BACKGROUND: We compared the impact of neoadjuvant chemotherapy on pathologic response and outcome in operable invasive lobular breast carcinoma (ILC) and invasive ductal breast carcinoma (IDC). PATIENTS AND METHODS: We extracted from our database all patients with pure invasive lobular (n=118, 14%) or pure invasive ductal carcinomas (n=742, 86%). Their treatment included neoadjuvant chemotherapy, adapted surgery, radiotherapy and adjuvant hormonal treatment. RESULTS: Compared with IDC, ILC presented with larger tumors (T3: 38.1% versus 21.4%, P=0.0007), more N0 nodes status (55.9% versus 43.3%, P=0.01), less inflammatory tumors (5.9% versus 11.8%, P=0.01), more hormone receptor positivity (65.5% versus 38.8%), lower histological grade (P<0.0001). Final surgery was a mastectomy in 70% of patients with ILC (34% were reoperated after initial partial mastectomy) and in 52% of IDC after 8% of reoperation (P=0.006). A pathological complete response (pCR) was achieved in 1% of ILC and 9% of IDC (P=0.002). The outcome at 60 months was significantly better for ILC, but histologic type was not an independent factor for survival in multivariate analysis. CONCLUSIONS: ILC appeared less responsive to chemotherapy but presented a better outcome than IDC. While new information on biological features of ILC is needed, we consider that neoadjuvant endocrine therapy in hormone receptor-positive ILC may be a more adapted approach than neoadjuvant chemotherapy.
BACKGROUND: We compared the impact of neoadjuvant chemotherapy on pathologic response and outcome in operable invasive lobular breast carcinoma (ILC) and invasive ductal breast carcinoma (IDC). PATIENTS AND METHODS: We extracted from our database all patients with pure invasive lobular (n=118, 14%) or pure invasive ductal carcinomas (n=742, 86%). Their treatment included neoadjuvant chemotherapy, adapted surgery, radiotherapy and adjuvant hormonal treatment. RESULTS: Compared with IDC, ILC presented with larger tumors (T3: 38.1% versus 21.4%, P=0.0007), more N0 nodes status (55.9% versus 43.3%, P=0.01), less inflammatory tumors (5.9% versus 11.8%, P=0.01), more hormone receptor positivity (65.5% versus 38.8%), lower histological grade (P<0.0001). Final surgery was a mastectomy in 70% of patients with ILC (34% were reoperated after initial partial mastectomy) and in 52% of IDC after 8% of reoperation (P=0.006). A pathological complete response (pCR) was achieved in 1% of ILC and 9% of IDC (P=0.002). The outcome at 60 months was significantly better for ILC, but histologic type was not an independent factor for survival in multivariate analysis. CONCLUSIONS: ILC appeared less responsive to chemotherapy but presented a better outcome than IDC. While new information on biological features of ILC is needed, we consider that neoadjuvant endocrine therapy in hormone receptor-positive ILC may be a more adapted approach than neoadjuvant chemotherapy.
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
Authors: Esther H Lips; Rita A Mukhtar; Christina Yau; Jorma J de Ronde; Chad Livasy; Lisa A Carey; Claudette E Loo; Marie-Jeanne T F D Vrancken-Peeters; Gabe S Sonke; Donald A Berry; Laura J Van't Veer; Laura J Esserman; Jelle Wesseling; Sjoerd Rodenhuis; E Shelley Hwang Journal: Breast Cancer Res Treat Date: 2012-09-08 Impact factor: 4.872
Authors: Otto Metzger Filho; Anita Giobbie-Hurder; Elizabeth Mallon; Barry Gusterson; Giuseppe Viale; Eric P Winer; Beat Thürlimann; Richard D Gelber; Marco Colleoni; Bent Ejlertsen; Marc Debled; Karen N Price; Meredith M Regan; Alan S Coates; Aron Goldhirsch Journal: J Clin Oncol Date: 2015-07-27 Impact factor: 44.544