Inwazyjny rak zrazikowy – Rokowania, prognozy i postęp choroby

Inwazyjny rak zrazikowy
Rokowania, prognozy i postęp choroby

Inwazyjny rak zrazikowy (ILC) stanowi 10-15% wszystkich inwazyjnych raków piersi i charakteryzuje się powolnym wzrostem oraz trudnościami diagnostycznymi ze względu na liniowy wzorzec rozrostu. Pięcioletni względny wskaźnik przeżycia dla ILC wynosi 88,6%, a dziesięcioletni 73,6%, z wyraźnym zróżnicowaniem w zależności od stadium choroby: zlokalizowane (ponad 99%), regionalne (87%) i odległe (32%). Rokowanie jest gorsze u pacjentek w wieku ≤35 lat oraz ≥70 lat, a także zależy od podtypów receptorów hormonalnych ER/PR. Raki HR+ wykazują niższe ryzyko nawrotów w pierwszych 5 latach, ale wyższe po 10 latach. Mutacje w genach ERBB2, ERBB3, TP53, AKT1 i ROS1 korelują z gorszym rokowaniem i opornością na terapię hormonalną. Nawrót ILC może wystąpić nawet po wielu latach, z predylekcją do przerzutów do wątroby, płuc, kości oraz narządów przewodu pokarmowego i ginekologicznych.

Inwazyjny rak zrazikowy – prognoza i predykcja wyników leczenia

Ogólne wskaźniki przeżycia
Wskaźniki przeżycia według stadium zaawansowania
Czynniki wpływające na prognozę
Nawroty choroby
Nowe metody predykcji rokowania
Znaczenie ścieżek molekularnych w prognozowaniu
Wyzwania w predykcji rokowania
Podsumowanie rokowania
Kolejne rozdziały

Inwazyjny rak zrazikowy – prognoza i predykcja wyników leczenia

Inwazyjny rak zrazikowy (ILC – Invasive Lobular Carcinoma) stanowi drugą najczęstszą postać raka piersi, odpowiadając za około 10-15% wszystkich diagnoz inwazyjnego raka piersi. Jest to nowotwór charakteryzujący się powolnym wzrostem, co stwarza większe szanse na wykrycie go we wczesnych stadiach, kiedy leczenie jest łatwiejsze. Jednakże diagnostyka ILC może być trudniejsza niż w przypadku innych typów raka piersi, ponieważ ma on tendencję do rozrastania się w prostych liniach, a nie w formie guza czy zgrubienia.¹

Ogólne wskaźniki przeżycia

Wskaźniki przeżycia dla inwazyjnego raka zrazikowego zależą od wielu czynników, w tym stadium nowotworu w momencie diagnozy, wieku pacjentki, ogólnego stanu zdrowia, skuteczności leczenia, stopnia złośliwości nowotworu oraz wyników określonych markerów, w tym receptorów estrogenowych, progesteronowych i HER2/neu.² Według najnowszych badań z 2024 roku, ogólny 5-letni wskaźnik przeżycia dla ILC wynosi 88,6%, a 10-letni wskaźnik przeżycia wynosi 73,6%.³

Inne badania wskazują, że około 94% kobiet z ILC żyje bez nawrotu choroby pięć lat po diagnozie, natomiast około 86% pacjentek przeżywa 10 lat od momentu rozpoznania.⁴ Warto zauważyć, że 5-letnie wskaźniki przeżycia dla ILC są podobne do innych typów raka piersi, jednak w perspektywie 10-letniej są o 4-10% niższe.⁵

Wskaźniki przeżycia według stadium zaawansowania

Wskaźniki przeżycia dla inwazyjnego raka zrazikowego są grupowane w trzy stadia: zlokalizowane, regionalne i odległe, z których każde ma własny 5-letni względny wskaźnik przeżycia:⁶⁷

Zlokalizowane (rak nie rozprzestrzenił się poza pierś): ponad 99% pacjentek przeżywa co najmniej 5 lat
Regionalne (rak rozprzestrzenił się do węzłów chłonnych w pobliżu piersi): 87% pacjentek przeżywa co najmniej 5 lat
Odległe (rak rozprzestrzenił się dalej w organizmie): 32% pacjentek przeżywa co najmniej 5 lat

⁸

Gdy inwazyjny rak zrazikowy jest wykrywany i leczony we wczesnych, zlokalizowanych stadiach, 5-letni względny wskaźnik przeżycia wynosi 99%. Jeśli ILC jest diagnozowany w późniejszym stadium, rozprzestrzenił się do pobliskich tkanek lub węzłów chłonnych, lub dał przerzuty do odległych obszarów ciała, wskaźnik przeżycia zaczyna spadać.⁹

Czynniki wpływające na prognozę

Wiek pacjentki

Analiza wieloczynnikowa wykazała, że pacjentki diagnozowane zarówno w młodym wieku (≤35 lat), jak i w starszym wieku (≥70 lat) mają gorsze rokowanie w porównaniu z osobami w średnim wieku. Ryzyko zgonu (HR) dla przeżycia całkowitego malało wraz z wiekiem od 1,55 (95% CI, 1,08-2,22; P=0,019) w grupie poniżej 35 lat do 1,38 (1,02-1,86; P=0,036) w grupie 35-39 lat, ale wzrastało wraz z wiekiem do 10,1 (8,49-11,94; P<0,001) w grupie powyżej 79 lat.¹⁰

Wpływ wieku na przeżycie całkowite w raku zrazikowym różni się w zależności od podtypów określonych przez receptory ER/PR. Pacjentki diagnozowane po 79. roku życia miały najgorszy wskaźnik przeżycia całkowitego we wszystkich czterech podtypach, podczas gdy grupa wiekowa o najlepszej prognozie różniła się w zależności od podtypu ER/PR.¹¹

Status receptorów hormonalnych

Raki piersi z dodatnimi receptorami hormonalnymi (HR+), takie jak większość przypadków ILC, mają zwykle niższy wskaźnik nawrotów w pierwszych 5 latach po diagnozie niż raki piersi z ujemnymi receptorami hormonalnymi (HR-). Jednakże raki HR+ mogą nawracać z wyższą częstotliwością niż raki HR- po upływie 10 i więcej lat od leczenia.¹²

Badania wykazały, że wpływ wieku na przeżycie całkowite raka zrazikowego w podtypach ER+PR- i ER-PR+ był bardziej zbliżony do podtypu ER-PR- niż do podgrupy ER+PR+, a młody wiek nie był predyktorem gorszego przeżycia całkowitego w raku zrazikowym ER+PR-, ER-PR+ lub ER-PR-.¹³

Mutacje genetyczne

ILC o złym rokowaniu, przewidywanym przez sygnaturę LobSig, charakteryzował się zwiększoną częstością mutacji w genach ERBB2, ERBB3, TP53, AKT1 i ROS1.¹⁴ Nabywanie mutacji ERBB2 i ERBB3 w ILC jest związane ze zwiększonym ryzykiem nawrotu i gorszymi wynikami, co prawdopodobnie stanowi mechanizm ucieczki przed terapią hormonalną.¹⁵

