Skip to main content

Advertisement

SpringerLink
Log in

Invasive lobular breast cancer: subtypes and outcome

  • Clinical Trial
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Invasive lobular carcinoma (ILC) is the most common “special type” of breast cancer. Although conflicting literature data are available on the outcome of ILC, recently reported data indicate that ILC carries a poorer prognosis if compared to invasive ductal carcinomas. We evaluated clinical and biological features of 981 consecutive patients with pT1-3, pN1-3 M0 ILC. Median follow-up was 7.4 years for survival. A total of 541 patients were classified as classic (55.8%), 146 alveolar (14.9%), 145 mixed non-classic (14.8%), 104 solid (10.6%), and 38 trabecular (3.9%). A statistically significant difference in the outcome was observed at multivariate analysis for patients with solid (HR 2.44, 95% CI 1.39–4.29 for OS; HR 1.92, 95% CI 1.29–2.88 for DFS) and mixed non-classic (HR 1.99, 95% CI 1.12–3.53 for OS) versus patients with classical ILC. A statistically significant difference in the risk of distant metastases was observed at multivariate analysis for patients with Luminal B (HR 2.56, 95% CI 1.38–4.76), HER2 positive (HR 7.80, 95% CI 1.55–39.3), and triple negative (HR 7.61, 95% CI 2.63–22.1) subtypes versus patients with Luminal A ILC. Age ≥70 years, tumor size and degree of nodal involvement were additional independent predictors of reduced overall survival. The outcome of ILC significantly correlated with histological and immunohistochemically defined molecular subtypes. New tailored strategies should be explored in these subgroups of patients with poor outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Li CI, Anderson BO, Daling JR et al (2003) Trends in incidence rates of invasive lobular and ductal breast carcinoma. JAMA 289:1421–1424

    Article  PubMed  Google Scholar 

  2. Li CI, Anderson BO, Porter P et al (2000) Changing incidence rate of invasive lobular breast carcinoma among older women. Cancer 88:2561–2569

    Article  PubMed  CAS  Google Scholar 

  3. Abdel-Fatah TM, Powe DG, Hodi Z, Reis-Filho JS, Lee AH, Ellis IO (2008) Morphologic and molecular evolutionary pathways of low nuclear grade invasive breast cancers and their putative precursor lesions further evidence to support the concept of low nuclear grade breast neoplasia family. Am J Surg Pathol 32:513–523

    Article  PubMed  Google Scholar 

  4. Weigelt B, Geyer FC, Natrajan R et al (2010) The molecular underpinning of lobular histological growth pattern: a genome-wide transcriptomic analysis of invasive lobular carcinomas and grade- and molecular subtype-matched invasive ductal carcinomas of no special type. J Pathol 220:45–57

    Article  PubMed  CAS  Google Scholar 

  5. Pestalozzi BC, Zahrieh D, Mallon E et al (2008) Distinct clinical and prognostic features of infiltrating lobular carcinoma of the breast: combined results of 15 international breast cancer study group clinical trials. J Clin Oncol 26:3006–3014

    Article  PubMed  Google Scholar 

  6. Dixon JM, Anderson TJ, Page DL et al (1982) Infiltrating lobular carcinoma of the breast. Histopathology 6:149–161

    Article  PubMed  CAS  Google Scholar 

  7. du Toit RS, Locker AP, Ellis IO et al (1991) An evaluation of differences in prognosis, recurrence patterns and receptor status between invasive lobular and other invasive carcinomas of the breast. Eur J Surg Oncol 17:251–257

    PubMed  Google Scholar 

  8. DiCostanzo D, Rosen PP, Gareen I et al (1990) Prognosis in infiltrating lobular carcinoma. An analysis of “classical” and variant tumors. Am J Surg Pathol 14:12–23

    Article  PubMed  CAS  Google Scholar 

  9. Orvieto E, Maiorano E, Bottiglieri L et al (2008) Clinicopathologic characteristics of invasive lobular carcinoma of the breast: results of an analysis of 530 cases from a single institution. Cancer 113(7):1511–1520

    Article  PubMed  Google Scholar 

  10. Ellis IO, Schnitt SJ, Sartre-Garau X et al (2003) Invasive breast carcinoma. In: Tavassoli FA, Devilee P (eds) World Health Organization classification of tumors. Pathology and genetics of tumors of the breast and female genital organs. IARC Press, Lyon, pp 23–26

    Google Scholar 

  11. Elston CW, Ellis IO (1991) Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology 19:403–410

    Article  PubMed  CAS  Google Scholar 

  12. Cristofanilli M, Gonzalez-Angulo A, Sneige N et al (2005) Invasive lobular carcinoma classic type: response to primary chemotherapy and survival outcomes. J Clin Oncol 23:41–48

    Article  PubMed  Google Scholar 

  13. Cocquyt VF, Blondeel PN, Depypere HT et al (2003) Different responses to preoperative chemotherapy for invasive lobular and invasive ductal breast carcinoma. Eur J Surg Oncol 29:361–367

