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Breast Cancer
Published in: Breast Cancer 5/2017

01-09-2017 | Original Article

Specific sites of metastases in invasive lobular carcinoma: a retrospective cohort study of metastatic breast cancer

Authors: Masayuki Inoue, Hiroshi Nakagomi, Haruka Nakada, Kazushige Furuya, Kou Ikegame, Hideki Watanabe, Masao Omata, Toshio Oyama

Published in: Breast Cancer | Issue 5/2017

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Abstract

Background

Invasive lobular carcinoma (ILC) is known to be the second most common histological type following invasive ductal carcinoma (IDC). Definitive clinical features of ILC are controversial.

Methods

We retrospectively analyzed a cohort of 330 patients with metastatic breast cancer, 303 of IDC, 19 of ILC, and 8 of others. We compared the patient age and tumor–node–metastasis factors, disease-free survival (DFS), estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) expression at the primary site between ILC and IDC. We then selected the patients in the ER+ or PR+/HER2− subtype specifically and compared sites of recurrence, and the survival curve starting from the point of development of metastatic disease.

Results

The clinical stage was significantly higher in the ILC patients than in the IDC (p = 0.001). The mean (±SD) of DFS for the ILC and IDC patients was 2.6 ± 0.6 and 2.4 ± 0.3 years, respectively, with no significant difference (p = 0.18). However, the hormone receptor status was same between both groups; the rate of HER2 positivity was significantly lower in the ILC group (0%) than in the IDC group (16.2%) (p = 0.05). In ER+ or PR+/HER2− subtype, the mean DFS for the ILC and IDC was 2.9 ± 0.6 and 3.1 ± 0.3 years, and the median survival time after the recurrence for ILC and IDC patients was 4.2 ± 0.7 and 5.6 ± 0.7 years, respectively, with no significant difference (p = 0.77). The frequency of lung metastases was significantly lower in the ILC group (6.3%) than in the IDC group (53.7%) (p < 0.01), while the frequency of peritoneal metastases was significantly higher in the ILC group (68.8%) than in the IDC group (1%) (p = 0.00). Of note, the prognosis after the diagnosis of peritoneal metastases was poor, with a median survival time of 19 ± 9 months and resistance to hormone therapy.

Conclusions

The extremely high rate (68.8%) of peritoneal metastases was observed in long-term follow-up for the metastatic breast cancer patients with ILC. We need to reveal the definitive feature of ILC and develop new therapeutic strategies to prevent the dissemination of ILCs.
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Metadata
Title
Specific sites of metastases in invasive lobular carcinoma: a retrospective cohort study of metastatic breast cancer
Authors
Masayuki Inoue
Hiroshi Nakagomi
Haruka Nakada
Kazushige Furuya
Kou Ikegame
Hideki Watanabe
Masao Omata
Toshio Oyama
Publication date
01-09-2017
Publisher
Springer Japan
Published in
Breast Cancer / Issue 5/2017
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-017-0753-4

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