Nawroty choroby

Nawrót inwazyjnego raka zrazikowego oznacza, że nowotwór zostaje później wykryty jako nadal obecny w organizmie po początkowym pomyślnym leczeniu. Nawrót może być miejscowy (w pozostałej tkance piersi), regionalny (w węzłach chłonnych pod pachą lub w pobliżu kości obojczyka) lub odległy, gdy komórki raka piersi pojawiają się w innych narządach ciała.¹⁶

W przypadku ILC nowotwór może powrócić, głównie w ciągu 5-10 lat, ale niektóre przypadki mogą nawrócić nawet po dziesięcioleciach.¹⁷ Warto zauważyć, że chociaż wcześniej uważano, że inwazyjny rak zrazikowy ma korzystne rokowanie w porównaniu z rakiem przewodowym, przeprowadzone badania pokazały, że nie jest to prawdą w perspektywie długoterminowej.¹⁸

Przerzutowy obraz ILC jest uważany za unikalny, z predylekcją do typowych miejsc (wątroba, płuca, kości), ale także do miejsc kolonizacji przewodu pokarmowego i narządów ginekologicznych.¹⁹ Niedawne badanie przerzutów do narządów ginekologicznych wykazało związek z ILC i młodym wiekiem w momencie diagnozy oraz potwierdziło wcześniejsze doniesienia o szerokiej kolonizacji przerzutowej ILC.²⁰

Nowe metody predykcji rokowania

Sygnatury genetyczne

Wiele testów opartych na sygnaturach molekularnych jest dostępnych komercyjnie, jednak użyteczność niektórych z tych testów w ILC pojawiła się dopiero niedawno.²¹ Indeks Genomowej Złośliwości (GGI/MapQuantDx) okazał się skuteczniejszy niż sam stopień złośliwości w populacji ILC i co ciekawe, był w stanie przekategoryzować niektóre przypadki PILC do grup niższego ryzyka, a niektóre klasyczne ILC do grup wyższego ryzyka na podstawie obliczonego genomowego stopnia złośliwości.²²

Istnieją również wątpliwości co do użyteczności klinicznej sygnatury 21-genowej, OncotypeDx, w ILC, przy czym dwa badania wykazały klasyfikację odpowiednio 42% i 35,5% pacjentów jako znajdujących się w pośrednim ryzyku.²³ Z kolei MammaPrint ma potwierdzoną wartość tylko u pacjentek z ILC bez zajęcia węzłów chłonnych.²⁴

LobSig

Niedawno opracowano 194-genową sygnaturę zdolną do istotnego uszeregowania prognozy u pacjentek z ILC (LobSig), wykorzystując integracyjną analizę danych dotyczących kopii genomu i transkryptomu z guzów ILC.²⁵ LobSig jest wysoce prognostyczny w nieselekcjonowanym ILC, a w szczególności w guzach ILC stopnia 2 i 3, a także w mniejszym stopniu w przypadkach ER-dodatnich, stopnia 2 IC-NST.²⁶ LobSig przewyższa istniejące sygnatury zarówno w kontekście jednowymiarowym (P=9,0×10^-6), jak i wielowymiarowym (P=3,14×10^-4).²⁷

Co istotne, status LobSig przewidywał wynik z 94,6% dokładnością wśród przypadków sklasyfikowanych jako umiarkowanego ryzyka według Nottingham Prognostic Index w kohorcie METABRIC.²⁸²⁹ LobSig jest szczególnie skuteczny w guzach ILC stopnia 2 (AUC=0,906).³⁰ Przedstawione dane sugerują, że pacjentki z niskim ryzykiem według LobSig nie muszą otrzymywać adiuwantowej chemioterapii.³¹³²

PSILC

Bazując na właściwościach prognostycznych ścieżek komórkowych (CP), utworzono sygnaturę wieloczynnikową poprzez zagregowanie wielu CP w model uczenia maszynowego przy użyciu algorytmu Random Forest, nazwaną PSILC. PSILC skutecznie klasyfikowała pacjentki do odpowiednich grup ryzyka w połączonej kohorcie walidacyjnej (HR=2,94, 95% CI=2,01-4,3, P=2,9×10^-8).³³ PSILC pozostała niezależnym biomarkerem prognostycznym po uwzględnieniu wieku, stopnia T, statusu węzłów chłonnych i czystości guza.³⁴

PSILC dokładnie przewidywała prawdopodobieństwo przerzutów (klasyfikacja dwugrupowa: P=6,6×10^-4).³⁵ Wynik ten podkreśla użyteczność PSILC jako narzędzia do identyfikacji pacjentek, u których obecne opcje leczenia prawdopodobnie nie przyniosą sukcesu, szczególnie w perspektywie długoterminowej, co pozostaje wyzwaniem klinicznym w leczeniu ILC w porównaniu z IBC-NST.³⁶

Znaczenie ścieżek molekularnych w prognozowaniu

Wyniki badań mRNA wskazują, że dysregulacja 25 ścieżek molekularnych była silnie prognostyczna w ILC (P≤0,05 po korekcie FDR). Spośród nich trzy ścieżki, w tym komunikacja międzykomórkowa, wrodzony układ odpornościowy i skurcz mięśni gładkich, były również niezależnymi predyktorami odpowiedzi na chemioterapię.³⁷

Najlepsze trzy prognostyczne ścieżki komórkowe obejmowały cykl komórkowy (HR=2,81, 95% CI=1,97-4,02, P po korekcie FDR=4,09×10^-7), biologię rozwojową/regulację komórek beta (HR=2,34, 95% CI=1,67-3,36, P po korekcie FDR=1,95×10^-5) i hemostazę (HR=2,3, 95% CI=1,62-3,26, P po korekcie FDR=2,33×10^-5).³⁸ Sugeruje to, że pacjentki przewidywane przez ścieżki komórkowe jako wysokiego ryzyka w grupie bez wcześniejszej chemioterapii mogłyby odnieść korzyść z leczenia chemioterapeutycznego.³⁹

Wyzwania w predykcji rokowania

Wyzwaniem dla walidacji diagnostyki predykcyjnej i prognostycznej w ILC pozostaje to, że latencja między diagnozą a nawrotem/wznową może być długa, co utrudnia finansowanie i śledzenie badań prospektywnych.⁴⁰ Pomimo jasnych różnic histologicznych, molekularnych i klinicznych między ILC a IBC-NST, opcje leczenia dla większości ILC (tj. ER+) i IBC-NST pozostają takie same, obejmując kombinację chirurgii, radioterapii, chemioterapii i terapii hormonalnej.⁴¹

Chociaż obecne opcje terapeutyczne oferują dobrą prognozę krótkoterminową, długoterminowy wynik (powyżej 5 lat) ILC pozostaje gorszy, przy czym ILC wykazuje preferencyjną skłonność do przerzutów do kości i przewodu pokarmowego w porównaniu z pacjentkami z częściej diagnozowanym IBC-NST.⁴²

