scholarly journals Invasive Pleomorphic Lobular Carcinoma of the Breast: Clinicopathologic Characteristics and Prognosis Compared with Invasive Ductal Carcinoma

2012 ◽  
Vol 15 (3) ◽  
pp. 313 ◽  
Author(s):  
Seung Pil Jung ◽  
Se Kyoung Lee ◽  
Sangmin Kim ◽  
Min-Young Choi ◽  
Soo Youn Bae ◽  
...  
Keyword(s):  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Carcinoma Of The Breast ◽  
Clinicopathologic Characteristics ◽  
Pleomorphic Lobular Carcinoma

scholarly journals The incidence of discordant clinical and genomic risk in patients with invasive lobular or ductal carcinoma of the breast: a National Cancer Database Study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mary Kathryn Abel ◽  
Amy M. Shui ◽  
Michelle Melisko ◽  
A. Jo Chien ◽  
Emi J. Yoshida ◽  
...  
Keyword(s):  
Overall Survival ◽  
Invasive Ductal Carcinoma ◽  
Invasive Lobular Carcinoma ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Low Risk ◽  
National Cancer Database ◽  
Carcinoma Of The Breast ◽  
The Impact ◽  
Genomic Risk

AbstractWhen molecular testing classifies breast tumors as low risk but clinical risk is high, the optimal management strategy is unknown. One group of patients who may be more likely to have such discordant risk are those with invasive lobular carcinoma of the breast. We sought to examine whether patients with invasive lobular carcinoma are more likely to have clinical high/genomic low-risk tumors compared to those with invasive ductal carcinoma, and to evaluate the impact on receipt of chemotherapy and overall survival. We conducted a cohort study using the National Cancer Database from 2010–2016. Patients with hormone receptor positive, HER2 negative, stage I-III breast cancer who underwent 70-gene signature testing were included. We evaluated the proportion of patients with discordant clinical and genomic risk by histology using Kaplan-Meier plots, log-rank tests, and Cox proportional hazards models with and without propensity score matching. A total of 7399 patients (1497 with invasive lobular carcinoma [20.2%]) were identified. Patients with invasive lobular carcinoma were significantly more likely to fall into a discordant risk category compared to those with invasive ductal carcinoma (46.8% versus 37.1%, p < 0.001), especially in the clinical high/genomic low risk subgroup (35.6% versus 19.2%, p < 0.001). In unadjusted analysis of the clinical high/genomic low-risk cohort who received chemotherapy, invasive ductal carcinoma patients had significantly improved overall survival compared to those with invasive lobular carcinoma (p = 0.02). These findings suggest that current tools for stratifying clinical and genomic risk could be improved for those with invasive lobular carcinoma to better tailor treatment selection.

Pleomorphic Lobular Carcinoma of the Breast: A Morphologically and Clinically Distinct Variant of Lobular Carcinoma

2013 ◽  
Vol 137 (11) ◽  
pp. 1688-1692 ◽  
Author(s):  
Dawn Butler ◽  
Marilin Rosa
Keyword(s):  
Protein Function ◽  
Patient Survival ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Genetic Alterations ◽  
Chromosome Band ◽  
Carcinoma Of The Breast ◽  
Molecular Alterations ◽  
Pleomorphic Lobular Carcinoma ◽  
Breast Malignancies

Pleomorphic lobular carcinoma is an uncommon variant of lobular carcinoma, characterized by significant cytologic atypia that contrasts with the low pleomorphism of classical lobular carcinoma. It accounts for approximately 1% of all epithelial breast malignancies. In addition to its pleomorphism, it is characterized by aggressive behavior and shortened patient survival. Although the morphologic features of pleomorphic lobular carcinoma are well described, it often eludes accurate pathologic characterization. Some controversy surrounds the pathogenesis of pleomorphic lobular carcinoma; however, it is now considered a well-defined variant of invasive lobular carcinoma. Pleomorphic lobular carcinoma shares molecular alterations with classical lobular carcinoma, such as alterations in the gene CDH1 on chromosome band 16q22 that results in changes in E-cadherin protein function. The aggressive biology of pleomorphic lobular carcinoma relates to the acquisition of genetic alterations typical of high-grade ductal carcinoma, such as overexpression of HER2/neu and c-myc.

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