Comparison of Clinicopathological Features of Pleomorphic and Invasive Lobular Breast Carcinomas

Am Surg. 2024 Jun;90(6):1383-1389. doi: 10.1177/00031348241241612. Epub 2024 Mar 21.

Abstract

Purpose: Accounting for about 15% of invasive lobular carcinomas and 1% of breast carcinomas, pleomorphic lobular carcinoma is known to be a rare histological subtype of invasive lobular carcinoma. Yet, it is more aggressive and produces a worse prognosis than other breast cancers. Ultimately, the present study compares the clinicopathological features of pleomorphic and invasive lobular breast carcinomas.

Methods: In the study, we retrospectively evaluated the data of 262 patients with histological subtypes of classical and pleomorphic lobular cancers having been recruited for surgical operations. After resorting to Kolmogorov-Smirnov and Shapiro-Wilk tests to check the normality of distribution, the categorical and continuous variables were compared between the groups using the chi-square test and independent samples t test, respectively. In all analyses, we considered a P-value of <.05 to be statistically significant.

Results: Our findings revealed that the groups with lobular and pleomorphic groups significantly differed by Ki-67 value, estrogen receptor negativity, grade, multicentricity, multifocality, surgical margin positivity, completion mastectomy, and metachronous contralateral tumor (P < .05).

Conclusion: We discovered that pleomorphic type was associated with higher grades, estrogen receptor negativity, and Ki-67 expression. The incidence of metachronous breast cancer was high in the pleomorphic group, which may be a noteworthy finding to be considered in follow-ups. In addition, the high rates of multicentricity and multifocality of tumors in the pleomorphic group may be associated with increased surgical margin positivity and a higher likelihood of mastectomy. In a nutshell, our findings may guide patients and surgeons regarding the type of intervention and reconstruction options to be adopted in prospective surgeries.

Keywords: breast cancer; lobular breast cancer; pleomorphic lobular breast cancer; surgical margin.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms* / pathology
  • Breast Neoplasms* / surgery
  • Carcinoma, Lobular* / pathology
  • Carcinoma, Lobular* / surgery
  • Female
  • Humans
  • Ki-67 Antigen / analysis
  • Ki-67 Antigen / metabolism
  • Margins of Excision
  • Mastectomy
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Invasiveness
  • Receptors, Estrogen / analysis
  • Receptors, Estrogen / metabolism
  • Retrospective Studies