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Clinical outcomes in patients with triple negative or HER2 positive lobular breast cancer: a single institution experience

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Abstract

Purpose

Invasive lobular carcinomas (ILC) are characterised by loss of the cell adhesion molecule E-cadherin. Approximately 15% of ILC are ER negative at the time of breast cancer diagnosis, or at relapse due to loss of ER expression. Less than 5% of classical ILC but up to 35% of pleomorphic ILC are HER2 positive (HER2+).

Methods

Retrospective analysis of clinic-pathological data from patients with Triple negative (TN) or HER2+ ILC diagnosed 2004–2014 at the Royal Marsden Hospital. The primary endpoint was median overall survival (OS) in patients with metastatic disease. Secondary endpoints included response rate to neo-adjuvant chemotherapy (NAC), median disease-free interval (DFI) and OS for patients with early disease.

Results

Three of 16 patients with early TN ILC and 7/33 with early HER2+ ILC received NAC with pCR rates of 0/3 and 3/5 patients who underwent surgery, respectively. Median DFI was 28.5 months [95% Confidence interval (95%CI) 15–78.8] for TN ILC and not reached (NR) (111.2-NR) for HER2+ early ILC. Five-year OS was 52% (95%CI 23–74%) and 77% (95%CI 58–88%), respectively. Twenty-three patients with advanced TN ILC and 14 patients with advanced HER2+ ILC were identified. Median OS was 18.3 months (95%CI 13.0–32.8 months) and 30.4 months (95%CI 8.8-NR), respectively.

Conclusions

In our institution we report a high relapse rate after treatment for early TN ILC, but median OS from metastatic disease is similar to that expected from TN IDC. Outcomes for patients with advanced HER2+ ILC were less favourable than those expected for IDC, possibly reflecting incomplete exposure to anti-HER2 therapies.

Clinical trial registration: ROLo (ClinicalTrials.gov Identifier: NCT03620643), ROSALINE (ClinicalTrials.gov Identifier: NCT04551495).

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Acknowledgements

The authors wish to acknowledge the support of the Royal Marsden NIHR Biomedical Research Centre for Cancer.

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Authors and Affiliations

  1. The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK

    Alicia Okines, Tazia Irfan, Bernice Asare, Kabir Mohammed, Peter Osin, Ashutosh Nerurkar, Ian E. Smith, Marina Parton, Stephen Johnston & Nicholas C. Turner

  2. The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK

    Alistair Ring

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  1. Alicia Okines
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  2. Tazia Irfan
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Correspondence to Alicia Okines.

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Okines, A., Irfan, T., Asare, B. et al. Clinical outcomes in patients with triple negative or HER2 positive lobular breast cancer: a single institution experience. Breast Cancer Res Treat 192, 563–571 (2022). https://doi.org/10.1007/s10549-021-06432-z

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  • DOI: https://doi.org/10.1007/s10549-021-06432-z

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