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Objective: To analyze and compare the clinicopathological features and prognostic factors between patients with advanced breast invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC). Methods: Fifty-nine female patients with advanced breast ILC from Tianjin Medical University Cancer Institute and Hospital were included in this retrospective case-controlled study. Matched two hundred and thirty-six female patients with advanced breast IDC were selected according to age at diagnosis and the time of surgery (±2 years) in Tianjin Medical University Cancer Institute and Hospital between January 2008 and December 2016. Clinical and pathological features and prognostic factors were analyzed by using univariate and multivariate analyses. Results: The clinical pathological features of clinical stage at initial diagnosis, T stage, M stage, histological degree, estrogen receptor (ER) status, progesterone receptor (PR) status, human epidermal growth factor receptor-2 (HER-2) status and molecular subtype were significantly different between two groups (all P < 0.05). The median ages at recurrence/metastasis of patients with breast ILC and IDC were 50 years (range: 28-73) and 51 years (range: 27-69), respectively. The differences in the number of first metastatic sites, lymph node metastasis, visceral metastasis, lung metastasis and bone metastasis were statistically significant between two groups (all P < 0.05). The median progression-free survivals of patients with breast ILC and IDC were 14 months (range: 2-62) and 11 months (range: 1-89), respectively (P = 0.121). The median metastasesoverall survivals (M-OS) of patients with ILC and IDC were 42 months (range: 5-78) and 44 months ((range: 1-110), respectively (P = 0.392). Multivariate analysis revealed that PR status, age at recurrence or metastasis and treatment of bone metastases were the independent predictors of survival in patients with advanced breast ILC (all P < 0.05). The molecular subtype, the number of first metastatic sites and pleural effusion were the independent prognostic factors in patients with breast IDC (all P < 0.05). Conclusion: Patients with advanced breast ILC have unique clinicopathological, recurrent/metastatic and prognostic features. It is necessary to reveal the definitive features of ILC and develop new personalized precision therapies.
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Breast cancer is the most common malignant tumor in females in the world. The characteristics of triple-negative breast cancer (TNBC) are defined as estrogen receptor (ER)-negative, progesterone receptor (PR)-negative and human epidermal growth factor receptor 2 (HER2)-negative. TNBC accounts for about 15%-20% in all the pathological types of breast cancer. With poor prognosis, high recurrence rate and high mortality rate, TNBC has become the focus of the research recently. At present, the treatment methods of breast cancer include surgery, neoadjuvant chemotherapy, adjuvant chemotherapy, endocrine therapy and targeted therapy, etc. Due to the lack of ER, PR and HER2 expressions, patients can not benefit from the endocrine therapy and anti-HER2 targeted therapy. Chemotherapy is currently recommended for the treatment of TNBC. Many chemotherapeutic regimens and new drugs are being explored. This paper reviews the progress in chemotherapy, endocrine therapy, targeted therapy and immunotherapy of TNBC.
RESUMO
10.3969/j.issn.2095-4344.2013.25.010