title: Comparative Long-term Study of a Large Series of Patients with Invasive Ductal Carcinoma and Invasive Lobular Carcinoma. Loco-Regional Recurrence, Metastasis, and Survival.
abstract: Our aim was to compare histologic and immunohistochemical features, surgical treatment and clinical course, including disease recurrence, distant metastases, and mortality between patients with invasive ductal carcinoma (IDC) or invasive lobular carcinoma (ILC). We included 1,745 patients operated for 1,789 breast tumors, with 1,639 IDC (1,600 patients) and 145 patients with ILC and 150 breast tumors. The median follow-up was 76 months. ILC was significantly more likely to be associated with a favorable phenotype. Prevalence of contralateral breast cancer was slightly higher for ILC patients than for IDC patients (4.0% versus 3.2%; p = n.s). ILC was more likely multifocal, estrogen receptor positive, Human Epidermal Growth Factor Receptor-2 (HER2) negative, and with lower proliferative index compared to IDC. Considering conservative surgery, ILC patients required more frequently re-excision and/or mastectomy. Prevalence of stage IIB and III stages were significantly more frequent in ILC patients than in IDC patients (37.4% versus 25.3%, p = 0.006). Positive nodes were significantly more frequent in the ILC patients (44.6% versus 37.0%, p = 0.04). After adjustment for tumor size and nodal status, frequencies of recurrence/metastasis, disease-free and specific survival were similar among patients with IDC and patients with ILC. In conclusion, women with ILC do not have worse clinical outcomes than their counterparts with IDC. Management decisions should be based on individual patient and tumor biologic characteristics rather than on lobular versus ductal histology.
authors.affiliation: Breast Unit, Department of Gynecology, University Hospital of MútuaTerrassa, University of Barcelona, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: García-Fernández
authors.affiliation: Breast Unit, Department of Gynecology, Hospital of Terrassa, Terrassa, Spain.
authors.forename: Josep María
authors.initials: JM
authors.lastname: Lain
authors.affiliation: Department of Nursing, School of Health Science TecnoCampus Mataró-Maresme, Barcelona, Spain.
authors.forename: Carol
authors.initials: C
authors.lastname: Chabrera
authors.affiliation: University International of Catalunya, Barcelona, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: García Font
authors.affiliation: Nuclear Medicine Department-CTD, University Hospital of MútuaTerrassa, University of Barcelona, Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Fraile
authors.affiliation: Breast Unit, Department of Gynecology, University Hospital of MútuaTerrassa, University of Barcelona, Barcelona, Spain.
authors.forename: Israel
authors.initials: I
authors.lastname: Barco
authors.affiliation: Breast Unit, Department of Gynecology, University Hospital of MútuaTerrassa, University of Barcelona, Barcelona, Spain.
authors.forename: Merçe
authors.initials: M
authors.lastname: Torras
authors.affiliation: Department of Radiology, University Hospital of MútuaTerrassa, University of Barcelona, Barcelona, Spain.
authors.forename: Asumpta
authors.initials: A
authors.lastname: Reñe
authors.affiliation: Department of Hemato-Oncology, University Hospital of MútuaTerrassa, University of Barcelona, Barcelona, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: González
authors.affiliation: Department of Pathology, University Hospital of MútuaTerrassa, University of Barcelona, Barcelona, Spain.
authors.forename: Clarissa
authors.initials: C
authors.lastname: González
authors.affiliation: Breast Unit, Department of Gynecology, University Hospital of MútuaTerrassa, University of Barcelona, Barcelona, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Piqueras
authors.affiliation: Department of Surgery, University Hospital of MútuaTerrassa, University of Barcelona, Barcelona, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Veloso
authors.affiliation: Department of Hemato-Oncology, University Hospital of MútuaTerrassa, University of Barcelona, Barcelona, Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Cirera
authors.affiliation: Department of Gynecology, University Hospital of MútuaTerrassa, University of Barcelona, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Pessarrodona
authors.affiliation: Research Unit, Research Foundation MútuaTerrassa, University of Barcelona, Barcelona, Spain.|Laboratory of Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Giménez
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000401:mortality* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000401:mortality* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D017741:Survivors / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: breast neoplasms; invasive ductal carcinoma; invasive lobular carcinoma; mortality; neoplasm recurrence; survival