Invasive lobular breast cancer. Prognostic significance of histological malignancy grading

Talman, Maj-Lis Møller; Jensen, Maj‐Britt; Rank, Fritz

doi:10.1080/02841860601137397

Cited by 35 publications

(8 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With the increase in the incidence of ILCs over the past decades,9,10 there is a clear clinical need to better evaluate the prognostic value of the MammaPrint test for specifically invasive lobular breast carcinomas. Hence, we have sought to validate the prognostic capacity of MammaPrint in primary invasive lobular breast cancers.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of MammaPrint^® in Invasive Lobular Breast Cancer

et al. 2016

View full text Add to dashboard Cite

BACKGROUNDMammaPrint® is a microarray-based gene expression test cleared by the US Food and Drug Administration to assess recurrence risk in early-stage breast cancer, aimed to guide physicians in making neoadjuvant and adjuvant treatment decisions. The increase in the incidence of invasive lobular carcinomas (ILCs) over the past decades and the modest representation of ILC in the MammaPrint development data set calls for a stratified survival analysis dedicated to this specific subgroup.STUDY AIMThe current study aimed to validate the prognostic value of the MammaPrint test for breast cancer patients with early-stage ILCs.MATERIALS AND METHODSUnivariate and multivariate survival associations for overall survival (OS), distant metastasis-free interval (DMFI), and distant metastasis-free survival (DMFS) were studied in a study population of 217 early-stage ILC breast cancer patients from five different clinical studies.RESULTS AND DISCUSSIONA significant association between MammaPrint High Risk and poor clinical outcome was shown for OS, DMFI, and DMFS. A subanalysis was performed on the lymph node-negative study population. In the lymph node-negative study population, we report an up to 11 times higher change in the diagnosis of an event in the MammaPrint High Risk group. For DMFI, the reported hazard ratio is 11.1 (95% confidence interval = 2.3–53.0).CONCLUSIONStudy results validate MammaPrint as an independent factor for breast cancer patients with early-stage invasive lobular breast cancer. Hazard ratios up to 11 in multivariate analyses emphasize the independent value of MammaPrint, specifically in lymph node-negative ILC breast cancers.

show abstract

Section: Introductionmentioning

confidence: 99%

Prognostic Value of MammaPrint^® in Invasive Lobular Breast Cancer

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Studies presenting data on ILC show that the most powerful prognostic factors for this histological subtype are nodal status and tumour size (Arpino et al 2004; Wasif et al 2010; Sastre-Garau et al 1996; Frost et al 1995; Orvieto et al 2008; Rakha et al 2008b; Moreno-Elola et al 1999). Histological grade has an important independent value in predicting outcome in IDC, but its prognostic impact in ILC is less clear (Rakha et al 2008b; Wachtel et al 2010; Talman et al 2007; Sinha et al 2000). The long-term prognostic value of Ki67 in ILC has not yet been fully studied.…”

Section: Introductionmentioning

confidence: 99%

Invasive lobular carcinoma of the breast: long-term prognostic value of Ki67 and histological grade, alone and in combination with estrogen receptor

et al. 2014

View full text Add to dashboard Cite

BackgroundThe aim of the present study was to investigate the long-term impact of prognostic factors in invasive lobular carcinoma (ILC) of the breast, with a primary focus on Ki67 and histological grade, alone and in combination with estrogen receptor (ER).Material and methodsOne hundred and ninety two well-characterised patients with ILC were included in the study. Ki67, histological grade and ER were evaluated and combined into a prognostic index (KiGE). All grade 1 tumours and ER-positive (ER+) grade 2 tumours with Ki67 ≤ 30% were classified as low-KiGE and all the others as high-KiGE.ResultsOverall, 31% of the patients have died from breast cancer. The median follow-up of the patients still alive was 21 years. Age, tumour size, axillary lymph node status (nodal status), histological grade, Ki67 and KiGE were significant prognostic factors for breast cancer mortality (BCM) in univariable analysis. In a multivariable model, adjusted for adjuvant treatment, age and progesterone receptor (PgR), the strongest prognostic factors for BCM were: Nodal status (hazard ratio (HR) = 2.9, 95% confidence interval (95% CI): 1.4-6.1), KiGE (HR = 2.0, 95% CI: 1.1-3.6), and tumour size (HR = 1.9, 95% CI: 0.98-3.8). By combining these three factors, 37% of the ILC’s could be further divided into a low-risk group, consisting of node negative small (≤ 20 mm) low-KiGE tumours, with a BCM of 5% (95% CI: 1-13%) at 10 years and 12% (95% CI: 5-22%) at 20 years follow-up. None of these patients recieved chemotherapy and only 2 recieved endocrine treatment with tamoxifen.ConclusionsThe combination of Ki67, histological grade and ER into KiGE, together with tumour size and nodal status make it possible to identify a large group of ILC patients with such a good long-term prognosis that chemotherapy can be safely avoided and exclusion of endocrine therapy considered.

show abstract

“…Among pleomorphic lobular carcinomas, apocrine, histiocytic, or signet-ring cell differentiation can be observed. Tumor grading of ILC is advocated, with the majority (approximately 76%) of classic ILCs being grade 2 in the Nottingham histological grading system, and ILC of grade 3 comprising mostly a solid and pleomorphic subtype [3,4]. Immunostaining with E-cadherin can help in distinguishing ILC from NST carcinomas, but as about 15% of ILCs also express E-cadherin (e.g.…”

Section: Special Subtypes Of Invasive Breast Carcinomamentioning

confidence: 99%

A Brief Overview of the WHO Classification of Breast Tumors, 4th Edition, Focusing on Issues and Updates from the 3rd Edition

2013

View full text Add to dashboard Cite

The WHO Classification of Tumors of the Breast, 4th edition, is an update to the 3rd edition that was published in 2003, and covers all neoplastic and preneoplastic lesions of the breast. Changes to the 4th edition include new aspects and changes to the terminology that reflect our present-day knowledge of these lesions. Definitions for histopathological diagnosis are complemented by a description of clinical features, epidemiology, macroscopy, genetics, and prognostic and predictive features. In this review of the WHO classification, we have focused on invasive carcinomas, precursor lesions, and some benign epithelial proliferations.

show abstract

Invasive lobular breast cancer. Prognostic significance of histological malignancy grading

Cited by 35 publications

References 21 publications

Prognostic Value of MammaPrint^® in Invasive Lobular Breast Cancer

Prognostic Value of MammaPrint^® in Invasive Lobular Breast Cancer

Invasive lobular carcinoma of the breast: long-term prognostic value of Ki67 and histological grade, alone and in combination with estrogen receptor

A Brief Overview of the WHO Classification of Breast Tumors, 4th Edition, Focusing on Issues and Updates from the 3rd Edition

Contact Info

Product

Resources

About

Invasive lobular breast cancer. Prognostic significance of histological malignancy grading

Cited by 35 publications

References 21 publications

Prognostic Value of MammaPrint® in Invasive Lobular Breast Cancer

Prognostic Value of MammaPrint® in Invasive Lobular Breast Cancer

Invasive lobular carcinoma of the breast: long-term prognostic value of Ki67 and histological grade, alone and in combination with estrogen receptor

A Brief Overview of the WHO Classification of Breast Tumors, 4th Edition, Focusing on Issues and Updates from the 3rd Edition

Contact Info

Product

Resources

About

Prognostic Value of MammaPrint^® in Invasive Lobular Breast Cancer

Prognostic Value of MammaPrint^® in Invasive Lobular Breast Cancer