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Lobular and non-lobular breast cancers differ regarding axillary lymph node metastasis: a cross-sectional study on 4,292 consecutive patients

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Abstract

Invasive lobular carcinoma (ILC) accounts for 8–14% of all breast cancers and carries distinct prognostic and biologic implications. The goal of our study was to investigate the impact of lobular histology on axillary lymph node (ALN) involvement. This is a cross-sectional study of 4,292 consecutive patients surgically treated for breast carcinoma at the University Hospitals Leuven. Logistic regression analysis was used to relate ILC to lymph node involvement while controlling for the following clinicopathologic features: tumor size, multifocal disease, tumor grade, lobular subtype and the combined steroid, and Her-2 status. Odds ratios (ORs) and 95% confidence intervals (CIS) were computed. A subgroup analysis was performed for patients that underwent a sentinel lymph node (SLN) procedure. The observed incidence of ILC was 13%. ILCs were larger, were more often grade II, multifocal, steroid receptor positive and Her-2 negative, and tended to be present in older patients. Incidence of ALN involvement was 42.0% for ILCs versus 38.3% for other tumors (OR 1.17, 95% CI 0.97–1.40). For the SLN subgroup, ILCs were less often ALN positive than non-ILCs (20.5% versus 28.3%, OR 0.66, 95% CI: 0.41–1.00). In the multivariable analysis, the lobular subtype was identified as less likely to have ALN involvement (adjusted OR 0.66, 95% CI 0.53–0.82). The analysis for the SLN subgroup showed comparable results (adjusted OR 0.49, 95% CI 0.30–0.78). This study has demonstrated that the lobular subtype is an independent predictor of lymph node involvement with ILC having a lower incidence of involved lymph nodes. The mildly higher incidence of ALN metastasis in lobular cancers in univariable analysis is not due to the lobular subtype, but due to confounding factors that interact with lymph node involvement.

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Acknowledgments

BVC is a postdoctoral fellow of the Research Foundation—Flanders (FWO). KVH is supported by a grant from the Agency for Innovation by Science and Technology (IWT).

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Authors and Affiliations

  1. Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium

    T. Vandorpe, A. Smeets, K. Leunen, F. Amant, Ph. Moerman, K. Deraedt, H. Wildiers, M. R. Christiaens & P. Neven

  2. Department of Electrical Engineering (ESAT-SISTA), Katholieke Universiteit Leuven, Leuven, Belgium

    T. Vandorpe, B. Van Calster, K. Van Hoorde & S. Van Huffel

  3. IBBT/K.U. Leuven Future Health Department, Katholieke Universiteit Leuven, Leuven, Belgium

    B. Van Calster, K. Van Hoorde & S. Van Huffel

  4. Division of Gynecologic Oncology, University Hospitals Leuven, Leuven, Belgium

    K. Leunen, F. Amant, O. Brouckaert & P. Neven

  5. Department of Pathology, University Hospitals Leuven, Leuven, Belgium

    Ph. Moerman & K. Deraedt

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  1. T. Vandorpe
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  2. A. Smeets
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  3. B. Van Calster
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  4. K. Van Hoorde
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  5. K. Leunen
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  6. F. Amant
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  7. Ph. Moerman
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  8. K. Deraedt
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  9. O. Brouckaert
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  10. S. Van Huffel
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  11. H. Wildiers
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  12. M. R. Christiaens
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  13. P. Neven
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Corresponding author

Correspondence to A. Smeets.

Additional information

T. Vandorpe and A. Smeets contributed equally in this study.

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Vandorpe, T., Smeets, A., Van Calster, B. et al. Lobular and non-lobular breast cancers differ regarding axillary lymph node metastasis: a cross-sectional study on 4,292 consecutive patients. Breast Cancer Res Treat 128, 429–435 (2011). https://doi.org/10.1007/s10549-011-1565-4

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  • DOI: https://doi.org/10.1007/s10549-011-1565-4

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