Ying L Liu1, Christine Choi2, Shing M Lee3, Xiaobo Zhong3, Hanina Hibshoosh4, Kevin Kalinsky5, Eileen P Connolly6. 1. Department of Medicine, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY. 2. College of Physicians and Surgeons, Columbia University, New York, NY. 3. Department of Biostatistics, Columbia University School of Medicine, New York, NY. 4. Department of Pathology and Cell Biology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY. 5. Department of Medical Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY. 6. Department of Radiation Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY. Electronic address: epc2116@cumc.columbia.edu.
Abstract
BACKGROUND: Invasive pleomorphic lobular carcinoma (IPLC) has been associated with a worse prognosis compared with classic invasive lobular carcinoma (cILC); however, studies are small and conflicting. We seek to examine the prognosis of women with IPLC compared with cILC. METHODS: A retrospective review of women with breast cancer at a single institution from 2003 to 2012 identified 193 women with invasive lobular carcinoma (ILC). IPLC was defined as ILC with a pathological description of primarily pleomorphic features and Nottingham histological grade score of 7, 8, or 9 or overall grade of 3 or mixed classic/pleomorphic features and overall grade of 3. All others were designated cILCs. Clinicopathologic variables, progression-free survival (PFS), per STEEP criteria, and overall survival (OS), using all-cause mortality, were examined in both groups. RESULTS: Of the 193 women, 46 (24%) had IPLC and 147 (76%) had cILC. The IPLC group had significantly higher stage at diagnosis and more Hispanic women, but there were no differences in other clinicopathologic features or treatment. Median follow-up was 57 months (0.1-155 months). In univariate analysis, IPLC was associated with worse PFS (log-rank P = .09, Wilcoxon P = .01) but no significant differences in OS (log-rank P = .20, Wilcoxon P = .16). In multivariate models adjusting for stage, IPLC was not significantly associated with PFS (hazard ratio [HR] 1.43; 95% confidence interval [CI], 0.73-2.79; P = .30) or OS (HR 1.52; 95% CI, 0.58-4.01; P = .40). CONCLUSIONS: IPLC was initially associated with worse PFS, but this was attenuated after adjustment for cancer stage, and there were no differences in OS.
BACKGROUND: Invasive pleomorphic lobular carcinoma (IPLC) has been associated with a worse prognosis compared with classic invasive lobular carcinoma (cILC); however, studies are small and conflicting. We seek to examine the prognosis of women with IPLC compared with cILC. METHODS: A retrospective review of women with breast cancer at a single institution from 2003 to 2012 identified 193 women with invasive lobular carcinoma (ILC). IPLC was defined as ILC with a pathological description of primarily pleomorphic features and Nottingham histological grade score of 7, 8, or 9 or overall grade of 3 or mixed classic/pleomorphic features and overall grade of 3. All others were designated cILCs. Clinicopathologic variables, progression-free survival (PFS), per STEEP criteria, and overall survival (OS), using all-cause mortality, were examined in both groups. RESULTS: Of the 193 women, 46 (24%) had IPLC and 147 (76%) had cILC. The IPLC group had significantly higher stage at diagnosis and more Hispanic women, but there were no differences in other clinicopathologic features or treatment. Median follow-up was 57 months (0.1-155 months). In univariate analysis, IPLC was associated with worse PFS (log-rank P = .09, Wilcoxon P = .01) but no significant differences in OS (log-rank P = .20, Wilcoxon P = .16). In multivariate models adjusting for stage, IPLC was not significantly associated with PFS (hazard ratio [HR] 1.43; 95% confidence interval [CI], 0.73-2.79; P = .30) or OS (HR 1.52; 95% CI, 0.58-4.01; P = .40). CONCLUSIONS: IPLC was initially associated with worse PFS, but this was attenuated after adjustment for cancer stage, and there were no differences in OS.
Authors: Leopoldo Costarelli; Domenico Campagna; Alessandra Ascarelli; Francesco Cavaliere; Maria Helena Colavito; Tatiana Ponzani; Laura Broglia; Massimo La Pinta; Elena Manna; Lucio Fortunato Journal: Breast Cancer (Dove Med Press) Date: 2017-12-08