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Prospective multicenter comparison of proliferation and other prognostic factors in lymph node negative lobular invasive breast cancer

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Abstract

Evaluation of prognostic factors in lymph node negative (LNneg) invasive lobular cancers (ILCs). Prospective analysis of proliferation and other prognosticators in 121 LNneg ILCs (119 months median follow-up, range 19–181), without adjuvant chemotherapy. ILC subtype was assessed in accordance with WHO-2003 criteria. Immunohistochemical E-cadherin and estrogen receptor were used. With a median follow up time of 83 months (range 19–181), 30 of the 121 (25%) ILC patients developed distant metastases and 27 (22%) died. None of the cases classified as solid/pleomorphic lobular were E-cadherin or estrogen receptor positive, contrasting the other ILCs. The solid/alveolar ILCs (n = 17) had a worse survival (50%) than the other ILCs (n = 104; 83%, P < 0.0001). Mitotic activity index (MAI) (but not nuclear grade or tubule formation) was prognostic with a threshold 0–5 versus >5 (=MAI-5) (contrasting MAI < 10 vs. ≥10 in breast cancers in general; 85 and 54% survival, P < 0.0001). In multivariate analysis only subtype and MAI but none of the other characteristics had independent prognostic value. Histologic subtype and MAI have independent prognostic value in node negative invasive lobular cancers.

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Acknowledgments

The MMMCP study is supported by grant #28-1398 of the Zorg Onderzoek Nederland (ZON) and grants #06-212 and 07-218 of the SBDM. Besides the authors, the project has been made possible by the continuing collaboration of all the specialists, bioengineers and administrative collaborators of the MMMCP project.

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Authors and Affiliations

  1. Department of Pathology, Stavanger University Hospital, Box 8100, 4068, Stavanger, Norway

    Einar Gudlaugsson, Ivar Skaland, Emiel A. M. Janssen, Kjell Kjellevold & Jan P. A. Baak

  2. The Gade Institute, University of Bergen, Bergen, Norway

    Einar Gudlaugsson, Ivar Skaland & Jan P. A. Baak

  3. Free University, Amsterdam, The Netherlands

    Jan P. A. Baak

  4. Department of Pathology, University Medical Center, Utrecht, The Netherlands

    Paul J. van Diest

  5. Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands

    Feja J. Voorhorst

  6. Department of Pathology, University Hospital Freiburg, Freiburg, Germany

    Axel zur Hausen

Authors
  1. Einar Gudlaugsson
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  2. Ivar Skaland
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  3. Emiel A. M. Janssen
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  4. Paul J. van Diest
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  5. Feja J. Voorhorst
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  6. Kjell Kjellevold
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  7. Axel zur Hausen
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  8. Jan P. A. Baak
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Correspondence to Jan P. A. Baak.

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Gudlaugsson, E., Skaland, I., Janssen, E.A.M. et al. Prospective multicenter comparison of proliferation and other prognostic factors in lymph node negative lobular invasive breast cancer. Breast Cancer Res Treat 121, 35–40 (2010). https://doi.org/10.1007/s10549-009-0442-x

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  • DOI: https://doi.org/10.1007/s10549-009-0442-x

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