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Breast Cancer Research

, 6:R149

First Online: 17 February 2004Received: 02 December 2003Accepted: 28 January 2004


IntroductionInvasive lobular carcinoma ILC comprises approximately 10% of breast cancers and appears to have a distinct biology. Because it is less common than infiltrating ductal carcinoma IDC, few data have been reported that address the biologic features of ILC in the context of their clinical outcome. In the present study we undertook an extensive comparison of ILC and IDC using a large database to provide a more complete and reliable assessment of their biologic phenotypes and clinical behaviors.

MethodsThe clinical and biological features of 4140 patients with ILC were compared with those of 45,169 patients with IDC not otherwise specified. The median follow-up period was 87 months.

ResultsIn comparison with IDC, ILC was significantly more likely to occur in older patients, to be larger in size, to be estrogen and progesterone receptor positive, to have lower S-phase fraction, to be diploid, and to be HER-2, p53, and epidermal growth factor receptor negative. It was more common for ILC than for IDC to metastasize to the gastrointestinal tract and ovary. The incidence of contralateral breast cancer was higher for ILC patients than for IDC patients 20.9% versus 11.2%; P < 0.0001. Breast preservation was modestly less frequent in ILC patients than in IDC patients. The 5-year disease-free survival was 85.7% for ILC and 83.5% for IDC P = 0.13. The 5-year overall survival was 85.6% for ILC and 84.1% for IDC P = 0.64.

ConclusionDespite the fact that the biologic phenotype of ILC is quite favorable, these patients do not have better clinical outcomes than do patients with IDC. At present, management decisions should be based on individual patient and tumor biologic characteristics, and not on lobular histology.

Keywordsbreast cancer breast carcinoma infiltrating ductal carcinoma infiltrating lobular carcinoma invasive ductal carcinoma of the breast invasive lobular carcinoma of the breast special type of breast cancer AbbreviationsCNScentral nervous system

DFSdisease-free survival

EGFRepidermal growth factor receptor

ERestrogen receptor

IDCinfiltrating ductal carcinoma

ILCinfiltrating lobular carcinoma

OSoverall survival

PgRprogesterone receptor.

Electronic supplementary materialThe online version of this article doi:10.1186-bcr767 contains supplementary material, which is available to authorized users.

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Autor: Grazia Arpino - Valerie J Bardou - Gary M Clark - Richard M Elledge


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