Survival analysis in patients with invasive lobular cancer and invasive ductal cancer according to hormone receptor expression status in the Korean population.

Douk Kwon,Byung Kyun Ko,Yong Sik Jung,Sae Byul Lee,Seung Pil Jung,Hyun Jo Youn,Hong-Kyu Kim,Eun-Kyu Kim,Ramon Andrade De Mello

doi:10.1371/journal.pone.0262709

Abstract

BackgroundWe compared the clinicopathological characteristics and survival outcomes of invasive lobular carcinoma (ILC) cases with those of invasive ductal carcinoma (IDC) cases in various hormone receptor expression subgroups.MethodsWe compared clinicopathological characteristics, overall survival (OS), and breast cancer-specific survival (BCSS) between patients with IDC (n = 95,486) and ILC (n = 3,023). In addition, we analyzed the effects of different hormone receptor expression subgroups on survival.ResultsThe ILC group had more instances of advanced stage and hormonal receptor positivity than did the IDC group (p < 0.001), but the IDC group had higher histological grade and nuclear grade, as well as higher frequency of human epidermal growth factor receptor 2 and Ki67 expression than did the ILC group (p < 0.001). The OS and BCSS were not significantly different between the IDC and ILC groups. The 5-year OS of the IDC group was 88.8%, while that of the ILC group was 90.6% (p = 0.113). The 5-year BCSS of the IDC group was 94.8%, while that of the ILC group was 95.0% (p = 0.552). When analyzing each hormone receptor expression subgroup, there were no significant differences in survival between the IDC and ILC groups. However, the estrogen receptor (ER) negative/progesterone receptor (PR) negative subgroup showed differences in survival between the IDC and ILC groups. Moreover, the hazard ratio of ILC in the ER negative/PR negative subgroup was 1.345 (95% confidence interval: 1.012–1.788; p = 0.041).ConclusionsHormone receptor expression should be considered when determining prognosis and treatment regimen for IDC and ILC. Researchers should further study the ER negative/PR negative population to identify treatment and prognostic models that will facilitate the development of individualized therapy for these patients, which is needed for good outcomes.

Highlights

In Korea, just as in western countries, the prevalence of breast cancer is increasing [1,2,3,4], and invasive breast cancer accounts for most cases [5]
When analyzing each hormone receptor expression subgroup, there were no significant differences in survival between the invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) groups
Researchers should further study the estrogen receptor (ER) negative/progesterone receptor (PR) negative population to identify treatment and prognostic models that will facilitate the development of individualized therapy for these patients, which is needed for good outcomes

Summary

Introduction

In Korea, just as in western countries, the prevalence of breast cancer is increasing [1,2,3,4], and invasive breast cancer accounts for most cases [5]. Several studies comparing invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) have been conducted worldwide [6,7,8,9,10]; these have shown that ILC cases have similar or better survival outcomes compared to those of IDC cases, which account for most invasive breast cancer cases [8,9,10,11,12]. As individualized therapy has become important, studies on hormone receptor expression subtypes have been conducted, mainly in the West. We compared the clinicopathological characteristics and survival outcomes of invasive lobular carcinoma (ILC) cases with those of invasive ductal carcinoma (IDC) cases in various hormone receptor expression subgroups

Methods

Results

Conclusion