Elsevier

The Breast

Volume 20, Issue 6, December 2011, Pages 505-509
The Breast

Original article
Influence of histology on the effectiveness of adjuvant chemotherapy in patients with hormone receptor positive invasive breast cancer

https://doi.org/10.1016/j.breast.2011.05.005Get rights and content
Under a Creative Commons license
open access

Abstract

Introduction

To investigate the effect of adjuvant chemotherapy on long term survival in addition to hormonal therapy in the systemic treatment of hormonal receptor positive breast cancer patients.

Methods

All patients with primary non-metastatic hormonal receptor positive invasive lobular (mixed) (=ILC) and invasive ductal (=IDC) breast cancer operated on between 1986 and 2007 were identified from a population based cohort. Four hundred ninety-eight patients with lobular (mixed) and sixteen hundred seventeen with ductal cancer were eligible. Both groups were divided in patients receiving adjuvant hormonal treatment with or without systemic chemotherapy.

Results

Overall survival was not statistically different in patients with ILC treated with adjuvant hormonal and chemotherapy compared to hormonal treatment alone (5-year survival 85.2% vs 82.8%, P = .68). In contrast, patients with IDC receiving adjuvant hormonal and chemotherapy had a significantly better overall survival compared to hormonal therapy alone (5-year survival rate 87.6% vs 80.8%, P < .001). In the multivariate analysis however, this significance disappeared suggesting that the data are possibly too small, too unbalanced, or influenced by other confounding factors to come to definitive conclusions.

Conclusions

There are good reasons to consider ductal and lobular breast cancers as different entities in future studies. Patients with hormone receptor positive ILC seem to benefit differently from additional adjuvant chemotherapy to hormonal therapy as compared with patients with IDC.

Highlights

► Invasive lobular breast cancer (ILC) is less responsive to neoadjuvant chemotherapy than ductal cancer (IDC). ► Patients with ILC also seem to benefit less from adjuvant chemotherapy than patients with IDC. ► Further research, based on randomized data or larger patient series, is urgently needed.

Keywords

Breast carcinoma
Invasive lobular carcinoma
Invasive ductal carcinoma
Hormonal therapy
Adjuvant chemotherapy
Survival

Cited by (0)