Division of Anatomical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa and National Health Laboratory Service, Tygerberg Academic Hospital, South Africa.
Breast and Endocrine Unit, Division of Surgery, Department of Surgical Sciences, Tygerberg Academic Hospital, Stellenbosch University, South Africa.
S Afr J Surg. 2022 Sep;60(3):176-181. doi: 10.17159/2078-5151/SAJS3768.
The second most common histological subtype of invasive breast carcinoma is invasive lobular carcinoma (ILC) occuring with a frequency 10-15% in Western countries and approximately 5%, in Africa, the Middle East and Asia (AMA). Combined hormone replacement therapy (CHRT) is a risk factor for the development of ILC which is infrequently diagnosed at our centre.This study aimed to investigate the incidence and clinicopathological characteristics of ILC as compared to invasive breast carcinoma of no special type (IBC-NST).
Clinical and pathological data on breast carcinoma patients attending the breast and endocrine unit at Tygerberg Academic Hospital since 2017 have been recorded on a Stellenbosch University REDCap database.
IBC-NST was the most frequent subtype diagnosed (83.9%) and ILC the second most common subtype (5.2%). Most ILCs were of luminal B intrinsic subtype, and the median size was slightly smaller than IBC-NST. There were significantly more grade 2 ILCs than IBC-NSTs (81.5% vs 50.9%). There was no statistical difference between stage and histological subtype.
ILC has clinicopathological differences when compared to IBC-NST, although these were less pronounced in this study. The prevalence of ILC was similar to numbers reported in AMA. We hypothesise that there may be a discrepancy in the prevalence of ILC between public and private healthcare systems in South Africa, and that it may be due to differing trends in prescribing CHRT.
浸润性乳腺癌的第二大组织学亚型是浸润性小叶癌（ILC），在西方国家的发病率为 10-15%，而在非洲、中东和亚洲（AMA）地区的发病率约为 5%。联合激素替代疗法（CHRT）是 ILC 发展的一个风险因素，而在我们中心，这种癌症的诊断率较低。本研究旨在调查 ILC 的发病率和临床病理特征，并与非特殊类型浸润性乳腺癌（IBC-NST）进行比较。
自 2017 年以来，在泰格伯格学术医院乳腺和内分泌科就诊的乳腺癌患者的临床和病理数据已记录在斯坦陵布什大学的 REDCap 数据库中。
IBC-NST 是最常见的诊断亚型（83.9%），其次是 ILC（5.2%）。大多数 ILC 为 luminal B 内在亚型，其平均大小略小于 IBC-NST。II 级 ILC 明显多于 IBC-NST（81.5% vs 50.9%）。在分期和组织学亚型之间没有统计学差异。
与 IBC-NST 相比，ILC 的临床病理特征存在差异，但在本研究中这些差异并不明显。ILC 的患病率与 AMA 报道的数字相似。我们假设，南非公共和私营医疗保健系统之间的 ILC 患病率可能存在差异，这可能是由于 CHRT 处方趋势的不同。
