title: Invasive pleomorphic lobular carcinoma of the breast: clinicopathologic characteristics and prognosis compared with invasive ductal carcinoma.
abstract: OBJECTIVE
  Invasive pleomorphic lobular carcinoma (IPLC) is a very rare and distinct morphological variant of invasive lobular carcinoma (ILC), characterized by nuclear atypia and pleomorphism contrasted with the cytologic uniformity of ILC. This study evaluated clinicopathologic characteristics and prognosis of IPLC compared with invasive ductal carcinoma (IDC).
  
  
  METHODS
  We retrospectively reviewed the medical records of 35 patients with IPLC and 6,184 patients with IDC, not otherwise specified. We compared the clinicopathologic characteristics, relapse-free survival (RFS) and disease specific survival (DSS) of patients who were surgically treated between January 1997 and December 2010.
  
  
  RESULTS
  Patients with IPLC presented at an older age with larger tumor size, worse histologic grade, higher rates of N3 stage, more multifocal/multicentric tumors, and more nipple-areolar complex involvement than those of patients with IDC. During the follow-up period, the IPLC group experienced five cases (14.3%) of disease recurrence and three cases (8.6%) of disease specific mortality compared with 637 cases (10.4%) of recurrence and 333 cases (5.4%) of disease specific mortality in the IDC group. Univariate analysis using the Kaplan-Meier method revealed that the IPLC group showed a significantly poorer prognosis than that of the IDC group (RFS, p=0.008; DSS, p<0.001). However, after adjusting for clinicopathologic factors, a multivariate analysis showed no statistical differences in RFS (p=0.396) and DSS (p=0.168) between the IPLC and the IDC groups.
  
  
  CONCLUSIONS
  Our data suggest that patients with IPLC present with poor prognostic factors such as large tumor size, poor histologic grade and advanced stage at diagnosis. These aggressive clinicopathologic characteristics may result in poor clinical outcomes. Although our study could not link IPLC histology to poor prognosis, considering the aggressive characteristics of IPLC, early detection and considerate treatment, including proper surgical and adjuvant intervention, could be helpful for disease progression and survival.
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seung Pil
authors.initials: SP
authors.lastname: Jung
authors.forename: Se Kyoung
authors.initials: SK
authors.lastname: Lee
authors.forename: Sangmin
authors.initials: S
authors.lastname: Kim
authors.forename: Min-Young
authors.initials: MY
authors.lastname: Choi
authors.forename: Soo Youn
authors.initials: SY
authors.lastname: Bae
authors.forename: Jiyoung
authors.initials: J
authors.lastname: Kim
authors.forename: Minkuk
authors.initials: M
authors.lastname: Kim
authors.forename: Won Ho
authors.initials: WH
authors.lastname: Kil
authors.forename: Eun Yoon
authors.initials: EY
authors.lastname: Cho
authors.forename: Jun-Ho
authors.initials: JH
authors.lastname: Choe
authors.forename: Jung-Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Jee Soo
authors.initials: JS
authors.lastname: Kim
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Nam
authors.forename: Jeong Eon
authors.initials: JE
authors.lastname: Lee
keywords: Breast; Lobular carcinoma; Prognosis