Breast conserving surgery for invasive lobular carcinoma as a continuing challenge: A comparison to other tumour subtypes.
Association of Breast Surgery ePoster Library. Lim J. 05/15/17; 166313; P102
Dr. Jie Lim
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Abstract
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Introduction
Invasive lobular carcinoma (ILC) with its peculiar growth pattern poses a challenge to breast conservation surgery (BCS). We compared initial surgical intervention and re-resection rates of ILC to other tumour subtypes.
Methods
4476 consecutive patients who underwent surgery in two breast units in Glasgow for breast cancer from 2008 to 2014 was analysed. Statistical significance was calculated using Mann-Whitney test and Chi-square tests, with significance of <0.05.
Results
ILC exhibited the lowest BCS success rate of all tumour subtypes (ILC: 50.34%; IDC (invasive ductal carcinoma): 65.77%, relative risk(RR): 1.3066; LMP (low malignant potential: tubular and mucoid carcinoma): 79.89%, RR:1.5871; DCIS (ductal carcinoma in situ): 64.74%, RR:1.2861 [all p values <0.0001]). A higher incomplete excision rate after initial conservation was also seen in ILC (ILC: 25.27%; IDC: 15.26%, RR:0.6038; LMP: 8.84%, RR:0.3499; DCIS: 18.56%, RR:0.7343 [all p values <0.05] ).
Mean whole tumour size of ILC was larger compared to other subtypes (ILC: 27.21mm; IDC: 21.82mm, P=0.01805; LMP: 18.65mm, P=0.015419; DCIS: 23.98mm, P=0.138351). In all tumour subtypes, increasing tumour size correlates with fall in BCS and higher mastectomy rates (all p values <0.0001). In all tumour sizes ≤50mm, ILC has the lowest BCS rates as well. [≤10mm: ILC-86.27%, IDC-88.77%(p=0.0532), LMP-93.94% (p <0.0001), DCIS-92.97% (p <0.0001); 10 to 20mm : ILC-74.44%, IDC-80.95%(p <0.0001), LMP-93.55% (p=0.0054), DCIS:82.80%(p=0.3827), 20 to 50mm: ILC-39.8%, IDC-46.15% (p=0.3752).
Conclusions
We observed higher BCS success rates in other tumour subtypes compared to ILC. Lobular histology and increasing tumour size are predictive of BCS failure
Invasive lobular carcinoma (ILC) with its peculiar growth pattern poses a challenge to breast conservation surgery (BCS). We compared initial surgical intervention and re-resection rates of ILC to other tumour subtypes.
Methods
4476 consecutive patients who underwent surgery in two breast units in Glasgow for breast cancer from 2008 to 2014 was analysed. Statistical significance was calculated using Mann-Whitney test and Chi-square tests, with significance of <0.05.
Results
ILC exhibited the lowest BCS success rate of all tumour subtypes (ILC: 50.34%; IDC (invasive ductal carcinoma): 65.77%, relative risk(RR): 1.3066; LMP (low malignant potential: tubular and mucoid carcinoma): 79.89%, RR:1.5871; DCIS (ductal carcinoma in situ): 64.74%, RR:1.2861 [all p values <0.0001]). A higher incomplete excision rate after initial conservation was also seen in ILC (ILC: 25.27%; IDC: 15.26%, RR:0.6038; LMP: 8.84%, RR:0.3499; DCIS: 18.56%, RR:0.7343 [all p values <0.05] ).
Mean whole tumour size of ILC was larger compared to other subtypes (ILC: 27.21mm; IDC: 21.82mm, P=0.01805; LMP: 18.65mm, P=0.015419; DCIS: 23.98mm, P=0.138351). In all tumour subtypes, increasing tumour size correlates with fall in BCS and higher mastectomy rates (all p values <0.0001). In all tumour sizes ≤50mm, ILC has the lowest BCS rates as well. [≤10mm: ILC-86.27%, IDC-88.77%(p=0.0532), LMP-93.94% (p <0.0001), DCIS-92.97% (p <0.0001); 10 to 20mm : ILC-74.44%, IDC-80.95%(p <0.0001), LMP-93.55% (p=0.0054), DCIS:82.80%(p=0.3827), 20 to 50mm: ILC-39.8%, IDC-46.15% (p=0.3752).
