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Lobular Breast Cancer: Same Survival and Local Control Compared with Ductal Cancer, but Should Both Be Treated the Same Way? Analysis of an Institutional Database over a 10-Year Period

Annals of Surgical Oncology volume 19, pages 1107–1114 (2012)Cite this article

Abstract

Background

Invasive lobular carcinoma (ILC) is believed to be more often multicentric and bilateral compared with invasive ductal cancer (IDC), leading clinicians to pursue a more aggressive local and contralateral approach.

Methods

Retrospective review of a consecutive cohort of breast cancer patients operated at one institution from January 2000 to January 2010 was performed. Median follow-up was 4 years.

Results

There were 171 ILC (14.5%) and 1,011 IDC patients in the study period. Median age (63 vs. 65 years) and tumor diameter (1.7 cm) were similar in the two groups. Diagnoses of ILC were more frequent in the second half of the study period (55/465 vs. 116/662, p < 0.01). Multicentricity was reported in 108/1,011 (10.6%) IDC and in 31/171 (18.1%) ILC patients (p < 0.01). A positive margin of resection at initial surgery was documented in 71/1,011 (7%) IDC and in 21/171 (12.3%) ILC patients (p < 0.001). Although the rate of mastectomy decreased over time in both groups, this was more pronounced for ILC patients (p < 0.001). Locoregional control, contralateral cancer, overall survival, disease-free survival, and survival according to diameter, nodal status, and type of surgical intervention did not differ between IDC and ILC. On multivariate analysis, stage of disease and hormone receptor status were associated with disease-free survival, but histology was not.

Conclusions

Although ILC is more often multicentric, bilateral, and associated with a positive margin of resection, local control and survival are similar to IDC. ILC can be treated similarly to IDC with good results.

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Acknowledgment

This work was supported by Fondazione Prometeus, ONLUS, for the development of research and training in oncology. This work was presented in part at the 7th European Breast Cancer Conference, Barcelona, Spain, 24–27th March, 2010.

Disclosure

There are no disclosures of potential conflicts of interests.

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Affiliations

  1. Department of Surgery, Senology Unit, San Giovanni Addolorata Hospital, Rome, Italy

    Lucio Fortunato MD, Alessandra Mascaro MD, Igor Poccia MD, Renato Andrich MD, Massimo Farina MD & Carlo Vitelli MD

  2. Department of Pathology, San Giovanni-Addolorata Hospital, Rome, Italy

    Mostafà Amini MD & Leopoldo Costarelli MD

  3. Department of Statistical Sciences, University of Padua, Padova, Italy

    Giuliana Cortese MD

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  1. Lucio Fortunato MD
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Fortunato, L., Mascaro, A., Poccia, I. et al. Lobular Breast Cancer: Same Survival and Local Control Compared with Ductal Cancer, but Should Both Be Treated the Same Way? Analysis of an Institutional Database over a 10-Year Period. Ann Surg Oncol 19, 1107–1114 (2012). https://doi.org/10.1245/s10434-011-1907-9

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Keywords

  • Sentinel Lymph Node
  • Human Epidermal Growth Factor Receptor
  • Invasive Lobular Carcinoma
  • Contralateral Breast Cancer
  • Breast Conservation