Analysis Of Recurrent Or Metastatic Features And Survival Between Invasive Lobular Cancer And Invasive Ductal Breast Cancer

Objective: To analyze and compare the clinicopathological features and prognostic factors between patients with recurrent or metastatic breast invasive lobular carcinoma(ILC)and invasive ductal carcinoma(IDC).Methods: Fifty-nine female patients with recurrent or metastatic breast ILC from Tianjin Medical University Cancer Institute and Hospital were included in this retrospective case-controlled study.Matched two hundred and thirty-six female patients with advanced breast IDC were selected according to age at diagnosis time(±2 years)in Tianjin Medical University Cancer Institute and Hospital between January 2008 and December 2016.Clinical and pathological features and prognostic factors were analyzed by using univariate and multivariate analyses.The data between the two groups were analyzed by χ2 test.The Kaplan-Meier method was used for survival analysis.Univariate analysis was performed by log-rank test,and the COX regression model was used for multivariate analysis.P < 0.05 was considered statistically significant.Results: In this study,59 cases of ILC group and 236 cases of IDC group were reported.The clinical pathological features of clinical stage at initial diagnosis,T stage,M stage,histological degree,estrogen receptor(ER)status,progesterone receptor(PR)status,human epidermal growth factor receptor-2(HER-2)status and molecular subtype were significantly different between two groups(all P < 0.05).The median ages at recurrence/metastasis of patients with breast ILC and IDC were50 years(range:28-73)and 51 years(range: 27-69),respectively.The differences in the number of first metastatic sites,lymph node metastasis,visceral metastasis,lung metastasis and bone metastasis were statistically significant between two groups(all P< 0.05).The median follow-up time was 46 months(range: 6 ~ 92 months)in the whole group.The median progression-free survivals of patients with breast ILC and IDC were 14 months(range:2-62)and 11 months(range: 1-89),respectively(P < 0.05).The median metastases overall survivals(M-OS)of patients with ILC and IDC were42 months(range: 5-78)and 44 months((range: 1-110),respectively(P = 0.392).According to different molecular typing,there was no significant difference in PFS and M-OS between ILC group and IDC group(all P < 0.05).Univariate analysis revealed that T stage,histological grade,PR status,Ki-67 index,age of recurrence/metastasis and treatment of bone metastases were all related to M-OS in patients with ILC group(P < 0.05),and ER status,PR status,molecular subtype,the number of first metastatic sites,pleural effusion and palliative endocrine therapy were all related to M-OS in the IDC group(P < 0.05).Multivariate analysis revealed that PR status,age at recurrence or metastasis and treatment of bone metastases were the independent predictors of survival in patients with advanced breast ILC(all P < 0.05).The molecular subtype,the number of first metastatic sites and pleural effusion were the independent prognostic factors in patients with breast IDC(all P < 0.05).Conclusion: Patients with recurrent or metastatic ILC have unique clinicopathological,recurrent/metastatic and prognostic features.It is necessary to reveal the definitive features of ILC and develop new personalized precision therapies.