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Invasive ductal carcinoma and invasive lobular carcinoma of breast differ in response following neoadjuvant therapy with epidoxorubicin and docetaxel + G-CSF

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Abstract

Purpose

Preoperative chemotherapy in patients with primary breast cancer treated with anthracyclines and taxanes results in high response rates, allowing breast conserving surgery (BCS) in patients primarily not suitable for this procedure. Pathological responses are important prognostic parameters for progression free and overall survival. We questioned the impact of histologic type invasive ductal carcinoma (IDC) versus invasive lobular carcinoma (ILC) on response to primary chemotherapy.

Patients and Methods

161 patients with breast cancer received preoperative chemotherapy consisted of epidoxorubicin 75 mg/m2 and docetaxel 75 mg/m2 administered in combination with granulocyte-colony stimulating factor (G-CSF) on days 3–10 (ED + G). Pathological complete response (pCR), biological markers and type of surgery as well as progression free and overall survival were compared between IDC and ILC.

Results

Out of 161 patients, 124 patients presented with IDC and 37 with ILC. Patients with ILC were less likely to have a pCR (3% vs. 20%, P < 0.009) and breast conserving surgeries (51% vs. 79%, P < 0.001). Patients with ILC tended to have oestrogen receptor positive tumors (86% vs. 52%, P < 0.0001), HER 2 negative tumors (69% vs. 84%), and lower nuclear grade (nuclear grade 3, 16% vs. 46%, P < 0.001). Patients with ILC tended to have longer time to progression (TTP) (42 months vs. 26 months) and overall survival (69 months vs. 65 months).

Conclusions

Our results indicate that patients with ILC achieved a lower pCR rate and ineligibility for BCS to preoperative chemotherapy, but this did not result in a survival disadvantage. Because of these results new strategies to achieve a pCR are warranted.

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Authors and Affiliations

  1. Department of Internal Medicine I, Division of Clinical Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Catharina Wenzel, Rupert Bartsch, Dagmar Hussian, Ursula Pluschnig, Gabriela Altorjai, Christoph C. Zielinski & Guenther G. Steger

  2. Department of Internal Medicine, Division of Clinical Oncology, LKH Feldkirch, Feldkirch, Austria

    Alois Lang

  3. Department of Surgery, LKH Feldkirch, Feldkirch, Austria

    Anton Haid

  4. Department of Surgery, Medical University of Vienna, Vienna, Austria

    Raimund Jakesz & Michael Gnant

Authors
  1. Catharina Wenzel
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  2. Rupert Bartsch
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  3. Dagmar Hussian
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  4. Ursula Pluschnig
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  5. Gabriela Altorjai
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  6. Christoph C. Zielinski
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  7. Alois Lang
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  8. Anton Haid
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  9. Raimund Jakesz
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  10. Michael Gnant
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  11. Guenther G. Steger
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Corresponding author

Correspondence to Catharina Wenzel.

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Wenzel, C., Bartsch, R., Hussian, D. et al. Invasive ductal carcinoma and invasive lobular carcinoma of breast differ in response following neoadjuvant therapy with epidoxorubicin and docetaxel + G-CSF. Breast Cancer Res Treat 104, 109–114 (2007). https://doi.org/10.1007/s10549-006-9397-3

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  • DOI: https://doi.org/10.1007/s10549-006-9397-3

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