TY - JOUR
T1 - Absence of lobular carcinoma in situ is a poor prognostic marker in invasive lobular carcinoma
AU - Mouabbi, Jason A.
AU - Raghavendra, Akshara Singareeka
AU - Bassett, Roland L.
AU - Christgen, Matthias
AU - Middleton, Lavinia
AU - Teshome, Mediget
AU - Nasrazadani, Azadeh
AU - Hortobagyi, Gabriel
AU - Hassan, Amy
AU - Tripathy, Debasish
AU - Layman, Rachel M.
N1 - Funding Information:
The study analyses in this work were supported in part by the NIH/NCI Cancer Centre Support Grant (award number P30 CA016672).
Funding Information:
The MD Anderson database is supported by the breast medical oncology departmental funds, Cancer Centre Support Grant (NIH/NCI P30 CA016672 [Peter Pisters, PI]) and CPRIT-MIRA grant that contributed to the recent updates of our database (CPRIT MIRA [RP#180712, Hunt, PI]).
Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023/9
Y1 - 2023/9
N2 - Aim: To determine if the outcomes of patients with ILC co-occurring with LCIS are similar to pure ILC and if the presence of LCIS is a prognostic factor for ILC. Methods: In an observational, population-based investigation using data from the MD Anderson breast cancer prospectively collected electronic database, we analysed patients with a diagnosis of stage I-III ILC. Patients were divided into two groups: those with ILC with co-occurring ipsilateral LCIS (ILC + LCIS) and those with pure ILC without a histologically detected co-occurring ipsilateral LCIS (ILC alone). We obtained data on demographics, pathologic tumour size (pT), pathologic lymph node (pN) involvement, estrogen (ER), progesterone (PR) receptor status, HER2 status, Ki67, treatment received, distant recurrence-free and overall survival (DRFS, OS). Results: We identified 4217 patients with stage I-III ILC treated at MD Anderson between 1966 and 2021. 45% of cases (n = 1881) had co-existing LCIS. Statistically and numerically, ILC alone tended to associate with pT4 and pN3 stage (P < 0.001), ER/PR negativity (P = 0.0002), HER2 positivity (P = 0.010), higher Ki67 (P = 0.005), non-classical ILC subtype (P = 0.04) and more exposure to neoadjuvant chemotherapy (P = 0.0002) compared to the ILC + LCIS group. The median follow-up time was 6.5 years. Patients with ILC + LCIS had better median DRFS (16.8 versus 10.1 years, Hazard ratio [HR] 0.55, 95% confidence interval [CI] 0.50–0.60, P < 0.0001) and better median OS (18.9 versus 13.7 years, HR 0.62, 95% CI 0.56–0.69; P < 0.0001). Multivariate analysis showed the absence of LCIS to be an independent poor prognostic factor along with a higher pT stage and higher pN stage for DRFS and OS. Conclusion: The findings of this study suggests that the absence of ipsilateral LCIS with ILC is an independent poor prognostic factor and that further studies are warranted to understand this phenomenon. Data availability: The data that support the findings of this study are available from the corresponding author, upon reasonable request.
AB - Aim: To determine if the outcomes of patients with ILC co-occurring with LCIS are similar to pure ILC and if the presence of LCIS is a prognostic factor for ILC. Methods: In an observational, population-based investigation using data from the MD Anderson breast cancer prospectively collected electronic database, we analysed patients with a diagnosis of stage I-III ILC. Patients were divided into two groups: those with ILC with co-occurring ipsilateral LCIS (ILC + LCIS) and those with pure ILC without a histologically detected co-occurring ipsilateral LCIS (ILC alone). We obtained data on demographics, pathologic tumour size (pT), pathologic lymph node (pN) involvement, estrogen (ER), progesterone (PR) receptor status, HER2 status, Ki67, treatment received, distant recurrence-free and overall survival (DRFS, OS). Results: We identified 4217 patients with stage I-III ILC treated at MD Anderson between 1966 and 2021. 45% of cases (n = 1881) had co-existing LCIS. Statistically and numerically, ILC alone tended to associate with pT4 and pN3 stage (P < 0.001), ER/PR negativity (P = 0.0002), HER2 positivity (P = 0.010), higher Ki67 (P = 0.005), non-classical ILC subtype (P = 0.04) and more exposure to neoadjuvant chemotherapy (P = 0.0002) compared to the ILC + LCIS group. The median follow-up time was 6.5 years. Patients with ILC + LCIS had better median DRFS (16.8 versus 10.1 years, Hazard ratio [HR] 0.55, 95% confidence interval [CI] 0.50–0.60, P < 0.0001) and better median OS (18.9 versus 13.7 years, HR 0.62, 95% CI 0.56–0.69; P < 0.0001). Multivariate analysis showed the absence of LCIS to be an independent poor prognostic factor along with a higher pT stage and higher pN stage for DRFS and OS. Conclusion: The findings of this study suggests that the absence of ipsilateral LCIS with ILC is an independent poor prognostic factor and that further studies are warranted to understand this phenomenon. Data availability: The data that support the findings of this study are available from the corresponding author, upon reasonable request.
KW - Breast cancer
KW - Invasive lobular carcinoma (ILC)
KW - Lobular carcinoma
KW - Lobular carcinoma in situ (LCIS)
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U2 - 10.1016/j.ejca.2023.113250
DO - 10.1016/j.ejca.2023.113250
M3 - Article
C2 - 37573674
AN - SCOPUS:85167433986
SN - 0959-8049
VL - 191
JO - European Journal of Cancer
JF - European Journal of Cancer
M1 - 113250
ER -