Wiele pacjentek z inwazyjnym rakiem zrazikowym otrzymuje standardową chemioterapię, jednak kompleksowy przegląd wykazał, że nie przynosi ona znaczących korzyści klinicznych.⁴³ Badania wykazały, że pacjentki odnoszą korzyści z kombinacji terapii celowanej i terapii hormonalnej.⁴⁴

Podsumowanie rokowania

Inwazyjny rak zrazikowy, chociaż często wykrywany w stadium umożliwiającym pomyślne leczenie, stanowi poważne zagrożenie dla życia wymagające leczenia medycznego. Może zostać wyleczony, jeśli zostanie zdiagnozowany i leczony we wczesnych stadiach.⁴⁵ Personalizowane strategie postępowania powinny być opracowywane w celu poprawy wyników u pacjentek z rakiem piersi o różnym wieku i statusie ER/PR.⁴⁶

Podjęcie decyzji terapeutycznych opartych na indywidualnej charakterystyce molekularnej guza może poprawić długoterminowe rokowanie u pacjentek z ILC, szczególnie biorąc pod uwagę unikalne cechy biologiczne i kliniczne tego podtypu raka piersi.

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Materiały źródłowe

#1 Invasive Lobular Carcinoma: Diagnosis, Treatment, & Prognosis
https://www.nationalbreastcancer.org/invasive-lobular-carcinoma/
Invasive lobular carcinoma (ILC) is the second most common form of breast cancer, accounting for approximately 10-15% of invasive breast cancer diagnoses. […] ILC is a slow-growing cancer. However, it can be more difficult to detect and diagnose than other types of breast cancer because it tends to grow out in straight lines rather than forming a mass or lump. […] The severity of invasive lobular carcinoma depends on the stage at diagnosis and how far the cancer has spread. When caught and treated in an early stage, the survival rate for ILC is very good. Survival rates for ILC decline the more progressed the cancer is when first diagnosed. […] When detected and treated in the early stages, the prognosis for invasive lobular carcinoma is very good. Because ILC is a slow-growing cancer, there is more opportunity to catch it in the early stages when it is easier to treat.
#2 Invasive lobular breast cancer: Prognosis, treatment, and remission
https://www.medicalnewstoday.com/articles/323284
Invasive lobular carcinoma (ILC) affects the lobules of the breast, which contain the glands that produce breast milk. It is a type of breast cancer, and the outlook can vary depending on multiple factors. […] The outlook after a cancer diagnosis depends on several factors, including: the size of the cancer, whether the cancer has spread and where it has spread to, a persons age, a persons general state of health, the effectiveness of the treatment, the cancer grade, which measures how abnormal the cells appear at a microscopic level, the results of certain markers, including estrogen receptor, progesterone receptor, and HER2/neu. […] The outlook also varies depending on the stage of the cancer. A lower number means the cancer is in an earlier stage, while a higher number means the cancer has advanced.
#3 Invasive lobular breast cancer: Prognosis, treatment, and remission
https://www.medicalnewstoday.com/articles/323284
A 2024 study found that the overall 5-year survival rate for ILC is 88.6%, and the 10-year survival rate is 73.6%. […] In general, if doctors diagnose and treat cancer in the early stages, survival rates tend to be higher. If cancer has advanced, for example, by spreading beyond the breast tissue, survival rates are likely to be lower. […] The 5-year survival rate for ILC is 88.6%, and the 10-year survival rate is 73.6%. […] Receiving a cancer diagnosis can be stressful, and many people worry about the outcome. When doctors diagnose ILC in early stages, survival rates are higher.
#4 Invasive Lobular Carcinoma: Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/21180-lobular-breast-cancer
Research shows that overall, 94% of women with ILC were alive and cancer-free five years after their diagnosis. […] In general, the earlier the stage at diagnosis, the better the prognosis. About 86% of women with ILC are alive and cancer-free 10 years after their diagnosis. […] The five-year survival rates for ILC are similar to other types of breast cancer. But theyre 4% to 10% lower at that 10-year mark. […] Healthcare providers are working to understand why this is and come up with treatment options to improve your chances of being cancer-free in the long run. […] The rates dont predict how long youll live with cancer. Survival rate information can be confusing and cause concern. If you have questions, your oncologist will explain what a survival rate means in your situation.
#5 Invasive Lobular Carcinoma: Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/21180-lobular-breast-cancer
Research shows that overall, 94% of women with ILC were alive and cancer-free five years after their diagnosis. […] In general, the earlier the stage at diagnosis, the better the prognosis. About 86% of women with ILC are alive and cancer-free 10 years after their diagnosis. […] The five-year survival rates for ILC are similar to other types of breast cancer. But theyre 4% to 10% lower at that 10-year mark. […] Healthcare providers are working to understand why this is and come up with treatment options to improve your chances of being cancer-free in the long run. […] The rates dont predict how long youll live with cancer. Survival rate information can be confusing and cause concern. If you have questions, your oncologist will explain what a survival rate means in your situation.
#6 Invasive Lobular Carcinoma: Diagnosis, Treatment, & Prognosis
https://www.nationalbreastcancer.org/invasive-lobular-carcinoma/
When detected and treated in the early, localized stages, the 5-year relative survival rate of invasive lobular carcinoma is 99%. If ILC is diagnosed at a later stage, has spread into nearby tissue or lymph nodes, or has metastasized to distant areas of the body, the survival rate begins to decline. […] Survival rates for invasive lobular carcinoma are grouped into three stages: localized, regional, and distant. Each stage has its own 5-year relative survival rate. […] Invasive lobular carcinoma recurrence is when the cancer is later found to still be present in the body somewhere after initial successful treatment. Recurrence can be local (within the remaining breast tissue) regional (in the lymph nodes under the arm or near the clavicle bone), or a distant, with breast cancer cells appearing in other organs of the body. […] Hormone receptor-positive (HR+) breast cancers, such as most ILC, tend to have a lower rate of recurrence in the first 5 years after diagnosis than hormone receptor-negative (HR-) breast cancers. However, HR+ breast cancers can recur at a higher rate than HR- cancers 10+ years after treatment.
#7 Invasive Lobular Carcinoma: Causes, Symptoms, Diagnosis & Risk
https://www.webmd.com/breast-cancer/lobular-carcinoma-invasive-and-in-situ
Invasive lobular carcinoma is the second most common type of breast cancer in the US. It often grows slowly, but it can be hard to detect. […] The likelihood of your cancer returning after treatment depends on several factors, including the stage at which it was diagnosed, how fast it developed, how well you responded to treatment, and whether your cancer was hormone-driven. […] In general, about 91% of all women with breast cancer live at least five years after diagnosis. […] While there isn’t much information about specific types of breast cancer, these survival rates are tracked by stage at diagnosis or how far the cancer has spread: Localized (cancer hasn’t spread outside the breast): More than 99% live at least five years; Regional (cancer has spread to lymph nodes near the breast): 87% live at least five years; Distant (cancer has spread farther in the body): 32% live at least five years.
