Viale Giuseppe, Rotmensz Nicole, Maisonneuve Patrick, Orvieto Enrico, Maiorano Eugenio, Galimberti Viviana, Luini Alberto, Colleoni Marco, Goldhirsch Aron, Coates Alan S
European Institute of Oncology, University of Milan, Italy.
Breast Cancer Res Treat. 2009 Sep;117(1):211-4. doi: 10.1007/s10549-008-0112-4. Epub 2008 Jul 16.
Whether invasive lobular carcinoma of the breast per se constitutes a prognostically favorable type has been debated. The present series comprises 301 consecutive "classic" lobular breast carcinomas seen at one institution between 1994 and 2001, compared to an equal number of invasive ductal carcinomas at the same institution during the same period, matched for year of surgery, age, menopausal status, primary tumor size, nodal involvement, hormone receptor status and where possible histological grade. Despite matching, the lobular carcinomas were more frequently multifocal, had more involved nodes, lower grade and lower proliferative fraction. There was no significant difference in disease-free or overall survival, locoregional relapse or time to distant metastasis between the lobular and ductal groups overall or within any examined subset, though the lobular group showed a trend to earlier appearance of contralateral breast cancer. Classical lobular histology is not an independent factor in the prognosis of early breast cancer.
乳腺小叶原位癌本身是否构成预后良好的类型一直存在争议。本系列研究纳入了1994年至2001年间在同一机构连续观察到的301例“经典”小叶型乳腺癌，同期该机构有数量相等的浸润性导管癌作为对照，两组在手术年份、年龄、绝经状态、原发肿瘤大小、淋巴结受累情况、激素受体状态以及可能的组织学分级方面进行匹配。尽管进行了匹配，但小叶型癌更常为多灶性，有更多的淋巴结受累，分级较低且增殖分数较低。小叶型和导管型两组在总体或任何检查亚组中的无病生存期或总生存期、局部区域复发或远处转移时间均无显著差异，不过小叶型组对侧乳腺癌出现的趋势较早。经典的小叶组织学不是早期乳腺癌预后的独立因素。
