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Specific sites of metastases in invasive lobular carcinoma: a retrospective cohort study of metastatic breast cancer

Breast Cancer volume 24, pages 667–672 (2017)Cite this article

A Letter to the Editor to this article was published on 16 March 2017

Abstract

Background

Invasive lobular carcinoma (ILC) is known to be the second most common histological type following invasive ductal carcinoma (IDC). Definitive clinical features of ILC are controversial.

Methods

We retrospectively analyzed a cohort of 330 patients with metastatic breast cancer, 303 of IDC, 19 of ILC, and 8 of others. We compared the patient age and tumor–node–metastasis factors, disease-free survival (DFS), estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) expression at the primary site between ILC and IDC. We then selected the patients in the ER+ or PR+/HER2− subtype specifically and compared sites of recurrence, and the survival curve starting from the point of development of metastatic disease.

Results

The clinical stage was significantly higher in the ILC patients than in the IDC (p = 0.001). The mean (±SD) of DFS for the ILC and IDC patients was 2.6 ± 0.6 and 2.4 ± 0.3 years, respectively, with no significant difference (p = 0.18). However, the hormone receptor status was same between both groups; the rate of HER2 positivity was significantly lower in the ILC group (0%) than in the IDC group (16.2%) (p = 0.05). In ER+ or PR+/HER2− subtype, the mean DFS for the ILC and IDC was 2.9 ± 0.6 and 3.1 ± 0.3 years, and the median survival time after the recurrence for ILC and IDC patients was 4.2 ± 0.7 and 5.6 ± 0.7 years, respectively, with no significant difference (p = 0.77). The frequency of lung metastases was significantly lower in the ILC group (6.3%) than in the IDC group (53.7%) (p < 0.01), while the frequency of peritoneal metastases was significantly higher in the ILC group (68.8%) than in the IDC group (1%) (p = 0.00). Of note, the prognosis after the diagnosis of peritoneal metastases was poor, with a median survival time of 19 ± 9 months and resistance to hormone therapy.

Conclusions

The extremely high rate (68.8%) of peritoneal metastases was observed in long-term follow-up for the metastatic breast cancer patients with ILC. We need to reveal the definitive feature of ILC and develop new therapeutic strategies to prevent the dissemination of ILCs.

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Affiliations

  1. Department of Surgery, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Japan

    Masayuki Inoue, Hiroshi Nakagomi, Haruka Nakada, Kazushige Furuya, Kou Ikegame & Hideki Watanabe

  2. Department of Internal Medicine, Yamanashi Prefectural Central Hospital, Kofu, Japan

    Masao Omata

  3. Department of Pathology, Yamanashi Prefectural Central Hospital, Kofu, Japan

    Toshio Oyama

  4. University of Tokyo, Tokyo, Japan

    Masao Omata

Authors
  1. Masayuki Inoue
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  2. Hiroshi Nakagomi
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  3. Haruka Nakada
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  4. Kazushige Furuya
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  6. Hideki Watanabe
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  7. Masao Omata
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Correspondence to Masayuki Inoue.

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Inoue, M., Nakagomi, H., Nakada, H. et al. Specific sites of metastases in invasive lobular carcinoma: a retrospective cohort study of metastatic breast cancer. Breast Cancer 24, 667–672 (2017). https://doi.org/10.1007/s12282-017-0753-4

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  • DOI: https://doi.org/10.1007/s12282-017-0753-4

Keywords

  • Invasive lobular carcinoma (ILC)
  • Metastatic breast cancer
  • Peritoneal metastases