#8 Invasive Lobular Carcinoma: Causes, Symptoms, Diagnosis & Risk
https://www.webmd.com/breast-cancer/lobular-carcinoma-invasive-and-in-situ
Invasive lobular carcinoma is the second most common type of breast cancer in the US. It often grows slowly, but it can be hard to detect. […] The likelihood of your cancer returning after treatment depends on several factors, including the stage at which it was diagnosed, how fast it developed, how well you responded to treatment, and whether your cancer was hormone-driven. […] In general, about 91% of all women with breast cancer live at least five years after diagnosis. […] While there isn’t much information about specific types of breast cancer, these survival rates are tracked by stage at diagnosis or how far the cancer has spread: Localized (cancer hasn’t spread outside the breast): More than 99% live at least five years; Regional (cancer has spread to lymph nodes near the breast): 87% live at least five years; Distant (cancer has spread farther in the body): 32% live at least five years.
#9 Invasive Lobular Carcinoma: Diagnosis, Treatment, & Prognosis
https://www.nationalbreastcancer.org/invasive-lobular-carcinoma/
When detected and treated in the early, localized stages, the 5-year relative survival rate of invasive lobular carcinoma is 99%. If ILC is diagnosed at a later stage, has spread into nearby tissue or lymph nodes, or has metastasized to distant areas of the body, the survival rate begins to decline. […] Survival rates for invasive lobular carcinoma are grouped into three stages: localized, regional, and distant. Each stage has its own 5-year relative survival rate. […] Invasive lobular carcinoma recurrence is when the cancer is later found to still be present in the body somewhere after initial successful treatment. Recurrence can be local (within the remaining breast tissue) regional (in the lymph nodes under the arm or near the clavicle bone), or a distant, with breast cancer cells appearing in other organs of the body. […] Hormone receptor-positive (HR+) breast cancers, such as most ILC, tend to have a lower rate of recurrence in the first 5 years after diagnosis than hormone receptor-negative (HR-) breast cancers. However, HR+ breast cancers can recur at a higher rate than HR- cancers 10+ years after treatment.
#10 The prognostic value of age for invasive lobular breast cancer depending on estrogen receptor and progesterone receptor-defined subtypes: A NCDB analysis
https://pmc.ncbi.nlm.nih.gov/articles/PMC4868740/
Multivariate analysis showed that patients diagnosed at both young (35 years) and old (ge;70 years) ages had worse prognosis compared with those in the middle ages. […] Our findings identified that the effect of age on OS in lobular breast cancer varied with ER/PR-defined subtypes. […] The patients who were diagnosed after 79 years old had the worst overall survival rate in all of the four subtypes, whereas the age group that had the best prognosis varied with different ER/PR-defined subtypes. […] The HR of OS declined with age from 1.55 (95% CI, 1.08â2.22; P = 0.019) in the group younger than 35 years to 1.38 (1.02â1.86; P = 0.036) in the 35â39 group, but increased with age to 10.1 (8.49â11.94; P 0.001) in the group older than 79. […] Our study demonstrated that the impact of age on OS of lobular breast cancer in ER+PR- and ER-PR+ subtypes were more likely to be similar with that in ER-PR- subtype rather than ER+PR+ subgroup, and young age was not a predictor for worse overall survival in ER+PR-, ER-PR+ or ER-PR- lobular breast cancer. […] Personalized management strategies should be developed to improve outcomes of breast cancer patients with different ages and ER/PR statuses.
#11 The prognostic value of age for invasive lobular breast cancer depending on estrogen receptor and progesterone receptor-defined subtypes: A NCDB analysis
https://pmc.ncbi.nlm.nih.gov/articles/PMC4868740/
Multivariate analysis showed that patients diagnosed at both young (35 years) and old (ge;70 years) ages had worse prognosis compared with those in the middle ages. […] Our findings identified that the effect of age on OS in lobular breast cancer varied with ER/PR-defined subtypes. […] The patients who were diagnosed after 79 years old had the worst overall survival rate in all of the four subtypes, whereas the age group that had the best prognosis varied with different ER/PR-defined subtypes. […] The HR of OS declined with age from 1.55 (95% CI, 1.08â2.22; P = 0.019) in the group younger than 35 years to 1.38 (1.02â1.86; P = 0.036) in the 35â39 group, but increased with age to 10.1 (8.49â11.94; P 0.001) in the group older than 79. […] Our study demonstrated that the impact of age on OS of lobular breast cancer in ER+PR- and ER-PR+ subtypes were more likely to be similar with that in ER-PR- subtype rather than ER+PR+ subgroup, and young age was not a predictor for worse overall survival in ER+PR-, ER-PR+ or ER-PR- lobular breast cancer. […] Personalized management strategies should be developed to improve outcomes of breast cancer patients with different ages and ER/PR statuses.
#12 Invasive Lobular Carcinoma: Diagnosis, Treatment, & Prognosis
https://www.nationalbreastcancer.org/invasive-lobular-carcinoma/
When detected and treated in the early, localized stages, the 5-year relative survival rate of invasive lobular carcinoma is 99%. If ILC is diagnosed at a later stage, has spread into nearby tissue or lymph nodes, or has metastasized to distant areas of the body, the survival rate begins to decline. […] Survival rates for invasive lobular carcinoma are grouped into three stages: localized, regional, and distant. Each stage has its own 5-year relative survival rate. […] Invasive lobular carcinoma recurrence is when the cancer is later found to still be present in the body somewhere after initial successful treatment. Recurrence can be local (within the remaining breast tissue) regional (in the lymph nodes under the arm or near the clavicle bone), or a distant, with breast cancer cells appearing in other organs of the body. […] Hormone receptor-positive (HR+) breast cancers, such as most ILC, tend to have a lower rate of recurrence in the first 5 years after diagnosis than hormone receptor-negative (HR-) breast cancers. However, HR+ breast cancers can recur at a higher rate than HR- cancers 10+ years after treatment.
#13 The prognostic value of age for invasive lobular breast cancer depending on estrogen receptor and progesterone receptor-defined subtypes: A NCDB analysis
https://pmc.ncbi.nlm.nih.gov/articles/PMC4868740/
Multivariate analysis showed that patients diagnosed at both young (35 years) and old (ge;70 years) ages had worse prognosis compared with those in the middle ages. […] Our findings identified that the effect of age on OS in lobular breast cancer varied with ER/PR-defined subtypes. […] The patients who were diagnosed after 79 years old had the worst overall survival rate in all of the four subtypes, whereas the age group that had the best prognosis varied with different ER/PR-defined subtypes. […] The HR of OS declined with age from 1.55 (95% CI, 1.08â2.22; P = 0.019) in the group younger than 35 years to 1.38 (1.02â1.86; P = 0.036) in the 35â39 group, but increased with age to 10.1 (8.49â11.94; P 0.001) in the group older than 79. […] Our study demonstrated that the impact of age on OS of lobular breast cancer in ER+PR- and ER-PR+ subtypes were more likely to be similar with that in ER-PR- subtype rather than ER+PR+ subgroup, and young age was not a predictor for worse overall survival in ER+PR-, ER-PR+ or ER-PR- lobular breast cancer. […] Personalized management strategies should be developed to improve outcomes of breast cancer patients with different ages and ER/PR statuses.
