Long-Term Survival Differences Between T1-2 Invasive Lobular Breast Cancer and Corresponding Ductal Carcinoma After Breast-Conserving Surgery

A Propensity-Scored Matched Longitudinal Cohort Study

Kang Wang, Gui Qi Zhu, Yang Shi, Zhu Yue Li, Xiang Zhang, Hong Yuan Li

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The role of histology subtype on the prognosis of T1-2 breast cancer patients receiving breast-conserving surgery (BCS) is not clear. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program was used to compare overall survival, second primary cancer-free survival (CFS), and local recurrence risk (LR) for patients with invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC), both receiving BCS. Results: The study enrolled 196,688 patients with T1-2 disease receiving BCS, including 12,906 with ILC and 183,782 with IDC. Patients with IDC showed higher unadjusted annual rates of BCS than ILC. Five- and 10-year estimated survival rates were, respectively, 92.06% and 86.14% in ILC, compared to 90.50% and 85.26% in IDC (P =.12). In multivariable Cox regression, ILC patients showed advantage over IDC in overall survival (hazard ratio [HR] = 0.93, P =.001), whereas no significant differences in CFS (HR = 1.03, P =.33) and LR (HR = 1.17, P =.06) were found, which were consistent with results from matched cohort. In subgroup analyses, patients with grade III ILC had poorer CFS (HR = 1.23, P =.009) and higher LR (HR = 1.59, P =.01) than IDC. Conclusion: Histologic type is of prognostic importance in T1-2 patients receiving BCS, and surgeons should be cautious in performing BCS for individuals with grade III ILC.

Original languageEnglish (US)
Pages (from-to)e101-e115
JournalClinical Breast Cancer
Volume19
Issue number1
DOIs
StatePublished - Feb 1 2019

Fingerprint

Lobular Carcinoma
Ductal Carcinoma
Segmental Mastectomy
Longitudinal Studies
Cohort Studies
Breast Neoplasms
Survival
Recurrence
Odds Ratio
SEER Program
Second Primary Neoplasms
Neoplasms
Histology
Survival Rate

Keywords

  • Invasive lobular carcinoma
  • Local recurrence risk
  • Overall survival
  • Second primary cancer-free survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Long-Term Survival Differences Between T1-2 Invasive Lobular Breast Cancer and Corresponding Ductal Carcinoma After Breast-Conserving Surgery : A Propensity-Scored Matched Longitudinal Cohort Study. / Wang, Kang; Zhu, Gui Qi; Shi, Yang; Li, Zhu Yue; Zhang, Xiang; Li, Hong Yuan.

In: Clinical Breast Cancer, Vol. 19, No. 1, 01.02.2019, p. e101-e115.

Research output: Contribution to journalArticle

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title = "Long-Term Survival Differences Between T1-2 Invasive Lobular Breast Cancer and Corresponding Ductal Carcinoma After Breast-Conserving Surgery: A Propensity-Scored Matched Longitudinal Cohort Study",
abstract = "Background: The role of histology subtype on the prognosis of T1-2 breast cancer patients receiving breast-conserving surgery (BCS) is not clear. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program was used to compare overall survival, second primary cancer-free survival (CFS), and local recurrence risk (LR) for patients with invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC), both receiving BCS. Results: The study enrolled 196,688 patients with T1-2 disease receiving BCS, including 12,906 with ILC and 183,782 with IDC. Patients with IDC showed higher unadjusted annual rates of BCS than ILC. Five- and 10-year estimated survival rates were, respectively, 92.06{\%} and 86.14{\%} in ILC, compared to 90.50{\%} and 85.26{\%} in IDC (P =.12). In multivariable Cox regression, ILC patients showed advantage over IDC in overall survival (hazard ratio [HR] = 0.93, P =.001), whereas no significant differences in CFS (HR = 1.03, P =.33) and LR (HR = 1.17, P =.06) were found, which were consistent with results from matched cohort. In subgroup analyses, patients with grade III ILC had poorer CFS (HR = 1.23, P =.009) and higher LR (HR = 1.59, P =.01) than IDC. Conclusion: Histologic type is of prognostic importance in T1-2 patients receiving BCS, and surgeons should be cautious in performing BCS for individuals with grade III ILC.",
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T1 - Long-Term Survival Differences Between T1-2 Invasive Lobular Breast Cancer and Corresponding Ductal Carcinoma After Breast-Conserving Surgery

T2 - A Propensity-Scored Matched Longitudinal Cohort Study

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AU - Zhu, Gui Qi

AU - Shi, Yang

AU - Li, Zhu Yue

AU - Zhang, Xiang

AU - Li, Hong Yuan

PY - 2019/2/1

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N2 - Background: The role of histology subtype on the prognosis of T1-2 breast cancer patients receiving breast-conserving surgery (BCS) is not clear. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program was used to compare overall survival, second primary cancer-free survival (CFS), and local recurrence risk (LR) for patients with invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC), both receiving BCS. Results: The study enrolled 196,688 patients with T1-2 disease receiving BCS, including 12,906 with ILC and 183,782 with IDC. Patients with IDC showed higher unadjusted annual rates of BCS than ILC. Five- and 10-year estimated survival rates were, respectively, 92.06% and 86.14% in ILC, compared to 90.50% and 85.26% in IDC (P =.12). In multivariable Cox regression, ILC patients showed advantage over IDC in overall survival (hazard ratio [HR] = 0.93, P =.001), whereas no significant differences in CFS (HR = 1.03, P =.33) and LR (HR = 1.17, P =.06) were found, which were consistent with results from matched cohort. In subgroup analyses, patients with grade III ILC had poorer CFS (HR = 1.23, P =.009) and higher LR (HR = 1.59, P =.01) than IDC. Conclusion: Histologic type is of prognostic importance in T1-2 patients receiving BCS, and surgeons should be cautious in performing BCS for individuals with grade III ILC.

AB - Background: The role of histology subtype on the prognosis of T1-2 breast cancer patients receiving breast-conserving surgery (BCS) is not clear. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program was used to compare overall survival, second primary cancer-free survival (CFS), and local recurrence risk (LR) for patients with invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC), both receiving BCS. Results: The study enrolled 196,688 patients with T1-2 disease receiving BCS, including 12,906 with ILC and 183,782 with IDC. Patients with IDC showed higher unadjusted annual rates of BCS than ILC. Five- and 10-year estimated survival rates were, respectively, 92.06% and 86.14% in ILC, compared to 90.50% and 85.26% in IDC (P =.12). In multivariable Cox regression, ILC patients showed advantage over IDC in overall survival (hazard ratio [HR] = 0.93, P =.001), whereas no significant differences in CFS (HR = 1.03, P =.33) and LR (HR = 1.17, P =.06) were found, which were consistent with results from matched cohort. In subgroup analyses, patients with grade III ILC had poorer CFS (HR = 1.23, P =.009) and higher LR (HR = 1.59, P =.01) than IDC. Conclusion: Histologic type is of prognostic importance in T1-2 patients receiving BCS, and surgeons should be cautious in performing BCS for individuals with grade III ILC.

KW - Invasive lobular carcinoma

KW - Local recurrence risk

KW - Overall survival

KW - Second primary cancer-free survival

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