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Optimal surgical treatment of invasive lobular carcinoma of the breast

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Abstract

Background: The roles of breast conservation and surgical evaluation of the contralateral breast in the treatment of lobular carcinoma of the breast remain unclear. The aim of this study was to compare local recurrence, 5-year survival, and incidence of contralateral breast cancer in women with lobular carcinoma to that in women with infiltrating ductal carcinoma.

Methods: Women with infiltrating ductal carcinoma (IDC) and invasive lobular breast carcinoma (ILC) diagnosed during the years 1984 to 1994 were identified through a statewide tumor registry. The women were divided into groups based on their histology and treatment (breast conservation or modified radical mastectomy). The incidences of contralateral breast cancer, local recurrence, and 5-year survival were compared within each histologic group and treatment category.

Results: During the period 1984 to 1994, 4886 women were diagnosed with invasive lobular or ductal breast carcinoma. Of these, 316 (6.5%) had infiltrating lobular cancer. The 5-year survival rates were 68% and 71% for ILC and IDC, respectively (p=0.5). The local recurrence rates were 2.8% and 4.3% for ILC treated with lumpectomy and axillary nodal dissection (LAND) and modified radical mastectomy (MRM), respectively, which were not significantly different from that obtained with IDC (LAND=2.5%, MRM=2.1%). The incidence of contralateral breast cancer during the period was 6.6% and 6.5% for ILC and IDC, respectively.

Conclusions: Invasive lobular carcinoma can be safely treated with breast conservation with no difference in local recurrence or survival. In the absence of a suspicious finding on clinical or radiologic examination, routine contralateral breast intervention is not recommended.

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References

  1. Parker SL, Tonga T, Bolden S, Wingo PA. Cancer statistics, 1997.CA Cancer J Clin 1997;47:5–27.

    CAS  PubMed  Google Scholar 

  2. Kinne DW. Controversies in primary breast cancer management.Am J Surg 1993;166:502–8.

    CAS  PubMed  Google Scholar 

  3. Fisher B, Redmond C, Poisson R, et al. Eight year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer.N Engl J Med 1989;320:822–8.

    CAS  PubMed  Google Scholar 

  4. Foote FW, Stewart FW. Lobular carcinoma in situ: a rare form of mammary cancer.Am J Path 1941;17:491–5.

    Google Scholar 

  5. Muir R. The evolution of carcinoma of the mammae.J Path Bacteriol 1941;52:155–72.

    CAS  Google Scholar 

  6. Winchester DJ, Chang HR, Graves TA, Menck HR, Bland KI, Winchester DP. A comparative analysis of lobular and ductal carcinoma of the breast: presentation, treatment and outcome.Ann Surg Oncol (in press).

  7. Le Gal M, Ollivier L, Asselain B, Meunier M, Laurent M, Vieth P, Neuenschwander S. Mammographic features of 455 invasive lobular carcinomas.Radiology 1992;185:705–8.

    PubMed  Google Scholar 

  8. Krecke KN, Gisvold JJ. Invasive lobular carcinoma of the breast: mammographic findings and extent of disease at diagnosis in 184 patients.AJR 1993;161:957–60.

    CAS  PubMed  Google Scholar 

  9. Yeatman TJ, Cantor AB, Smith TJ, et al. Tumor biology of infiltrating lobular carcinoma. Implications for management.Ann Surg 1995;222:549–61.

    CAS  PubMed  Google Scholar 

  10. Shnitt SJ, Connolly JL, Recht A, Silver B, Harris JR. Influence of infiltrating lobular histology on local tumor control in breast cancer patients treated with conservative surgery and radiotherapy.Cancer 1989;64:448–54.

    Google Scholar 

  11. Kurtz JM, Jacquemier J, Torhorst J, et al. Conservation therapy for breast cancers other than infiltrating ductal carcinoma.Cancer 1989;63:1630–5.

    CAS  PubMed  Google Scholar 

  12. du Toit RS, Locker AP, Ellis IO, Elston CW, Nicholson RI, Robertson JFR, Blamey RW. An evaluation of differences in prognosis, recurrence patterns and receptor status between invasive lobular and other invasive carcinomas of the breast.Eur J Surg Oncol 1991;17:251–7.

