Department of Medical Oncology, Georges-François Leclerc Cancer Center, 1 rue du Professeur Marion, 21000 Dijon, France; Department of Medical Oncology, CHUV, rue du Bugnon 46, 1011 Lausanne, Switzerland.
Department of Medical Oncology, CHUV, rue du Bugnon 46, 1011 Lausanne, Switzerland.
Crit Rev Oncol Hematol. 2014 Dec;92(3):235-57. doi: 10.1016/j.critrevonc.2014.07.003. Epub 2014 Jul 30.
The WHO classification of breast tumors distinguishes, besides invasive breast cancer 'of no special type' (former invasive ductal carcinoma, representing 60-70% of all breast cancers), 30 special types, of which invasive lobular carcinoma (ILC) is the most common (5-15%). We review the literature on (i) the specificity and heterogeneity of ILC biology as documented by various analytical techniques, including the results of molecular testing for risk of recurrence; (ii) the impact of lobular histology on prediction of prognosis and effect of systemic therapies in patients. Though it is generally admitted that ILC has a better prognosis than IDC, is endocrine responsive, and responds poorly to chemotherapy, currently available data do not unanimously support these assumptions. This review demonstrates some lack of specific data and a need for improving clinical research design to allow oncologists to make informed systemic therapy decisions in patients with ILC. Importantly, future studies should compare various endpoints in ILC breast cancer patients among the group of hormonosensitive breast cancer.
世界卫生组织（WHO）的乳腺肿瘤分类除了“非特殊型浸润性乳腺癌”（前身为浸润性导管癌，占所有乳腺癌的 60%-70%）外，还区分了 30 种特殊类型，其中浸润性小叶癌（ILC）最为常见（占 5%-15%）。我们回顾了关于（i）小叶癌生物学的特异性和异质性的文献，这些特性可通过多种分析技术来证实，包括对复发风险的分子检测结果；（ii）小叶状组织学对预测预后和影响患者全身治疗效果的影响。虽然普遍认为 ILC 的预后优于 IDC，对内分泌治疗有反应，且对化疗反应不佳，但目前的可用数据并不一致支持这些假设。这篇综述表明，一些特定数据的缺乏以及需要改进临床研究设计，以使肿瘤学家能够在 ILC 患者中做出明智的全身治疗决策。重要的是，未来的研究应在激素敏感型乳腺癌患者中比较 ILC 乳腺癌患者的各种终点。
