Abstract
PurposeWe investigated the relationship between obesity, menopausal status, and invasive lobular carcinoma (ILC), the second most common histological subtype of breast cancer. Specifically, we evaluated the association between body mass index (BMI), metabolic syndrome, the 21-gene Oncotype Recurrence Score (Oncotype RS), and pathological features in patients with hormone receptor (HR)-positive, human epidermal growth factor receptor-2-negative ILC.MethodsThe study cohort included 491 patients from a prospectively maintained institutional database consisting of patients with stage I-III, HR-positive ILC who underwent surgical treatment between 1996 and 2019.ResultsContrary to our expectations, we found that lower BMI was significantly associated with having higher Oncotype RS (18.9% versus 4.8%, p = 0.028) in post-menopausal patients, but was not related to tumor characteristics in pre-menopausal patients. Multivariate network analyses suggested a strong relationship between post-menopausal status itself and tumor characteristics, with lesser influence of BMI.ConclusionThese findings provide further insight into the recently appreciated heterogeneity within ILC and support the need for further investigation into the drivers of this disease and tailored treatment strategies.
Highlights
Invasive lobular carcinoma (ILC) is the second most common histological subtype of breast cancer, accounting for 10%–15% of all invasive breast tumors [1]
ILC, of which the majority are estrogen receptor (ER) positive, appears to be hormonally driven, as it is more strongly associated with early menarche, late menopause, and hormone replacement therapy use compared to invasive ductal carcinoma (IDC) [2,3,4,5]
Given that the development of ILC may be tied to hormonal exposure, we aimed to evaluate associations between body mass index (BMI), metabolic syndrome, and ILC histopathological features in pre- versus post-menopausal women with early stage ILC
Summary
Invasive lobular carcinoma (ILC) is the second most common histological subtype of breast cancer, accounting for 10%–15% of all invasive breast tumors [1]. ILC, of which the majority are estrogen receptor (ER) positive, appears to be hormonally driven, as it is more strongly associated with early menarche, late menopause, and hormone replacement therapy use compared to invasive ductal carcinoma (IDC) [2,3,4,5]. As the rate of obesity has increased, the incidence of ILC among post-menopausal women has increased, while that of invasive ductal carcinoma has remained stable [6]. Obesity at breast cancer diagnosis has been shown to confer worse disease-free survival and overall survival in all breast cancer subtypes [7].
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