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Analysis of prognosis in different subtypes of invasive lobular carcinoma using the Japanese National Cancer Database-Breast Cancer Registry

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Abstract

Purpose

Many studies have shown that the prognosis of invasive lobular carcinoma (ILC) is better than that of invasive ductal carcinoma (IDC). However, both disorders exhibit different prognoses according to molecular subtype, and the prognosis of ILC subtypes might depend on their hormone receptor positivity rate. This study clarified the prognosis of ILC and IDC in each subtype and examined the effectiveness of adjuvant chemotherapy (CT) in luminal ILC.

Methods

We planned the analysis using data from the Breast Cancer Registry in Japan. Because it was presumed that there are differences in characteristics between ILC and IDC, we created matched cohorts using exact matching to compare their prognoses. We compared the prognosis of ILC and IDC for each subtype. We also compared the prognosis of luminal ILC between the CT and non-CT groups.

Results

For all subtypes, the disease-free survival (DFS) and overall survival (OS) of ILC were poorer than those of IDC. In the analysis by each subtype, no statistically significant difference was found in DFS and OS in luminal human epidermal growth factor 2 (HER2), HER2, and triple-negative cohorts; however, luminal ILC had significantly poorer DFS and OS than luminal IDC. The CT effects on the prognosis of luminal ILC were greater in more advanced cases.

Conclusion

Luminal ILC had a poorer prognosis than luminal IDC, contributing to the worse prognosis of ILC than that of IDC in the overall cohort. Different therapeutic approaches from luminal IDC are essential for a better prognosis of luminal ILC.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available due to ethical restrictions but are available from the corresponding author on reasonable request.

Abbreviations

ILC:

Invasive lobular carcinoma

IDC:

Invasive ductal carcinoma

CT:

Chemotherapy

DFS:

Disease-free survival

OS:

Overall survival

HER2:

Luminal human epidermal growth factor 2

JBCR:

Japanese Breast Cancer Registry

NCD:

National Clinical Database

HR:

Hormone receptor

IHC:

Immunohistochemistry

ER:

Estrogen receptor

PR:

Progesterone receptor

TN:

Triple-negative

CI:

Confidence interval

ET:

Endocrine therapy

SEER:

Surveillance, Epidemiology, and End Results

RS:

Recurrence score

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Acknowledgements

We would like to thank the JBCS staff and the National Clinical Database Office staff for their support in this study. YA would like to thank Mitsuo Terada and Hiroji Iwata at Aichi Cancer Center for their support in the application of this research.

Funding

This work was supported by the Japanese Breast Cancer Society.

Author information

Authors and Affiliations

  1. Department of Breast Oncology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, 464-8681, Nagoya, Aichi, Japan

    Yayoi Adachi

  2. Department of Pathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, 75206, Dallas, TX, USA

    Yayoi Adachi

  3. Department of Surgery, Keiyu Hospital, 3-7-3 Minatomirai, 220-8521, Yokohama, Kanagawa, Japan

    Sota Asaga

  4. Department of Healthcare Quality Assessment, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan

    Hiraku Kumamaru & Naoko Kinugawa

  5. Department of Breast Surgical Oncology, Social Medical Cooperation Hakuaikai, 3-31 Matsubara-cho, 892-0833, Kagoshima, Japan

    Yasuaki Sagara

  6. Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143, Shimokasuya, 259-1193, Isehara, Kanagawa, Japan

    Naoki Niikura

  7. Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, 173-8606, Tokyo, Japan

    Hiromitsu Jinno

  8. Department of Medical Oncology, Fukushima Medical University, 1 Hikariga-oka, 960-1295, Fukushima, Fukushima, Japan

    Shigehira Saji

  9. Department of Breast Surgery, Kyoto University Graduate School of Medicine, 54 Kawaracho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan

    Masakazu Toi

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  1. Yayoi Adachi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by YA, SA, HK, NK, YS, NN, HJ, SS and MT. The first draft of the manuscript was written by YA, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yayoi Adachi.

Ethics declarations

Competing interests

HK reports received consultation fees from Mitsubishi-Tanabe Pharma Corporation and EPS Corporation and speaker fees from Chugai Pharmaceutical Co., Ltd. and Johnson and Johnson KK. HK and NK are affiliated with the Department of Health Quality Assessment at the University of Tokyo, a social collaboration department supported by the National Clinical Database, Johnson and Johnson K.K., Nipro Corporation, and Intuitive Surgical Sàrl. NN received honoraria from Astra Zeneca, Chugai, Daiichi Sankyo, Pfizer, Eli Lilly and MSD; and research funding from Chugai, Daiichi Sankyo, Pfizer, Eisai, Mochida and Novartis. SS received honoraria from Astra Zeneca, Chugai, Daiichi Sankyo, Eisai, Eli Lilly, Kyowa Kirin, MSD, Ono, Pfizer, Taiho and Takeda; and research funding from Astra Zeneca, Chugai, Daiichi Sankyo, MSD and Taiho. MT reports received honoraria from Chugai, Takeda, Pfizer, Kyowa-Kirin, Taiho, Eisai, Daiichi-Sankyo, AstraZeneca, Eli Lilly and companies, MSD, Exact Science, Novartis, Shimadzu, Yakult, Nippon Kayaku, Devicore Medical Japan, and Sysmex; and research funding from Chugai, Takeda, Pfizer, Taiho, JBCRG assoc., KBCRN assoc., Eisai, Eli Lilly, Daiichi-Sankyo, AstraZeneca, Astellas, Shimadzu, Yakult, Nippon Kayaku, AFI technology, Luxonus, Shionogi, GL Science, and Sanwa Shurui. YA, SA, NK, YS, HJ, and MT have no relevant financial or non-financial interests to disclose.

Ethics approval

This study was performed in accordance with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Aichi Cancer Center (5.8.2019/No.2019-1-042).

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Adachi, Y., Asaga, S., Kumamaru, H. et al. Analysis of prognosis in different subtypes of invasive lobular carcinoma using the Japanese National Cancer Database-Breast Cancer Registry. Breast Cancer Res Treat 201, 397–408 (2023). https://doi.org/10.1007/s10549-023-07022-x

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  • DOI: https://doi.org/10.1007/s10549-023-07022-x

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