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

PLoS One. 2022 Jan 20;17(1):e0262709. doi: 10.1371/journal.pone.0262709. eCollection 2022.

Abstract

Background: 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: We 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.

Results: The 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).

Conclusions: Hormone 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Breast / metabolism
  • Breast / pathology
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / pathology
  • Carcinoma, Ductal, Breast / metabolism
  • Carcinoma, Ductal, Breast / mortality*
  • Carcinoma, Ductal, Breast / pathology
  • Carcinoma, Lobular / metabolism
  • Carcinoma, Lobular / mortality*
  • Carcinoma, Lobular / pathology
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Receptors, Estrogen / metabolism*
  • Receptors, Progesterone / metabolism*
  • Republic of Korea / epidemiology
  • Survival Analysis
  • Survival Rate

Substances

  • Receptors, Estrogen
  • Receptors, Progesterone

Grants and funding

Sae Byul Lee 2017-1341 Elimination of Cancer Project Fund from the Asan Cancer Institute of Asan Medical Center http://cancer.amc.seoul.kr/asan/depts/cancer/K/deptMain.do The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.