#14 LobSig is a multigene predictor of outcome in invasive lobular carcinoma | npj Breast Cancer
https://www.nature.com/articles/s41523-019-0113-y
Invasive lobular carcinoma (ILC) is the most common special type of breast cancer, and is characterized by functional loss of E-cadherin, resulting in cellular adhesion defects. ILC typically present as estrogen receptor positive, grade 2 breast cancers, with a good short-term prognosis. […] Using in silico integrative analyses, a 194-gene set was derived that is highly prognostic in ILC (P=1.20105) we named this metagene LobSig. […] Importantly, LobSig status predicted outcome with 94.6% accuracy amongst cases classified as moderate-risk according to Nottingham Prognostic Index in the METABRIC cohort. […] ILC with a poor outcome as predicted by LobSig were enriched with mutations in ERBB2, ERBB3, TP53, AKT1 and ROS1. […] LobSig has the potential to be a clinically relevant prognostic signature and warrants further development.
#15 Invasive lobular carcinoma of the breast: the increasing importance of this special subtype | Breast Cancer Research | Full Text
https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-020-01384-6
The presence of common mutations shared between lesions within an individual case inferred that PLCIS or FLCIS had a common clonal ancestry to classic LCIS, but that the additional acquisition of mutations in ERBB2 and ERBB3 suggests these alterations are likely drivers of the enhanced cytological atypia and proliferative state seen in these variants. […] The acquisition of ERBB2 and ERBB3 mutations in ILC has been shown to be associated with an increased risk of relapse and poorer outcomes, likely representing an escape mechanism to endocrine therapy. […] This important finding is supported by another study that also demonstrated an enrichment of ERBB2 and ERBB3 mutations in 50% of PLCIS and FLCIS variants relative to co-occurring CLCIS. […] The challenge for the validation of predictive and prognostic diagnostics in ILC remains that the latency between diagnosis and relapse/recurrence can be long, making prospective studies difficult to fund and follow.
#16 Invasive Lobular Carcinoma: Diagnosis, Treatment, & Prognosis
https://www.nationalbreastcancer.org/invasive-lobular-carcinoma/
When detected and treated in the early, localized stages, the 5-year relative survival rate of invasive lobular carcinoma is 99%. If ILC is diagnosed at a later stage, has spread into nearby tissue or lymph nodes, or has metastasized to distant areas of the body, the survival rate begins to decline. […] Survival rates for invasive lobular carcinoma are grouped into three stages: localized, regional, and distant. Each stage has its own 5-year relative survival rate. […] Invasive lobular carcinoma recurrence is when the cancer is later found to still be present in the body somewhere after initial successful treatment. Recurrence can be local (within the remaining breast tissue) regional (in the lymph nodes under the arm or near the clavicle bone), or a distant, with breast cancer cells appearing in other organs of the body. […] Hormone receptor-positive (HR+) breast cancers, such as most ILC, tend to have a lower rate of recurrence in the first 5 years after diagnosis than hormone receptor-negative (HR-) breast cancers. However, HR+ breast cancers can recur at a higher rate than HR- cancers 10+ years after treatment.
#17 Invasive Lobular Carcinoma: Causes, Symptoms, Diagnosis & Risk
https://www.webmd.com/breast-cancer/lobular-carcinoma-invasive-and-in-situ
Invasive lobular cancers prognosis is slightly worse. […] In ILC, the cancer can come back, mostly within 5 to 10 years, but some may not return for decades. […] Very serious. ILC is a life-threatening disease that requires medical treatment. But it can be cured if diagnosed and treated in its early stages.
#18 What is invasive lobular carcinoma? | MD Anderson Cancer Center
https://www.mdanderson.org/cancerwise/What-is-invasive-lobular-carcinoma-8-insights-on-lobular-breast-cancer.h00-159539745.html
Invasive lobular carcinoma is different from ductal carcinoma. […] Many patients with invasive lobular carcinoma receive the standard-of-care chemotherapy, but the comprehensive review showed there isn’t much clinical benefit. […] While it’s been thought that invasive lobular has a favorable prognosis when compared to ductal carcinoma, our review showed that’s not true in the long-term, Mouabbi says. […] We found that patients benefit from a combination of targeted therapy and endocrine therapy, Mouabbi says.
#19 Invasive lobular carcinoma of the breast: the increasing importance of this special subtype | Breast Cancer Research | Full Text
https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-020-01384-6
Invasive lobular carcinoma (ILC) is the most common of the breast cancer special types, accounting for up to 15% of all breast cancer cases. […] Although ILCs are generally palpable, a high false-negative mammography rate is possible. […] Whilst the biological characteristics of ILC afford patients a good prognosis in the short term, it has become clear that the longer-term prognosis of ILC is frequently worse than for patients with the more commonly diagnosed invasive breast carcinoma of no special type (IBC-NST). […] The metastatic presentation of ILC has long been considered unique, with a predilection for common sites (liver, lung, bone), but also gastrointestinal and gynaecological sites of colonisation. […] A recent study of metastatic spread to gynaecological sites demonstrated an association with ILC and young age at diagnosis and confirmed earlier reports of the wide metastatic colonisation of ILC.
#20 Invasive lobular carcinoma of the breast: the increasing importance of this special subtype | Breast Cancer Research | Full Text
https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-020-01384-6
Invasive lobular carcinoma (ILC) is the most common of the breast cancer special types, accounting for up to 15% of all breast cancer cases. […] Although ILCs are generally palpable, a high false-negative mammography rate is possible. […] Whilst the biological characteristics of ILC afford patients a good prognosis in the short term, it has become clear that the longer-term prognosis of ILC is frequently worse than for patients with the more commonly diagnosed invasive breast carcinoma of no special type (IBC-NST). […] The metastatic presentation of ILC has long been considered unique, with a predilection for common sites (liver, lung, bone), but also gastrointestinal and gynaecological sites of colonisation. […] A recent study of metastatic spread to gynaecological sites demonstrated an association with ILC and young age at diagnosis and confirmed earlier reports of the wide metastatic colonisation of ILC.
#21 Invasive lobular carcinoma of the breast: the increasing importance of this special subtype | Breast Cancer Research | Full Text
https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-020-01384-6
