Distant metastases from invasive lobular breast carcinoma classic type - treatment and prognosis

Invasive lobular carcinoma (ILC) comprises 4-15% of all malignant neoplasms of the breast. The "classical variant of ILC" (C-ILC) constitutes some 60-80% of this cancer. The main cause of treatment failures is dissemination observed in 8-38% patients The disant metastases (DM) are frequently localized in: bones, gastrointestinal tract, uterus, leptomeninges, and ovaries. The aim of this study was to present the methods and results of the treatment of patients with DM from the classical variant of ILC (C-ILC) at a single institution in Poland.

Between January 1983 and December 2004, 210 women with C-ILC of the breast were primarily treated surgically (mastectomy in 182 (86.7%) patients and breast conserving therapy in 28 (13.3%) patients). Then adjuvant therapy (radiotherapy, chemotherapy, and hormonotherapy) was applied according to presence of clinical indications.

The present study focused on a group of 41 patients with a median age of 59 that died with DM from C-ILC during the ten-year follow-up. This failure developed on average 65 months (3-186) after surgery of ILC. The most frequently DM developed: bones (39.1%), GI (small bowell, stomach, colon, rectum) - 31.8%, and reproductive organs (ovary, uterus) - 19.1%. In therapy of DM, different configuration surgery, radiotherapy, and chemo-hormonotherapy were used. The median survival after the diagnosis of DM was connected with localization of distant metastases.

Patients with classic variant of infiltrate lobular cancer of breast should be regularly follow-up, which could permit early diagnosis of distant metastases and improve treatment results.