    Article  PubMed  CAS  Google Scholar 

  14. Chaturvedi S, Heys SD, Chaturvedi RS (2004) Primary chemotherapy for breast cancers: does histological type of cancer matter? Breast Cancer Res Treat 88:S106 (abstr 2089)

    Google Scholar 

  15. Pu RT, Schott AF, Sturtz DE, Griffith KA, Kleer CG (2005) Pathologic features of breast cancer associated with complete response to neoadjuvant chemotherapy: importance of tumor necrosis. Am J Surg Pathol 29:354–358

    Article  PubMed  Google Scholar 

  16. Vincent-Salomon A, Pierga J-Y, Gautier C (2005) Neoadjuvant chemotherapy for invasive lobular carcinoma of the breast: a poorer response rate but not a worse prognosis than invasive ductal carcinoma. Breast Cancer Res Treat 94:S231 (abstr 5071)

    Google Scholar 

  17. Toikkanen S, Pylkkanen L, Joensuu H (1997) Invasive lobular carcinoma of the breast has better short- and long-term survival than invasive ductal carcinoma. Br J Cancer 76:1234–1240

    Article  PubMed  CAS  Google Scholar 

  18. Eusebi V, Magalhaes F, Azzopardi JG (1992) Pleomorphic lobular carcinoma of the breast: an aggressive tumor showing apocrine differentiation. Hum Pathol 23:655–662

    Article  PubMed  CAS  Google Scholar 

  19. Buchanan CL, Flynn LW, Murray MP et al (2008) Is pleomorphic lobular carcinoma really a distinct clinical entity? J Surg Oncol 98:314–317

    Article  PubMed  Google Scholar 

  20. Cheang MC, Chia SK, Voduc D et al (2009) Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst 101(10):736–750

    Article  PubMed  CAS  Google Scholar 

  21. Goldhirsch A, Wood WC, Coates AS et al (2011) Strategies for subtypes—dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer. Ann Oncol 22(8):1736–1747

    Article  PubMed  CAS  Google Scholar 

  22. Arpino G, Bardou VJ, Clark GM et al (2004) Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome. Breast Cancer Res 6:R149–R156

    Article  PubMed  Google Scholar 

  23. Gonzalez-Angulo AM, Sahin A, Krishnamurthy S et al (2006) Biologic markers in axillary node-negative breast cancer: differential expression in invasive ductal carcinoma versus invasive lobular carcinoma. Clin Breast Cancer 7:396–400

    Article  PubMed  CAS  Google Scholar 

  24. Tubiana-Hulin M, Stevens D, Lasry S et al (2006) Response to neoadjuvant chemotherapy in lobular and ductal breast carcinomas: a retrospective study on 860 patients from one institution. Ann Oncol 17:1228–1233

    Article  PubMed  CAS  Google Scholar 

  25. Rakha EA, El-Sayed ME, Powe DG et al (2008) Invasive lobular carcinoma of the breast: response to hormonal therapy and outcomes. Eur J Cancer 44:73–83

    Article  PubMed  Google Scholar 

  26. Mersin H, Yildirim E, Gulben K et al (2003) Is invasive lobular carcinoma different from invasive ductal carcinoma? Eur J Surg Oncol 29:390–395

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare no conflict of interest related to this study.

Author information

Authors and Affiliations

  1. Research Unit in Medical Senology, Department of Medicine, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy

    Monica Iorfida, Emilia Montagna, Silvia Dellapasqua & Marco Colleoni

  2. Department of Pathology, Univerisity of Bari “Aldo Moro”, Bari, Italy

    Eugenio Maiorano

  3. Surgical Pathology and Cytopathology Unit, University of Padova, Padua, Italy

    Enrico Orvieto

  4. Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy

    Patrick Maisonneuve & Nicole Rotmensz

  5. Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy

    Luca Bottiglieri & Giuseppe Viale

  6. Integrated Breast Surgery Unit, European Institute of Oncology, Milan, Italy

    Paolo Veronesi

  7. School of Medicine, University of Milan, Milan, Italy

    Paolo Veronesi

  8. Unit of Molecular Senology, European Institute of Oncology, Milan, Italy

    Viviana Galimberti

  9. Division of Senology, European Institute of Oncology, Milan, Italy

    Alberto Luini

  10. Department of Medicine, European Institute of Oncology, Milan, Italy

    Aron Goldhirsch

  11. Oncology Institute of Southern Switzerland, Bellinzona, Switzerland

    Aron Goldhirsch

Authors
  1. Monica Iorfida
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eugenio Maiorano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Enrico Orvieto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Patrick Maisonneuve
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luca Bottiglieri
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nicole Rotmensz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Emilia Montagna
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Silvia Dellapasqua
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Paolo Veronesi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Viviana Galimberti
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Alberto Luini
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Aron Goldhirsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Marco Colleoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Giuseppe Viale
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Monica Iorfida.

Additional information

Monica Iorfida, Eugenio Maiorano and Enrico Orvieto contributed equally to this study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Iorfida, M., Maiorano, E., Orvieto, E. et al. Invasive lobular breast cancer: subtypes and outcome. Breast Cancer Res Treat 133, 713–723 (2012). https://doi.org/10.1007/s10549-012-2002-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-012-2002-z

Keywords

Search

Navigation