Conclusions
We observed higher BCS success rates in other tumour subtypes compared to ILC. Lobular histology and increasing tumour size are predictive of BCS failure
Introduction
Invasive lobular carcinoma (ILC) with its peculiar growth pattern poses a challenge to breast conservation surgery (BCS). We compared initial surgical intervention and re-resection rates of ILC to other tumour subtypes.
Methods
4476 consecutive patients who underwent surgery in two breast units in Glasgow for breast cancer from 2008 to 2014 was analysed. Statistical significance was calculated using Mann-Whitney test and Chi-square tests, with significance of <0.05.
Results
ILC exhibited the lowest BCS success rate of all tumour subtypes (ILC: 50.34%; IDC (invasive ductal carcinoma): 65.77%, relative risk(RR): 1.3066; LMP (low malignant potential: tubular and mucoid carcinoma): 79.89%, RR:1.5871; DCIS (ductal carcinoma in situ): 64.74%, RR:1.2861 [all p values <0.0001]). A higher incomplete excision rate after initial conservation was also seen in ILC (ILC: 25.27%; IDC: 15.26%, RR:0.6038; LMP: 8.84%, RR:0.3499; DCIS: 18.56%, RR:0.7343 [all p values <0.05] ).
Mean whole tumour size of ILC was larger compared to other subtypes (ILC: 27.21mm; IDC: 21.82mm, P=0.01805; LMP: 18.65mm, P=0.015419; DCIS: 23.98mm, P=0.138351). In all tumour subtypes, increasing tumour size correlates with fall in BCS and higher mastectomy rates (all p values <0.0001). In all tumour sizes ≤50mm, ILC has the lowest BCS rates as well. [≤10mm: ILC-86.27%, IDC-88.77%(p=0.0532), LMP-93.94% (p <0.0001), DCIS-92.97% (p <0.0001); 10 to 20mm : ILC-74.44%, IDC-80.95%(p <0.0001), LMP-93.55% (p=0.0054), DCIS:82.80%(p=0.3827), 20 to 50mm: ILC-39.8%, IDC-46.15% (p=0.3752).
Conclusions
We observed higher BCS success rates in other tumour subtypes compared to ILC. Lobular histology and increasing tumour size are predictive of BCS failure
Invasive lobular carcinoma (ILC) with its peculiar growth pattern poses a challenge to breast conservation surgery (BCS). We compared initial surgical intervention and re-resection rates of ILC to other tumour subtypes.
Methods
4476 consecutive patients who underwent surgery in two breast units in Glasgow for breast cancer from 2008 to 2014 was analysed. Statistical significance was calculated using Mann-Whitney test and Chi-square tests, with significance of <0.05.
Results
ILC exhibited the lowest BCS success rate of all tumour subtypes (ILC: 50.34%; IDC (invasive ductal carcinoma): 65.77%, relative risk(RR): 1.3066; LMP (low malignant potential: tubular and mucoid carcinoma): 79.89%, RR:1.5871; DCIS (ductal carcinoma in situ): 64.74%, RR:1.2861 [all p values <0.0001]). A higher incomplete excision rate after initial conservation was also seen in ILC (ILC: 25.27%; IDC: 15.26%, RR:0.6038; LMP: 8.84%, RR:0.3499; DCIS: 18.56%, RR:0.7343 [all p values <0.05] ).
Mean whole tumour size of ILC was larger compared to other subtypes (ILC: 27.21mm; IDC: 21.82mm, P=0.01805; LMP: 18.65mm, P=0.015419; DCIS: 23.98mm, P=0.138351). In all tumour subtypes, increasing tumour size correlates with fall in BCS and higher mastectomy rates (all p values <0.0001). In all tumour sizes ≤50mm, ILC has the lowest BCS rates as well. [≤10mm: ILC-86.27%, IDC-88.77%(p=0.0532), LMP-93.94% (p <0.0001), DCIS-92.97% (p <0.0001); 10 to 20mm : ILC-74.44%, IDC-80.95%(p <0.0001), LMP-93.55% (p=0.0054), DCIS:82.80%(p=0.3827), 20 to 50mm: ILC-39.8%, IDC-46.15% (p=0.3752).
Conclusions
We observed higher BCS success rates in other tumour subtypes compared to ILC. Lobular histology and increasing tumour size are predictive of BCS failure
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