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. 2016 May 17;7(20):29412-9.
doi: 10.18632/oncotarget.8838.

The role of histological subtype in hormone receptor positive metastatic breast cancer: similar survival but different therapeutic approaches

Dorien Lobbezoo  1   2 , Wilfred Truin  1   3 , Adri Voogd  1 , Rudi Roumen  1   3 , Gerard Vreugdenhil  1   2 , Marcus Wouter Dercksen  2 , Franchette van den Berkmortel  4 , Tineke Smilde  5 , Agnes van de Wouw  6 , Roel van Kampen  1   7 , Johanna van Riel  8 , Natascha Peters  9 , Petronella Peer  10 , Vivianne C G Tjan-Heijnen  1
Affiliations

The role of histological subtype in hormone receptor positive metastatic breast cancer: similar survival but different therapeutic approaches

Dorien Lobbezoo et al. Oncotarget. .

Abstract

Introduction: This study describes the differences between the two largest histological breast cancer subtypes (invasive ductal carcinoma (IDC) and invasive (mixed) lobular carcinoma (ILC) with respect to patient and tumor characteristics, treatment-choices and outcome in metastatic breast cancer.

Results: Patients with ILC were older at diagnosis of primary breast cancer and had more often initial bone metastasis (46.5% versus 34.8%, P = 0.01) and less often multiple metastatic sites compared to IDC (23.7% versus 30.9%, P = 0.11). Six months after diagnosis of metastatic breast cancer, 28.1% of patients with ILC and 39.8% of patients with IDC had received chemotherapy with a longer median time to first chemotherapy for those with ILC (P = 0.001). After six months 84.8% of patients with ILC had received endocrine therapy versus 72.5% of patients with IDC (P = 0.0001). Median overall survival was 29 months for ILC and 25 months for IDC (P = 0.53).

Materials and methods: We included 437 patients with hormone receptor-positive IDC and 131 patients with hormone receptor-positive ILC, all diagnosed with metastatic breast cancer between 2007-2009, irrespective of date of the primary diagnosis. Patient and tumor characteristics and data on treatment and outcome were collected. Survival curves were obtained using the Kaplan-Meier method.

Conclusions: Treatment strategies of hormone receptor-positive metastatic breast cancer were remarkably different for patients with ILC and IDC. Further research is required to understand tumor behavior and treatment-choices in real-life.

Keywords: histology; invasive ductal carcinoma; invasive lobular carcinoma; metastatic breast cancer; treatment.

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Conflict of interest statement

The authors have declared no conflicts of interest.

Figures

Figure 1
Figure 1
Time to first palliative chemotherapy (A) and endocrine therapy (B) by histological subtype.
Figure 2
Figure 2
Residual survival for patients with HR-positive ILC (A) and HR-positive IDC (B) treated with or without any palliative chemotherapy during the first six months after diagnosis of metastatic breast cancer.
Figure 3
Figure 3
Residual survival for patients with HR-positive ILC (A) and HR-positive IDC (B) treated with or without any palliative endocrine therapy during the first six months after diagnosis of metastatic breast cancer.
See this image and copyright information in PMC

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