Author(s): Lorimier G, Fondrinier E, Gurin O
Five studies comparing metastatic patterns of lobular and ductal carcinoma have reported conflicting results. These results are based on the evaluation of heterogeneous groups, without taking clinical differences into account. The aim of this clinical study is to compare metastatic patterns of matched ductal and lobular carcinomas. One hundred eighty-eight lobular carcinomas were matched with 188 ductal carcinomas who showed identical ages, menopausal status, TNM, and dates of treatment. Hepatic, lung and brain metastases are more frequent in ductal carcinoma. Metastases to the gastrointestinal system, gynecologic organs, and peritoneum are more characteristic of lobular carcinoma. Life table analysis of overall and disease free survival shows no significant differences. The metastatic patterns of ductal and lobular carcinomas are different, and physicians should be aware that the classical staging of the breast cancer is not fit to lobular carcinoma. fit to lobular carcinoma. Could we define patients presenting high metastatic risks? Could we use CA. 125, sonography, laparoscopy in the staging? Should we change the whole therapeutic approach of lobular carcinoma?