Comparison of long-term outcome between clinically high risk lobular versus ductal breast cancer: a propensity score matched study
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View abstract on PubMed
Summary
This summary is machine-generated.High-risk hormone receptor-positive breast cancer (BC) shows similar long-term outcomes for invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) when treated with adjuvant abemaciclib. This supports similar treatment strategies for both subtypes in real-world settings.
Area Of Science
- Oncology
- Breast Cancer Research
- Clinical Pathology
Background
- Abemaciclib is approved for high-risk, lymph node-positive, hormone receptor-positive breast cancer (BC).
- Real-world data on clinicopathologic features and outcomes for patients eligible for adjuvant abemaciclib are limited.
- Conflicting data exist regarding the biological behavior and long-term outcomes of invasive lobular carcinoma (ILC) versus invasive ductal carcinoma (IDC).
Purpose Of The Study
- To retrospectively assess real-world data and long-term outcomes of high-risk ILC compared to IDC, based on MonarchE trial inclusion criteria.
- To define clinicopathologic features of patients eligible for adjuvant abemaciclib in a real-world setting.
- To evaluate if histological subtype influences long-term outcomes in high-risk HR-positive early BC.
Main Methods
- Retrospective analysis of 15,071 patients with primary, non-metastatic, HR-positive, HER2-negative BC treated between 2000-2008.
- Identification of high-risk patients based on MonarchE criteria (e.g., positive lymph nodes, tumor size, tumor grade).
- Propensity score matching was used to compare high-risk ILC and IDC cohorts, with a median follow-up of 13.2 years.
Main Results
- A total of 2872 high-risk patients were identified (361 ILC, 2511 IDC); 322 ILC were matched with IDC.
- No statistically significant differences in invasive disease-free survival (IDFS) or overall survival (OS) were observed between matched high-risk ILC and IDC groups.
- 5-year IDFS rates were 75.5% for ILC vs. 77.7% for IDC; 10-year IDFS rates were 50.7% for ILC vs. 57.3% for IDC.
- Axillary recurrence was more common in ILC (n=17) than IDC (n=10).
- Predictors of unfavorable IDFS and OS included age <35, pT2-3, and >10 positive axillary nodes.
Conclusions
- Real-world data show similar long-term invasive disease-free survival (IDFS) and distant relapse-free survival (DRFS) for high-risk hormone receptor-positive early breast cancer, irrespective of histological subtype (ILC vs. IDC).
- These findings support the use of similar treatment escalation strategies for both ILC and IDC when high-risk features are present.
- Approximately 21% of high-risk HR-positive early BC patients in this dataset were potentially eligible for adjuvant abemaciclib treatment.
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