title: Effect of adjuvant chemotherapy in postmenopausal patients with invasive ductal versus lobular breast cancer.
abstract: BACKGROUND
  On the basis of the lack of response of invasive lobular breast cancer to neoadjuvant chemotherapy, we questioned the effectiveness of adjuvant chemotherapy in relation to histology.
  
  
  METHODS
  Women with primary nonmetastatic invasive ductal or (mixed type) lobular breast cancer, aged 50-70 years, diagnosed between 1995 and 2008, were selected from the Netherlands Cancer Registry and followed until January 1, 2010. The patients were divided in two groups: one group receiving adjuvant hormonal therapy only and the other receiving adjuvant hormonal therapy in combination with adjuvant chemotherapy.
  
  
  RESULTS
  In total, 19,609 patients had ductal cancer and 3685 had lobular cancer. The 10-year overall survival rate in ductal cancer when treated with hormonal therapy alone was 69%, compared with 74% with the combination therapy (P < 0.0001). In lobular cancer, 10-year survival rates were 68% after hormonal treatment alone and 66% after the combination therapy (P = 0.45). The hazard ratio (HR) for mortality in ductal cancer after combination therapy was 0.70 [95% confidence interval (CI) 0.64-0.76; P < 0.0001], compared with hormonal treatment alone. The HR in lobular cancer was 1.00 (95% CI 0.82-1.21; P = 0.97).
  
  
  CONCLUSIONS
  Adjuvant chemotherapy seems to confer no additional beneficial effects in postmenopausal patients with pure or mixed type lobular breast cancer receiving hormonal therapy.
authors: Department of Surgery, Máxima Medical Centre, Veldhoven. Electronic address: wilfredtruin@hotmail.com.
authors: W
authors: W
authors: Truin
authors: Department of Epidemiology, School GROW, Maastricht University Medical Centre, Maastricht; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven.
authors: A C
authors: AC
authors: Voogd
authors: Department of Internal Medicine, Máxima Medical Centre, Veldhoven.
authors: G
authors: G
authors: Vreugdenhil
authors: Department of Research, Comprehensive Cancer Centre the Netherlands, Utrecht.
authors: M
authors: M
authors: van der Heiden-van der Loo
authors: Department of Research, Comprehensive Cancer Centre the Netherlands, Enschede; Department of Health Technology and Services Research, Twente University, Enschede, The Netherlands.
authors: S
authors: S
authors: Siesling
authors: Department of Surgery, Máxima Medical Centre, Veldhoven.
authors: R M
authors: RM
authors: Roumen
mesh_terms: D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D018275:Carcinoma, Lobular / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017698:Postmenopause; D015996:Survival Rate
chemical_list: D018931:Antineoplastic Agents, Hormonal