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Population Trends in Lobular Carcinoma of the Breast: The Ontario Experience

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Invasive lobular carcinoma (ILC) is less common that invasive ductal carcinoma (IDC), and more challenging to diagnose by examination and screening mammography. This study evaluated current trends in ILC incidence, and described the 5-, 10-, and 15-year survival probabilities for women diagnosed with ILC in Ontario, Canada.

Methods

This retrospective cohort analysis included all women aged 18 years and older diagnosed with breast cancer between 1991 and 2015. Health administrative data from the Institute of Clinical Evaluative Sciences and the Ontario Cancer Registry were used to identify breast cancer cases. Age-adjusted incidence was plotted by year. Crude proportions were plotted by year of diagnosis for stage and hormone receptor status. Kaplan–Meier curves were generated to determine the 5-, 10-, and 15-year survival probabilities for ILC and IDC.

Results

From 1991 to 2015, there were 194,065 cases of breast cancer in Ontario, 14.7% of which were ILC. The age-adjusted incidence of breast cancer increased 1.04-fold, while ILC rates increased 1.53-fold. All bilateral breast cancers were of lobular origin. The proportion of stage 1 ILC decreased, while the proportion of stage 2–4 ILC increased. The 5-, 10-, and 15-year overall survival probabilities for women diagnosed with ILC were 82.7%, 65.3%, and 50.2%, respectively.

Conclusions

This study contains the largest population dataset of ILC evaluated to date. While total breast cancer incidence rates in Ontario are largely unchanged, ILC incidence rates are steadily increasing and there is a trend towards diagnosis of ILC at a later stage. These trends highlight the ongoing diagnostic and treatment challenge ILC presents for patients and clinicians.

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Acknowledgment

The authors thank the University of Ottawa, the ICES, University of Ottawa, and the OCR at CCO for their support to accomplish this work.

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Authors and Affiliations

  1. Department of Surgery, University of Ottawa, Ottawa, ON, Canada

    Lisa J. Findlay-Shirras MBBS, MSc & Angel Arnaout MD, MSc, FRCSC, FACS, MBA

  2. Department of General Surgery, The Ottawa Hospital, General Campus, Ottawa, ON, Canada

    Lisa J. Findlay-Shirras MBBS, MSc & Angel Arnaout MD, MSc, FRCSC, FACS, MBA

  3. Institute of Clinical Evaluative Sciences (ICES), University of Ottawa, Ottawa, ON, Canada

    Isac Lima MSc, PhD & Glenys Smith MSc

  4. Ottawa Hospital Research Institute, Ottawa, ON, Canada

    Isac Lima MSc, PhD, Glenys Smith MSc & Angel Arnaout MD, MSc, FRCSC, FACS, MBA

  5. Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada

    Mark Clemons MD, FRCPC

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  1. Lisa J. Findlay-Shirras MBBS, MSc
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  2. Isac Lima MSc, PhD
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  4. Mark Clemons MD, FRCPC
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  5. Angel Arnaout MD, MSc, FRCSC, FACS, MBA
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Correspondence to Lisa J. Findlay-Shirras MBBS, MSc.

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Lisa Findlay-Shirras, Isac Lima, Glenys Smith, Mark Clemons, and Angel Arnaout have no commercial interests or financial or material supports to disclose.

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Findlay-Shirras, L.J., Lima, I., Smith, G. et al. Population Trends in Lobular Carcinoma of the Breast: The Ontario Experience. Ann Surg Oncol 27, 4711–4719 (2020). https://doi.org/10.1245/s10434-020-08895-8

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  • DOI: https://doi.org/10.1245/s10434-020-08895-8

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