A number of molecular signature-based tests are available commercially; however, the utility of some of these tests in ILC has only recently emerged. […] The Genomic Grade Index (GGI/MapQuantDx) panel has been shown to be more powerful than grade alone in the ILC population, and interestingly was able to recategorise some PILC to lower risk, and some classic ILC to higher risk groups based on their calculated genomic grade. […] We recently developed a 194-gene signature capable of significantly stratifying prognosis in ILC patients (LobSig); using an integrative analysis of genome copy number and the transcriptome data from ILC tumours.
#22 Invasive lobular carcinoma of the breast: the increasing importance of this special subtype | Breast Cancer Research | Full Text
https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-020-01384-6
A number of molecular signature-based tests are available commercially; however, the utility of some of these tests in ILC has only recently emerged. […] The Genomic Grade Index (GGI/MapQuantDx) panel has been shown to be more powerful than grade alone in the ILC population, and interestingly was able to recategorise some PILC to lower risk, and some classic ILC to higher risk groups based on their calculated genomic grade. […] We recently developed a 194-gene signature capable of significantly stratifying prognosis in ILC patients (LobSig); using an integrative analysis of genome copy number and the transcriptome data from ILC tumours.
#23 LobSig is a multigene predictor of outcome in invasive lobular carcinoma | npj Breast Cancer
https://www.nature.com/articles/s41523-019-0113-y
This presents a conundrum for clinicians with few clues to inform which patients will develop recurrent or metastatic disease. […] The Genomic Grade Index (GGI/MapQuantDx) panel has been shown to be more powerful than grade alone in the ILC population, while MammaPrint has validated value only in node negative ILC patients. […] The clinical utility in ILC of the 21-gene signature, OncotypeDx, remains unclear with two studies showing classification of 42% and 35.5% of patients as being as of intermediate risk. […] LobSig is highly prognostic in unselected ILC, and specifically in grade 2 and grade 3 ILC tumors, as well as to a lesser degree in ER-positive, grade 2 IC-NST cases. […] LobSig outperforms existing signatures in both a univariate (P=9.0106) and multivariate context (P=3.14104).
#24 LobSig is a multigene predictor of outcome in invasive lobular carcinoma | npj Breast Cancer
https://www.nature.com/articles/s41523-019-0113-y
This presents a conundrum for clinicians with few clues to inform which patients will develop recurrent or metastatic disease. […] The Genomic Grade Index (GGI/MapQuantDx) panel has been shown to be more powerful than grade alone in the ILC population, while MammaPrint has validated value only in node negative ILC patients. […] The clinical utility in ILC of the 21-gene signature, OncotypeDx, remains unclear with two studies showing classification of 42% and 35.5% of patients as being as of intermediate risk. […] LobSig is highly prognostic in unselected ILC, and specifically in grade 2 and grade 3 ILC tumors, as well as to a lesser degree in ER-positive, grade 2 IC-NST cases. […] LobSig outperforms existing signatures in both a univariate (P=9.0106) and multivariate context (P=3.14104).
#25 Invasive lobular carcinoma of the breast: the increasing importance of this special subtype | Breast Cancer Research | Full Text
https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-020-01384-6
A number of molecular signature-based tests are available commercially; however, the utility of some of these tests in ILC has only recently emerged. […] The Genomic Grade Index (GGI/MapQuantDx) panel has been shown to be more powerful than grade alone in the ILC population, and interestingly was able to recategorise some PILC to lower risk, and some classic ILC to higher risk groups based on their calculated genomic grade. […] We recently developed a 194-gene signature capable of significantly stratifying prognosis in ILC patients (LobSig); using an integrative analysis of genome copy number and the transcriptome data from ILC tumours.
#26 LobSig is a multigene predictor of outcome in invasive lobular carcinoma | npj Breast Cancer
https://www.nature.com/articles/s41523-019-0113-y
This presents a conundrum for clinicians with few clues to inform which patients will develop recurrent or metastatic disease. […] The Genomic Grade Index (GGI/MapQuantDx) panel has been shown to be more powerful than grade alone in the ILC population, while MammaPrint has validated value only in node negative ILC patients. […] The clinical utility in ILC of the 21-gene signature, OncotypeDx, remains unclear with two studies showing classification of 42% and 35.5% of patients as being as of intermediate risk. […] LobSig is highly prognostic in unselected ILC, and specifically in grade 2 and grade 3 ILC tumors, as well as to a lesser degree in ER-positive, grade 2 IC-NST cases. […] LobSig outperforms existing signatures in both a univariate (P=9.0106) and multivariate context (P=3.14104).
#27 LobSig is a multigene predictor of outcome in invasive lobular carcinoma | npj Breast Cancer
https://www.nature.com/articles/s41523-019-0113-y
This presents a conundrum for clinicians with few clues to inform which patients will develop recurrent or metastatic disease. […] The Genomic Grade Index (GGI/MapQuantDx) panel has been shown to be more powerful than grade alone in the ILC population, while MammaPrint has validated value only in node negative ILC patients. […] The clinical utility in ILC of the 21-gene signature, OncotypeDx, remains unclear with two studies showing classification of 42% and 35.5% of patients as being as of intermediate risk. […] LobSig is highly prognostic in unselected ILC, and specifically in grade 2 and grade 3 ILC tumors, as well as to a lesser degree in ER-positive, grade 2 IC-NST cases. […] LobSig outperforms existing signatures in both a univariate (P=9.0106) and multivariate context (P=3.14104).
#28 LobSig is a multigene predictor of outcome in invasive lobular carcinoma | npj Breast Cancer
https://www.nature.com/articles/s41523-019-0113-y
Invasive lobular carcinoma (ILC) is the most common special type of breast cancer, and is characterized by functional loss of E-cadherin, resulting in cellular adhesion defects. ILC typically present as estrogen receptor positive, grade 2 breast cancers, with a good short-term prognosis. […] Using in silico integrative analyses, a 194-gene set was derived that is highly prognostic in ILC (P=1.20105) we named this metagene LobSig. […] Importantly, LobSig status predicted outcome with 94.6% accuracy amongst cases classified as moderate-risk according to Nottingham Prognostic Index in the METABRIC cohort. […] ILC with a poor outcome as predicted by LobSig were enriched with mutations in ERBB2, ERBB3, TP53, AKT1 and ROS1. […] LobSig has the potential to be a clinically relevant prognostic signature and warrants further development.
#29 LobSig is a multigene predictor of outcome in invasive lobular carcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC6597578/
LobSig is a multigene predictor of outcome in invasive lobular carcinoma. Invasive lobular carcinoma (ILC) is the most common special type of breast cancer, and is characterized by functional loss of E-cadherin, resulting in cellular adhesion defects. ILC typically present as estrogen receptor positive, grade 2 breast cancers, with a good short-term prognosis. […] Using in silico integrative analyses, a 194-gene set was derived that is highly prognostic in ILC (P=1.20105) we named this metagene LobSig. […] Importantly, LobSig status predicted outcome with 94.6% accuracy amongst cases classified as moderate-risk according to Nottingham Prognostic Index in the METABRIC cohort. […] LobSig has the potential to be a clinically relevant prognostic signature and warrants further development.
