Robertson JF, Blamey RW (1992) An evaluation of difference in prognosis, recurrence patterns and receptor status between invasive lobular and other invasive carcinomas of the breast. Eur J Surg Oncol 17:251–257Google Scholar
  22. 22.
    Kaplan EL, Meier P (1958) Nonparametric estimation for incomplete observations. J Am Stat Assoc 53:457–481CrossRefGoogle Scholar
  23. 23.
    Peiro G, Bornstein BA, Connolly JL, Gelman R, Heteledekidis S, Nixon AJ, Recht A, Silver B, Harris JR, Schnitt SJ (2000) The influence of infiltrating lobular carcinoma on the outcome of patients treated with breast-conserving surgery and radiation therapy. Breast Cancer Res Treat 59:49–54PubMedCrossRefGoogle Scholar
  24. 24.
    Cristofanilli M, Gonzalez-Angulo A, Sneige N, Kau SW, Broglio K, Theriault RL, Valero V, Buzdar AU, Kuerer H, Buccholz TA, Hortobagyi GN (2005) Invasive lobular carcinoma classic type: response to primary chemotherapy and survival outcomes. J Clin Oncol 23:41–48PubMedCrossRefGoogle Scholar
  25. 25.
    Coquyt VF, Blondeel PN, Depypere HT, Praet MM, Schelfhout VR, Silva OE, Hurley J, Serreyn RF, Daems KK, Van Belle SJ (2003) Different responses to preoperative chemotherapy for invasive lobular and invasive ductal carcinoma. Eur J Surg Oncol 29:361–367CrossRefGoogle Scholar
  26. 26.
    Li Cl, Uribe DJ, Daling JR (2005) Clinical characteristics of different histologic types of breast cancer. Br J Cancer 93(9):1046–1052PubMedCrossRefGoogle Scholar
  27. 27.
    Jalava P, Kuopio T, Huovinen R, Laine J, Collan Y (2005) Immunohistochemical staining of estrogen and progesterone receptors: aspects for evaluating positivity and defining the cutpoints. Anticancer Res 25(3c):35–42Google Scholar
  28. 28.
    Ariga R, Zarif A, Korasick J, Reddy V, Siziopikou K, Gattuso P (2005) Correlation of her–2/neu gene amplification with other prognostic and predictive factors in female breast carcinoma. Breast J 11(4):278–280PubMedCrossRefGoogle Scholar
  29. 29.
    Rosenthal SI, Depowski PL, Sheehan CE, Ross JS (2002) Comparison of HER-2/neu oncogene amplification detected by fluorescence in situ hybridization in lobular and ductal breast cancer. Appl Immunohistochem Mol Morphol 10(1):40–46PubMedCrossRefGoogle Scholar
  30. 30.
    Cellini C, Houston TL, Martins D, Christos P, Carson J, Kemper S, Simmons RM (2005) Multiple re-excisions versus mastectomy in patients with persistent residual disease following breast conservation surgery. Am J Surg 189(6):682–686CrossRefGoogle Scholar
  31. 31.
    Krecke KN, Gisvold JJ (1993) Invasive lobular carcinoma of the breast: mammographic findings and extent of disease at diagnosis in 184 patients. Am J Roentgenol 161:957–960Google Scholar
  32. 32.
    Le Gal M, Ollivier L, Asselain B, Meunier M, Laurent M, Vielh P, Neuenschwander S (1992) Mammographic features of 455 invasive lobular carcinomas. Radiology 185:705–708PubMedGoogle Scholar
  33. 33.
    Newcomer LM, Newcomb PA, Potter JD, Yasui Y, Trentham-Dietz A, Storer BE, Longnecker MP, Baron JA, Daling JR (2003) Postmenopausal hormone therapy and risk of breast cancer by histologic type (United States). Cancer Causes Control 14(3):225–233PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Darius Dian
    • 1
  • Hannes Herold
    • 1
  • Ioannis Mylonas
    • 1
  • Christoph Scholz
    • 1
  • Wolfgang Janni
    • 1
  • Harald Sommer
    • 1
  • Klaus Friese
    • 1
  1. 1.Department of Obstetrics and Gynaecology, I. Universitätsfrauenklinik, der LMUUniversity Hospital MunichMunichGermany

Personalised recommendations