PURPOSE: To investigate the impact of histologic type invasive lobular carcinoma (ILC) versus invasive ductal carcinoma (IDC) on response to primary chemotherapy (PC) and long-term outcome. PATIENTS AND METHODS: The study included 1,034 patients with stage II and III breast cancer who participated in six clinical trials of PC at our institution between 1985 and 2002. One hundred twenty-two patients (12%) had ILC and 912 (88%) had IDC. All patients received anthracycline-based PC, and 346 patients (33.5%) also received a taxane as part of PC. Pathologic complete response (pCR) was defined as no evidence of invasive disease in the breast and axillary lymph nodes. RESULTS: The median patient age was 48 years (range, 18 to 79 years). Patients with ILC tended to be older (median age, 53 years v 47 years for patients with IDC) and have more hormone-receptor-positive tumors (92% v 62%; P < .001), lower nuclear grade (nuclear grade 3, 16% v 56%; P < .001), and higher stage at diagnosis (10% v 0% with stage IIIB or IIIC disease; P < .001). Patients with ILC were less likely to have a pCR (3% v 15%; P < .001) and had a larger number of involved axillary lymph nodes (41% v 26% had > 3 involved nodes; P = .001). At a median follow-up time of 70 months, ILC patients tended to have longer recurrence-free survival (P = .004) and overall survival (P = .001). CONCLUSION: ILC is characterized by lower rates of pathologic response to PC but better long-term outcomes compared to IDC. pCR might not be a prognostic indicator for this group of patients.
PURPOSE: To investigate the impact of histologic type invasive lobular carcinoma (ILC) versus invasive ductal carcinoma (IDC) on response to primary chemotherapy (PC) and long-term outcome. PATIENTS AND METHODS: The study included 1,034 patients with stage II and III breast cancer who participated in six clinical trials of PC at our institution between 1985 and 2002. One hundred twenty-two patients (12%) had ILC and 912 (88%) had IDC. All patients received anthracycline-based PC, and 346 patients (33.5%) also received a taxane as part of PC. Pathologic complete response (pCR) was defined as no evidence of invasive disease in the breast and axillary lymph nodes. RESULTS: The median patient age was 48 years (range, 18 to 79 years). Patients with ILC tended to be older (median age, 53 years v 47 years for patients with IDC) and have more hormone-receptor-positive tumors (92% v 62%; P < .001), lower nuclear grade (nuclear grade 3, 16% v 56%; P < .001), and higher stage at diagnosis (10% v 0% with stage IIIB or IIIC disease; P < .001). Patients with ILC were less likely to have a pCR (3% v 15%; P < .001) and had a larger number of involved axillary lymph nodes (41% v 26% had > 3 involved nodes; P = .001). At a median follow-up time of 70 months, ILC patients tended to have longer recurrence-free survival (P = .004) and overall survival (P = .001). CONCLUSION: ILC is characterized by lower rates of pathologic response to PC but better long-term outcomes compared to IDC. pCR might not be a prognostic indicator for this group of patients.
Authors: Otto Metzger-Filho; Arlindo R Ferreira; Rinath Jeselsohn; William T Barry; Deborah A Dillon; Jane E Brock; Ines Vaz-Luis; Melissa E Hughes; Eric P Winer; Nancy U Lin Journal: Oncologist Date: 2018-12-05
Authors: Nina Tamirisa; Hannah V Williamson; Samantha M Thomas; Kelly E Westbrook; Rachel A Greenup; Jennifer K Plichta; Laura H Rosenberger; Terry Hyslop; Eun-Sil Shelley Hwang; Oluwadamilola M Fayanju Journal: J Surg Oncol Date: 2019-05-06 Impact factor: 3.454
Authors: Judy C Boughey; Jamie Wagner; Betsy J Garrett; Lori Harker; Lavinia P Middleton; Gildy V Babiera; Funda Meric-Bernstam; Anthony Lucci; Kelly K Hunt; Isabelle Bedrosian Journal: Ann Surg Oncol Date: 2009-03-12 Impact factor: 5.344
Authors: M E Straver; E J Th Rutgers; S Rodenhuis; S C Linn; C E Loo; J Wesseling; N S Russell; H S A Oldenburg; N Antonini; M T F D Vrancken Peeters Journal: Ann Surg Oncol Date: 2010-04-06 Impact factor: 5.344