    PubMed  Google Scholar 

  13. Poen JC, Tran L, Juillard G, et al. Conservation therapy for invasive lobular carcinoma of the breast.Cancer 1992;69:2789–95.

    CAS  PubMed  Google Scholar 

  14. Weiss MC, Fowble BL, Solin LJ, Yeh IT, Schultz DJ. Outcome of conservative therapy for invasive breast cancer by histologic type.Int J Radiation Oncology Biol Phys 1992;23:941–7.

    CAS  Google Scholar 

  15. White JR, Gustafson GS, Wimbish KW, et al. Conservative surgery and radiation therapy for infiltrating lobular carcinoma of the breast. The role of preoperative mammograms in guiding treatment.Cancer 1994;74:640–7.

    CAS  PubMed  Google Scholar 

  16. Veronesi U, Marubini E, Del Vecchio M, et al. Local recurrences and distant metastases after conservative breast cancer treatments: partly independent events.J Natl Can Inst 1995;87:19–27.

    CAS  Google Scholar 

  17. Sastre-Garau X, Jouve M, Asselain B, et al. Infiltrating lobular carcinoma of the breast. Clinicopathologic analysis of 975 cases with reference to data on conservative therapy and metastatic patterns.Cancer 1996;77:113–20.

    Article  CAS  PubMed  Google Scholar 

  18. Salvadori B, Biganzoli E, Veronesi P, Sacozzi R, Rilke F. Conservative surgery for infiltrating breast carcinoma.Br J Surg 1997;84:106–9.

    Article  CAS  PubMed  Google Scholar 

  19. Wanebo HJ, Senofsky GM, Fechner RE, Kaiser D, Lynn S, Paradies J. Bilateral breast cancer. Risk reduction by contralateral biopsy.Ann Surg 1985;201:667–77.

    CAS  PubMed  Google Scholar 

  20. Silverstein MJ, Lewinsky BS, Waisman JR, et al. Infiltrating lobular carcinoma. Is it different from infiltrating duct carcinoma?Cancer 1994;73:1673–7.

    CAS  PubMed  Google Scholar 

  21. Broet P, de la Rochefordiere A, Scholl S, et al. Contralateral breast cancer: annual incidence and risk parameters.J Clin Oncol 1995;13:1578–83.

    CAS  PubMed  Google Scholar 

  22. Healey EA, Cook EF, Orav EJ, Schnitt SJ, Connolly JL, Harris JR. Contralateral breast cancer: clinical characteristics and impact on prognosis.J Clin Oncol 1993;11:1545–52.

    CAS  PubMed  Google Scholar 

  23. Smith BL, Bertagnolli M, Klein BB, Batter S, Chang H, Douville LM, Eberlein TJ. Evaluation of the contralateral breast. The role of biopsy at the time of treatment.Ann Surg 1992;216:17–21.

    CAS  PubMed  Google Scholar 

  24. Singletary SE, Taylor SH, Guinee VF, Whitworth PW. Occurrence and prognosis of contralateral carcinoma of the breast.J Am Coll Surg 1994;178:390–6.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Rhode Island Hospital, Brown University, Providence, Rhode Island

    Kirby I. Bland MD

  2. Center for Statistical Science, Brown University, Providence, Rhode Island

    Bernard Cole PhD

  3. Dept. of Surgery, Roger Williams Medical Center, 825 Chalkstone Ave., 02908, Providence, RI, USA

    Maureen A. Chung MD, Harold J. Wanebo MD &  Helena R. Chang MD, PhD

Authors
  1. Maureen A. Chung MD
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  2. Bernard Cole PhD
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  3. Harold J. Wanebo MD
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  4. Kirby I. Bland MD
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  5. Helena R. Chang MD, PhD
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Chung, M.A., Cole, B., Wanebo, H.J. et al. Optimal surgical treatment of invasive lobular carcinoma of the breast. Annals of Surgical Oncology 4, 545–550 (1997). https://doi.org/10.1007/BF02305534

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  • DOI: https://doi.org/10.1007/BF02305534

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