A new retrospective study has reported that lobular and ductal breast cancer can be treated similarly (taking into account other tumor characteristics) and obtain similar outcomes. Invasive lobular carcinoma is more likely to be mulitcentric (two or more simultaneous tumors) and bilateral (tumors in both breasts) than invasive ductal breast cancer. These characteristics have led to a more aggressive treatment approach.
To conduct the study, the authors reviewed 171 lobular breast cancer and 1,011 ductal breast cancer cases treated at one Italian institution between January 2000 and January 2010. Median age at diagnosis was slightly lower for the lobular breast cancer patients (63 years) than the ductal breast cancer cases (65 years). Median tumor diameter (1.7 cm) was similar in the two groups. Median follow-up was four years.
Multicentric disease was reported in 108 (10.6%) of the ductal breast cancer cases and in 31 (18.1%) of the lobular breast cancer cases. A positive surgical margin was found after initial surgery in 71 (7%) of the ductal and 21 (12.3%) of the lobular cases. Although the rate of mastectomy decreased over the study period in both groups, the decline was more evident among lobular breast cancer patients. Locoregional recurrence, contralateral disease, overall survival, disease-free survival, and survival based on tumor diameter, lymph node status, and type of surgery were not significantly different between the two types of breast cancer. Disease stage and hormone receptor status were found to be associated with disease-free survival, but whether the cancer was lobular or ductal was not. The authors conclude that although lobular breast cancer is more often multicentric, bilateral, and associated with a positive surgical margin, local control and survival are similar to ductal breast cancer. Lobular breast cancer can be treated similarly to ductal breast cancer with good results, according to the authors.
Please see our article on lobular breast cancer prognosis for more information.