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Poor response to chemotherapy does not mean poor outcome for patients with rare breast cancer

ast cancer through a series of clinical trials conducted at the institution between 1985 and 2002. But patients were not divided by tumor histology within these studies because too few women had invasive lobular carcinoma. Now, by combining these trials together, Cristofanilli and his research team had enough patients (122 with invasive lobular carcinoma and 912 with invasive ductal carcinoma) to better understand possible effects of treatments on response and outcome.

They evaluated the impact of "histological" type of cancer - determined from tumor biopsies - on the likelihood that patients would achieve a "pathological complete response," on evidence of cancer remaining in the breast or lymph nodes, and on long-term outcome.

What they found was contrary to what they had anticipated. Women with invasive lobular carcinoma had a poorer response to primary chemotherapy yet better overall survival. Specifically, only 3 percent of lobular carcinoma patients had a pathological complete response, compared to 15 percent of ductal carcinoma patients; 41 percent of women with lobular cancers had residual lymph node disease compared to 26 percent of women with ductal disease.

Yet, five years after treatment, breast cancer had not come back in 80 percent of women with lobular carcinoma, compared with 66 percent of ductal carcinoma patients. And five-year survival in women with invasive lobular carcinoma was significantly higher - 91 percent - compared with 72 percent in women with invasive ductal carcinoma.


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Contact: Laura Sussman
lsussman@mdanderson.org
713-792-0655
University of Texas M. D. Anderson Cancer Center
29-Dec-2004


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