title: Invasive lobular breast cancer: the prognostic impact of histopathological grade, E-cadherin and molecular subtypes.
abstract: OBJECTIVE
  The aim of this study was to compare breast cancer specific survival (BCSS) for invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC) and, further, to evaluate critically the prognostic value of histopathological grading of ILC and examine E-cadherin as a prognostic marker in ILC.
  
  
  RESULTS
  The study comprised 116 lobular and 611 ductal breast carcinomas occurring between 1961 and 2008. All cases had been classified previously according to histopathological type and grade, stained for oestrogen receptor (ER), progesterone receptor (PR), antigen Ki67 (Ki67), epithelial growth factor receptor (EGFR), cytokeratin 5 (CK5) and human epidermal growth factor receptor 2 (HER2) and classified into molecular subtypes. For the present study, immunohistochemical staining for E-cadherin was performed. The Kaplan-Meier method and Cox proportional hazards models were used in the analyses. Grade 2 tumours comprised 85.3% of the lobular tumours and 51.9% of the ductal tumours. BCSS in ILC grade 2 was comparable to that of IDC grade 3. E-cadherin-negative ILC had a poorer prognosis compared to E-cadherin positive ILC and to IDC regardless of E-cadherin status.
  
  
  CONCLUSIONS
  The implication of histopathological grading may differ in ILC compared to IDC. E-cadherin may be useful in prognostication in ILC and thereby influence the determination of treatment strategies for this group of women.
authors.affiliation: Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Monica J
authors.initials: MJ
authors.lastname: Engstrøm
authors.forename: Signe
authors.initials: S
authors.lastname: Opdahl
authors.forename: Lars J
authors.initials: LJ
authors.lastname: Vatten
authors.forename: Olav A
authors.initials: OA
authors.lastname: Haugen
authors.forename: Anna M
authors.initials: AM
authors.lastname: Bofin
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology*; D015820:Cadherins / Q000032:analysis / Q000096:biosynthesis*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000473:pathology; D018275:Carcinoma, Lobular / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D016016:Proportional Hazards Models
chemical_list: D014408:Biomarkers, Tumor; D015820:Cadherins
keywords: E-cadherin; breast cancer; breast cancer-specific survival; histopathological grade; invasive lobular carcinoma; prognosis