ILC current research review article

Robyn_S

Hello ladies,

I found this following article to be an excellent review of the current research available for our form of BC.

Crit Rev Oncol Hematol. 2014 Jul 30. pii: S1040-8428(14)00129-2. doi: 10.1016/j.critrevonc.2014.07.003. [Epub ahead of print]

Invasive lobular breast cancer and its variants: How special are they for systemic therapy decisions?

Guiu S¹, Wolfer A², Jacot W³, Fumoleau P⁴, Romieu G³, Bonnetain F⁵, Fiche M⁶.

Abstract

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

Link: http://www.sciencedirect.com/science/article/pii/S1040842814001292

Robyn

toomuch

Robyn - Every once in awhile I search for new publications on ILC and I never come up with any. Thanks so much for posting this with the link!

Momine

Robyn, thanks for posting. I just wish we had access to more than the abstract.

Lily55

yes i can only access the abstract too, not sure if this article represents good or bad news.....

Gitane

Good compilation of a lot of what is out there to know about ILC.  It's frustratingly inconclusive, but at least it's there.  For those making treatment decisions the idea that ILC should get chemo (or at least not be excluded from it because of histology) and that ILC responds better to Letrozole are good things to know. Thank you for providing this link.

Momine

Duh! OK, make it a mega-duh! When you click on the link, you get the abstract. However, there are tabs on top of the box with the abstract, one of them being "full text."

I just read most of the article, although it is pretty dense.

One conclusion is that lower PCR (Pathological Complete Response) rates from neo-adjuvant chemo in ILC should not be taken as evidence that chemo "doesn't work" in ILC, since survival advantage from chemo appears similar to IDC, when patients are matched for age, stage etc. Also, PCR (achieved or not achieved) does not seem to have prognostic significance in ILC, only in high-grade IDC, or possibly only in high-grade BC generally (which ILC typically is not).

This confirms my gut feeling on the matter. I did not have a PCR from neo-adjuvant chemo, but I did have a very significant response to the chemo, tumor going from 5X3 cms, at least, to 1.6X0.2 cms. I also started feeling significantly better after 2 rounds of chemo (by which time the tumor had halved in size), presumably from the reduced tumor load on my body. This in spite the discomfort from the chemo itself.

Anonymous

Momine, thank you for translating some of this into plain English!  Doesn't seem to be new "news", but at least there don't seem to be any negative surprises for us, either.  

Claire in AZ

Anonymous

And thank you Robyn  for posting!