#30 LobSig is a multigene predictor of outcome in invasive lobular carcinoma | npj Breast Cancer
https://www.nature.com/articles/s41523-019-0113-y
LobSig is particularly effective in grade 2 ILC tumors (AUC=0.906). […] The data presented here supports that LobSig low-risk patients need not receive adjuvant chemotherapy. […] In conclusion, we present the molecular signature, LobSig, which captures the peculiar genomic landscape of ILC tumors, and together with clinico-pathology information, provides a robust mechanism for prognostication in ILC.
#31 LobSig is a multigene predictor of outcome in invasive lobular carcinoma | npj Breast Cancer
https://www.nature.com/articles/s41523-019-0113-y
LobSig is particularly effective in grade 2 ILC tumors (AUC=0.906). […] The data presented here supports that LobSig low-risk patients need not receive adjuvant chemotherapy. […] In conclusion, we present the molecular signature, LobSig, which captures the peculiar genomic landscape of ILC tumors, and together with clinico-pathology information, provides a robust mechanism for prognostication in ILC.
#32 LobSig is a multigene predictor of outcome in invasive lobular carcinoma
https://pmc.ncbi.nlm.nih.gov/articles/PMC6597578/
Despite clear biological and clinical differences, treatment of IC-NST and ILC remains the same. It is currently impossible to predict ILC clinical course at diagnosis, as a result of homogeneity in the standard diagnostic criteria for ILC. […] The data presented here supports that LobSig low-risk patients need not receive adjuvant chemotherapy. […] In conclusion, we present the molecular signature, LobSig, which captures the peculiar genomic landscape of ILC tumors, and together with clinico-pathology information, provides a robust mechanism for prognostication in ILC.
#33 Pathway-based signatures predict patient outcome, chemotherapy benefit and synthetic lethal dependencies in invasive lobular breast cancer | British Journal of Cancer
https://www.nature.com/articles/s41416-024-02679-7
The top three prognostic CPs included Cell cycle (HR=2.81, 95% CI=1.974.02, FDR-adjusted P=4.09107), Developmental biology/regulation of beta cells (HR=2.34, 95% CI=1.673.36, FDR-adjusted P=1.95105) and Haemostasis (HR=2.3, 95% CI=1.623.26, FDR-adjusted P=2.33105). […] This suggests that CP-predicted high-risk patients in the chemotherapy nave group could benefit from chemotherapy. […] Building on the prognostic capabilities of CPs, we created a multivariable signature by aggregating multiple CPs into a machine learning model using the Random Forest algorithm. […] PSILC was able to successfully classify patients into appropriate risk groups in the combined validation cohort (HR=2.94, 95% CI=2.014.3, P=2.9108). […] PSILC remained an independent prognostic biomarker when adjusted for age, T-stage, nodal status and tumour purity.
#34 Pathway-based signatures predict patient outcome, chemotherapy benefit and synthetic lethal dependencies in invasive lobular breast cancer | British Journal of Cancer
https://www.nature.com/articles/s41416-024-02679-7
The top three prognostic CPs included Cell cycle (HR=2.81, 95% CI=1.974.02, FDR-adjusted P=4.09107), Developmental biology/regulation of beta cells (HR=2.34, 95% CI=1.673.36, FDR-adjusted P=1.95105) and Haemostasis (HR=2.3, 95% CI=1.623.26, FDR-adjusted P=2.33105). […] This suggests that CP-predicted high-risk patients in the chemotherapy nave group could benefit from chemotherapy. […] Building on the prognostic capabilities of CPs, we created a multivariable signature by aggregating multiple CPs into a machine learning model using the Random Forest algorithm. […] PSILC was able to successfully classify patients into appropriate risk groups in the combined validation cohort (HR=2.94, 95% CI=2.014.3, P=2.9108). […] PSILC remained an independent prognostic biomarker when adjusted for age, T-stage, nodal status and tumour purity.
#35 Pathway-based signatures predict patient outcome, chemotherapy benefit and synthetic lethal dependencies in invasive lobular breast cancer | British Journal of Cancer
https://www.nature.com/articles/s41416-024-02679-7
PSILC accurately predicted the likelihood of metastasis (two group classification: P=6.6104). […] This result highlights the utility of PSILC as a tool to identify patients where current treatment options are unlikely to succeed, especially in the long-term, which remains a clinical challenge in the management of ILCs compared to IBC-NST.
#36 Pathway-based signatures predict patient outcome, chemotherapy benefit and synthetic lethal dependencies in invasive lobular breast cancer | British Journal of Cancer
https://www.nature.com/articles/s41416-024-02679-7
PSILC accurately predicted the likelihood of metastasis (two group classification: P=6.6104). […] This result highlights the utility of PSILC as a tool to identify patients where current treatment options are unlikely to succeed, especially in the long-term, which remains a clinical challenge in the management of ILCs compared to IBC-NST.
#37 Pathway-based signatures predict patient outcome, chemotherapy benefit and synthetic lethal dependencies in invasive lobular breast cancer | British Journal of Cancer
https://www.nature.com/articles/s41416-024-02679-7
Invasive Lobular Carcinoma (ILC) is a morphologically distinct breast cancer subtype that represents up to 15% of all breast cancers. Compared to Invasive Breast Carcinoma of No Special Type (IBC-NST), ILCs exhibit poorer long-term outcome and a unique pattern of metastasis. Despite these differences, the systematic discovery of robust prognostic biomarkers and therapeutically actionable molecular pathways in ILC remains limited. […] mRNA dysregulation scores of 25 pathways were strongly prognostic in ILC (FDR-adjusted P0.05). Of these, three pathways including Cell-cell communication, Innate immune system and Smooth muscle contraction were also independent predictors of chemotherapy response. […] This study provides interpretable prognostic and predictive biomarkers of ILC which could serve as the starting points for targeted drug discovery for this disease.
#38 Pathway-based signatures predict patient outcome, chemotherapy benefit and synthetic lethal dependencies in invasive lobular breast cancer | British Journal of Cancer
https://www.nature.com/articles/s41416-024-02679-7
The top three prognostic CPs included Cell cycle (HR=2.81, 95% CI=1.974.02, FDR-adjusted P=4.09107), Developmental biology/regulation of beta cells (HR=2.34, 95% CI=1.673.36, FDR-adjusted P=1.95105) and Haemostasis (HR=2.3, 95% CI=1.623.26, FDR-adjusted P=2.33105). […] This suggests that CP-predicted high-risk patients in the chemotherapy nave group could benefit from chemotherapy. […] Building on the prognostic capabilities of CPs, we created a multivariable signature by aggregating multiple CPs into a machine learning model using the Random Forest algorithm. […] PSILC was able to successfully classify patients into appropriate risk groups in the combined validation cohort (HR=2.94, 95% CI=2.014.3, P=2.9108). […] PSILC remained an independent prognostic biomarker when adjusted for age, T-stage, nodal status and tumour purity.
#39 Pathway-based signatures predict patient outcome, chemotherapy benefit and synthetic lethal dependencies in invasive lobular breast cancer | British Journal of Cancer
