TY - JOUR
T1 - Distinct clinical and prognostic features of infiltrating lobular carcinoma of the breast
T2 - Combined results of 15 International Breast Cancer Study Group clinical trials
AU - Pestalozzi, Bernhard C.
AU - Zahrieh, David
AU - Mallon, Elizabeth
AU - Gusterson, Barry A.
AU - Price, Karen N.
AU - Gelber, Richard D.
AU - Holmberg, Stig B.
AU - Lindtner, Jurij
AU - Snyder, Raymond
AU - Thürlimann, Beat
AU - Murray, Elizabeth
AU - Viale, Giuseppe
AU - Castiglione-Gertsch, Monica
AU - Coates, Alan S.
AU - Goldhirsch, Aron
PY - 2008
Y1 - 2008
N2 - Purpose: To determine how patients with infiltrating lobular carcinoma (ILC) differ from patients with the more common infiltrating ductal carcinoma (IDC) with regard to patient and tumor factors, local treatment, and patterns of recurrence. Patients and Methods: Twelve thousand two hundred six breast cancer patients entered onto 15 International Breast Cancer Study Group trials between 1978 and 2002 were categorized as having ILC, IDC, or other/mixed types. Results: Seven hundred sixty-seven tumors (6.2%) were classified as ILC, 8,607 (70.5%) were classified as IDC, and 2,832 (23.2%) were classified as other. The analysis is limited to the 9,374 patients categorized as either pure IDC or ILC. The median follow-up time was 13 years. Compared with IDC, ILC was associated with older age; larger, better differentiated, and estrogen receptor (ER)-positive tumors; and less vessel invasion. Mastectomy was used more frequently for ILC (P < .01). There was a significant (P < .01) early advantage in disease-free survival and overall survival for the ILC cohort followed by a significant (P < .01) late advantage for the IDC cohort after 6 and 10 years, respectively. Similar patterns were observed in cohorts defined by ER status. ILC was associated with an increased incidence of bone events but a decrease in regional and lung events (all P < .01). Conclusion: ILC is more than a histologic variant of breast cancer. The diagnosis of ILC carries distinct prognostic and biologic implications.
AB - Purpose: To determine how patients with infiltrating lobular carcinoma (ILC) differ from patients with the more common infiltrating ductal carcinoma (IDC) with regard to patient and tumor factors, local treatment, and patterns of recurrence. Patients and Methods: Twelve thousand two hundred six breast cancer patients entered onto 15 International Breast Cancer Study Group trials between 1978 and 2002 were categorized as having ILC, IDC, or other/mixed types. Results: Seven hundred sixty-seven tumors (6.2%) were classified as ILC, 8,607 (70.5%) were classified as IDC, and 2,832 (23.2%) were classified as other. The analysis is limited to the 9,374 patients categorized as either pure IDC or ILC. The median follow-up time was 13 years. Compared with IDC, ILC was associated with older age; larger, better differentiated, and estrogen receptor (ER)-positive tumors; and less vessel invasion. Mastectomy was used more frequently for ILC (P < .01). There was a significant (P < .01) early advantage in disease-free survival and overall survival for the ILC cohort followed by a significant (P < .01) late advantage for the IDC cohort after 6 and 10 years, respectively. Similar patterns were observed in cohorts defined by ER status. ILC was associated with an increased incidence of bone events but a decrease in regional and lung events (all P < .01). Conclusion: ILC is more than a histologic variant of breast cancer. The diagnosis of ILC carries distinct prognostic and biologic implications.
UR - http://www.scopus.com/inward/record.url?scp=46449118312&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=46449118312&partnerID=8YFLogxK
U2 - 10.1200/JCO.2007.14.9336
DO - 10.1200/JCO.2007.14.9336
M3 - Article
C2 - 18458044
AN - SCOPUS:46449118312
SN - 0732-183X
VL - 26
SP - 3006
EP - 3014
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 18
ER -