Response Rates of Invasive Lobular Cancer in Patients Undergoing Neoadjuvant Endocrine or Chemotherapy

James W. Jakub, Wenexia Zhang, Malvika Solanki, Jennifer Yonkus, Judy C. Boughey, Scott Harmsen, Karthik V. Giridhar

Research output: Contribution to journalArticlepeer-review

Abstract

Background: A gap remains in the role of neoadjuvant therapy for patients with ILC. Method: Single-institution retrospective review of patients with ILC who received neoadjuvant therapy between 2008 and 2019. Results: 141 patients met inclusion criteria: 71 neoadjuvant chemotherapy (NACT) and 70 neoadjuvant endocrine therapy (NET). 7/71 (9.9%) patients had a pCR following NACT compared to 1/70 (1.4%) with NET (P =.063). pCR was observed in 5/18 (27.8%) patients with Her2Neu-positive disease following NACT, compared to 2/53 (3.8%) with Her2Neu-negative disease (P =.01). For luminal B tumors, median Ki-67 decrease was similar following NACT and NET (18.3 vs 16.3, P =.26). T category decreased in 59 (42.1%) patients following neoadjuvant therapy, increased in 9 (6.4%), and was unchanged in 72 (51.4%). More patients had an increase (28.6%) than decrease (12.1%) in their N category, including 13/60 (21.7%) who were clinically node-negative at diagnosis and identified to have node-positive disease following neoadjuvant therapy, at definitive surgery. Conclusion: In Her2Neu-negative ILC, the potential of a pCR with NACT or NET is low. Most patients’ nodal status and tumor size remain unchanged. There is a potential for pathologic stage to be higher at surgery compared to the clinical stage prior to neoadjuvant therapy.

Original languageEnglish (US)
JournalAmerican Surgeon
DOIs
StateAccepted/In press - 2022

Keywords

  • complete response
  • downstage
  • Her2Neu
  • Ki-67
  • PEPI

ASJC Scopus subject areas

  • Surgery

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