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Lobular breast cancer and prognosis: what should we tell patients?
Tivya Kulasegaran1,2, Kate Beecher1, Pamela Kinnon3
1Fraser Institute, Faculty of Health, Medicine and Behavioural Science, The University of Queensland, Brisbane, QLD, Australia.
Background:
Invasive lobular carcinoma (ILC) is the second most common subtype of breast cancer. It accounts for up to 15% of all breast cancer diagnoses, and there is an increasing population of people living with a diagnosis of 'lobular'. ILC has historically been understudied and is underrepresented in clinical trials. Presenting with pathology features typical of a good prognosis (oestrogen receptor-positive, HER2-negative, grade 2), a diagnosis of ILC can be framed as one with a 'good outcome'. But whether the data support this over time remains to be seen.
Methods:
We present a comprehensive narrative review to ascertain whether ILC has a better outcome than invasive carcinoma of no special type (IC-NST).
Results:
A number of the research studies analysed showed that ILC can have a better outcome at 5 years and still have a poorer outcome over time, whilst others showed that IC-NST has a poor outcome early, which is maintained over time.
Conclusions:
We discuss limitations and confounders and, critically, give voice to the people living with a lobular breast cancer diagnosis.
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