175 Background: Pleomorphic lobular carcinoma (PL) is an aggressive subtype of invasive lobular carcinoma. A previous report of 52 patients showed an increase in development of metastases for pleomorphic lobular carcinoma patients. There are relatively few case series reporting on this aggressive form of breast cancer. This report features a descriptive and survivorship comparison of a large case series of PL reviewed by a single breast pathologist. Methods: From 1993-2010 we retrospectively reviewed 198 cases of invasive lobular carcinomas, 35 cases (34 patients with one patient presenting with 2 independent cancers) of PL and 163 cases of non-pleomorphic invasive lobular carcinoma (NPL). The pathology was reviewed by a single breast pathologist and classified as either PL or NPL according to WHO classification. Kaplan-Meier survivals were computed and compared with a log rank test using SPSS 18. Overall survival (OS) was computed from date of diagnosis to date of last update (02/01/11). Progression free survival (PFS) until either local or metastatic failure was also computed. Results: The median follow-up was 59.5 months and 73 months, for NPL and PL patients respectively. The median age of diagnosis was 55 (range 40-80) and 58.67 (range 36-89) for PL and NPL groups. Of the NPL group, 75.5% were post-menopausal as opposed to 67.6% in the PL group. PL cases were ER positive 87.1% vs. 90.1% of the NPL cases. Her-2/neu status was known in nearly 50% of cases with 17 positive NPL cases and 5 positive PL cases. Clinical stage at presentation was stage IIB or less in 67.6% of the PL patients and 80.1% of the NPL patients. Six patients presented (17.6%) with metastatic disease in the PL group and 12 patients (7.7%) in the NPL group. None of the descriptive comparisons above were significantly different by χ2 analysis. PFS at 5 years was 30% and 21% in PL and NPL patients, respectively (p=0.73). OS at 5 years was 68.5% for PL patients and 83.9% for NPL patients (p=0.031). Conclusions: In this large case series of PL cases reviewed by a single breast pathologist, PL patients showed a statistically significant decreased OS, but no significant difference in PFS, at 5 years from diagnosis.
Triple-negative pleomorphic lobular carcinoma and expression of androgen receptor: Personal case series and review of the literature
