Histologic grading is an independent prognostic factor in invasive lobular carcinoma of the breast

Evaluation of prognostic factors in lymph node negative (LNneg) invasive lobular cancers (ILCs). Prospective analysis of proliferation and other prognosticators in 121 LNneg ILCs (119 months median follow-up, range 19-181), without adjuvant chemotherapy. ILC subtype was assessed in accordance with WHO-2003 criteria. Immunohistochemical E-cadherin and estrogen receptor were used. With a median follow up time of 83 months (range 19-181), 30 of the 121 (25%) ILC patients developed distant metastases and 27 (22%) died. None of the cases classified as solid/pleomorphic lobular were E-cadherin or estrogen receptor positive, contrasting the other ILCs. The solid/alveolar ILCs (n = 17) had a worse survival (50%) than the other ILCs (n = 104; 83%, P \ 0.0001). Mitotic activity index (MAI) (but not nuclear grade or tubule formation) was prognostic with a threshold 0-5 versus [5 (=MAI-5) (contrasting MAI \ 10 vs. C10 in breast cancers in general; 85 and 54% survival, P \ 0.0001). In multivariate analysis only subtype and MAI but none of the other characteristics had independent prognostic value. Histologic subtype and MAI have independent prognostic value in node negative invasive lobular cancers.

Section: Discussionsupporting

confidence: 92%

Prospective multicenter comparison of proliferation and other prognostic factors in lymph node negative lobular invasive breast cancer

Gudlaugsson

Skaland

Janssen

et al. 2009

“…The non-tubular architecture of ILC restricts the histological grade assessment in ILC, as most tumours will be grade 2. In a study by Rakha et al [36] investigating 517 ILCs, 76 % of the ILCs were grade 2, while only 12 % were grade 1 or grade 3. Interestingly, grading was still an independent prognostic factor in that ILC cohort as well as in our analysis for DDFS, LRFS and OS.…”

Section: Discussionmentioning

confidence: 98%

Response and prognosis after neoadjuvant chemotherapy in 1,051 patients with infiltrating lobular breast carcinoma

Loibl

Volz

Mau

et al. 2014

101

Response and prognosis after neoadjuvant chemotherapy in 1,051 patients with infiltrating lobular breast carcinoma 123Breast Cancer Res Treat (2014) 144:153-162 DOI 10.1007/s10549-014-2861 pCR and this is not well correlated with further outcome. The mastectomy rate was considerably high in ILC patients even after obtaining a pCR. We, therefore, suggest to offer NACT mainly to ILC patients with HR-negative tumours.

“…The most commonly used prognosticators for breast cancer are TNM stage, histological grade, estrogen receptor (ER) status and S-phase [14]. In the current study we decided to include the component variables of TNM stage, lymph node status and tumour size, along with histological grade.…”

Section: Prognosticators For Breast Cancermentioning

confidence: 99%

Genetic variation in the androgen estrogen conversion pathway in relation to breast cancer prognosticators

Darabi

Czene

Wedrén

et al. 2010

Purpose:Genetic variation in the androgen-to-estrogen conversion pathway has been shown to be associated with risk of breast cancer, and in particular with Estrogen Receptor (ER) positive tumours. We aimed at studying how the genetic alterations, which have been identified for risk, are associated with breast cancer prognosticators, with a prior hypothesis that, in general, hormone related breast cancers have a better prognosis than non-hormone related breast cancers. Methods:Association between tagging SNPs in genes involved in estrogen metabolism and patient's lymph node status, tumour size and histological grade, were estimated in a sample of 1569 Swedish breast cancer patients. Results:Polymorphisms in CYP19A1, which have previously been linked to breast cancer risk, are shown to be associated with breast cancer prognosticators. The strongest association was observed for rs4646, with histological grade. The common allele of rs4646, which has been associated with increased breast cancer risk, was associated with low histological grade and small tumour size (p=0.001 and 0.015; 1-sided, respectively). We also found evidence that SNP rs7167936 is associated with histological grade and tumour size (p=0.010 and 0.005; 1-sided, respectively). We show that rs4646 and rs7167936 are associated with histological grade even amongst only ER-positive tumours (p=0.008 and 0.011; 1-sided, respectively). Conclusions:Our results provide new evidence that CYP19A1 is involved in both breast cancer risk and prognosis.3