https://www.nature.com/articles/s41416-024-02679-7
The top three prognostic CPs included Cell cycle (HR=2.81, 95% CI=1.974.02, FDR-adjusted P=4.09107), Developmental biology/regulation of beta cells (HR=2.34, 95% CI=1.673.36, FDR-adjusted P=1.95105) and Haemostasis (HR=2.3, 95% CI=1.623.26, FDR-adjusted P=2.33105). […] This suggests that CP-predicted high-risk patients in the chemotherapy nave group could benefit from chemotherapy. […] Building on the prognostic capabilities of CPs, we created a multivariable signature by aggregating multiple CPs into a machine learning model using the Random Forest algorithm. […] PSILC was able to successfully classify patients into appropriate risk groups in the combined validation cohort (HR=2.94, 95% CI=2.014.3, P=2.9108). […] PSILC remained an independent prognostic biomarker when adjusted for age, T-stage, nodal status and tumour purity.
#40 Invasive lobular carcinoma of the breast: the increasing importance of this special subtype | Breast Cancer Research | Full Text
https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-020-01384-6
The presence of common mutations shared between lesions within an individual case inferred that PLCIS or FLCIS had a common clonal ancestry to classic LCIS, but that the additional acquisition of mutations in ERBB2 and ERBB3 suggests these alterations are likely drivers of the enhanced cytological atypia and proliferative state seen in these variants. […] The acquisition of ERBB2 and ERBB3 mutations in ILC has been shown to be associated with an increased risk of relapse and poorer outcomes, likely representing an escape mechanism to endocrine therapy. […] This important finding is supported by another study that also demonstrated an enrichment of ERBB2 and ERBB3 mutations in 50% of PLCIS and FLCIS variants relative to co-occurring CLCIS. […] The challenge for the validation of predictive and prognostic diagnostics in ILC remains that the latency between diagnosis and relapse/recurrence can be long, making prospective studies difficult to fund and follow.
#41 Pathway-based signatures predict patient outcome, chemotherapy benefit and synthetic lethal dependencies in invasive lobular breast cancer | British Journal of Cancer
https://www.nature.com/articles/s41416-024-02679-7
Despite clear histological, molecular and clinical differences between ILCs and IBC-NST, the treatment options for the majority of ILCs (i.e. ER+) and IBC-NST remain the same, involving a combination of surgery, radiotherapy, chemotherapy and hormone therapy. […] While current therapeutic options offer good short-term prognosis, longer-term outcome (beyond 5 years) of ILCs remains inferior, with ILCs displaying preferential metastatic propensity to bone and gastrointestinal tract compared to patients with the more commonly diagnosed IBC-NST. […] Here we developed prognostic biomarkers of lobular breast cancer using a robust pathway-centric approach that enabled integration of ILC-specific biology. […] The prognostic evaluation in the combined validation cohort revealed 25 CPs significantly associated with patient outcome (FDR-adjusted P0.05, Wald test).
#42 Pathway-based signatures predict patient outcome, chemotherapy benefit and synthetic lethal dependencies in invasive lobular breast cancer | British Journal of Cancer
https://www.nature.com/articles/s41416-024-02679-7
Despite clear histological, molecular and clinical differences between ILCs and IBC-NST, the treatment options for the majority of ILCs (i.e. ER+) and IBC-NST remain the same, involving a combination of surgery, radiotherapy, chemotherapy and hormone therapy. […] While current therapeutic options offer good short-term prognosis, longer-term outcome (beyond 5 years) of ILCs remains inferior, with ILCs displaying preferential metastatic propensity to bone and gastrointestinal tract compared to patients with the more commonly diagnosed IBC-NST. […] Here we developed prognostic biomarkers of lobular breast cancer using a robust pathway-centric approach that enabled integration of ILC-specific biology. […] The prognostic evaluation in the combined validation cohort revealed 25 CPs significantly associated with patient outcome (FDR-adjusted P0.05, Wald test).
#43 What is invasive lobular carcinoma? | MD Anderson Cancer Center
https://www.mdanderson.org/cancerwise/What-is-invasive-lobular-carcinoma-8-insights-on-lobular-breast-cancer.h00-159539745.html
Invasive lobular carcinoma is different from ductal carcinoma. […] Many patients with invasive lobular carcinoma receive the standard-of-care chemotherapy, but the comprehensive review showed there isn’t much clinical benefit. […] While it’s been thought that invasive lobular has a favorable prognosis when compared to ductal carcinoma, our review showed that’s not true in the long-term, Mouabbi says. […] We found that patients benefit from a combination of targeted therapy and endocrine therapy, Mouabbi says.
#44 What is invasive lobular carcinoma? | MD Anderson Cancer Center
https://www.mdanderson.org/cancerwise/What-is-invasive-lobular-carcinoma-8-insights-on-lobular-breast-cancer.h00-159539745.html
Invasive lobular carcinoma is different from ductal carcinoma. […] Many patients with invasive lobular carcinoma receive the standard-of-care chemotherapy, but the comprehensive review showed there isn’t much clinical benefit. […] While it’s been thought that invasive lobular has a favorable prognosis when compared to ductal carcinoma, our review showed that’s not true in the long-term, Mouabbi says. […] We found that patients benefit from a combination of targeted therapy and endocrine therapy, Mouabbi says.
#45 Invasive Lobular Carcinoma: Causes, Symptoms, Diagnosis & Risk
https://www.webmd.com/breast-cancer/lobular-carcinoma-invasive-and-in-situ
Invasive lobular cancers prognosis is slightly worse. […] In ILC, the cancer can come back, mostly within 5 to 10 years, but some may not return for decades. […] Very serious. ILC is a life-threatening disease that requires medical treatment. But it can be cured if diagnosed and treated in its early stages.
#46 The prognostic value of age for invasive lobular breast cancer depending on estrogen receptor and progesterone receptor-defined subtypes: A NCDB analysis
https://pmc.ncbi.nlm.nih.gov/articles/PMC4868740/
Multivariate analysis showed that patients diagnosed at both young (35 years) and old (ge;70 years) ages had worse prognosis compared with those in the middle ages. […] Our findings identified that the effect of age on OS in lobular breast cancer varied with ER/PR-defined subtypes. […] The patients who were diagnosed after 79 years old had the worst overall survival rate in all of the four subtypes, whereas the age group that had the best prognosis varied with different ER/PR-defined subtypes. […] The HR of OS declined with age from 1.55 (95% CI, 1.08â2.22; P = 0.019) in the group younger than 35 years to 1.38 (1.02â1.86; P = 0.036) in the 35â39 group, but increased with age to 10.1 (8.49â11.94; P 0.001) in the group older than 79. […] Our study demonstrated that the impact of age on OS of lobular breast cancer in ER+PR- and ER-PR+ subtypes were more likely to be similar with that in ER-PR- subtype rather than ER+PR+ subgroup, and young age was not a predictor for worse overall survival in ER+PR-, ER-PR+ or ER-PR- lobular breast cancer. […] Personalized management strategies should be developed to improve outcomes of breast cancer patients with different ages and ER/PR statuses.