A pooled analysis evaluating prognostic significance of Residual Cancer Burden in invasive lobular breast cancer
Residual Cancer Burden (RCB) after neoadjuvant chemotherapy (NAC) is validated to predict event-free survival (EFS) in breast cancer but has not been studied for invasive lobular carcinoma (ILC). We studied patient-level data from a pooled cohort across 12 institutions. Associations between RCB index, class, and EFS were assessed in ILC and non-ILC with mixed effect Cox models and multivariable analyses. Recursive partitioning was used in an exploratory model to stratify prognosis by RCB components. Of 5106 patients, the diagnosis was ILC in 216 and non-ILC in 4890. Increased RCB index was associated with worse EFS in both ILC and non-ILC (p = 0.002 and p < 0.001, respectively) and remained prognostic when stratified by receptor subtype and adjusted for age, grade, T category, and nodal status. Recursive partitioning demonstrated residual invasive cancer cellularity as most prognostic in ILC. These results underscore the utility of RCB for evaluating NAC response in those with ILC.
Authors
- W. Fraser Symmans (ORCID: https://orcid.org/0000-0002-1526-184X)
- Anne‐Sophie Hamy (ORCID: https://orcid.org/0000-0003-4430-3022)
- Fabien Reyal (ORCID: https://orcid.org/0000-0002-2318-3589)
- Angela M. DeMichele (ORCID: https://orcid.org/0000-0003-1297-4251)
- Tanya L. Hoskin (ORCID: https://orcid.org/0000-0002-7429-7674)
- David Cameron (ORCID: https://orcid.org/0000-0002-2717-7979)
- Jean Abraham (ORCID: https://orcid.org/0000-0003-0688-4807)
- Matthew P. Goetz (ORCID: https://orcid.org/0000-0002-4383-270X)
- Laura van ‘t Veer (ORCID: https://orcid.org/0000-0002-9838-8298)
- Tessa G. Steenbruggen (ORCID: https://orcid.org/0000-0001-6870-5785)
- Stephen B. Edge (ORCID: https://orcid.org/0000-0002-3285-6191)
- Jelle Wesseling (ORCID: https://orcid.org/0000-0002-8940-2676)
- Lajos Pusztai (ORCID: https://orcid.org/0000-0001-9632-6686)
- Marieke van der Noordaa
- Janet Dunn (ORCID: https://orcid.org/0000-0001-7313-4446)
- Maartje van Seijen (ORCID: https://orcid.org/0000-0002-9348-239X)
- Marie Osdoit (ORCID: https://orcid.org/0000-0003-1123-3400)
- Lorna Mackintosh
- Judy C. Boughey (ORCID: https://orcid.org/0000-0003-3820-3228)
- Andrew K. Godwin (ORCID: https://orcid.org/0000-0002-3987-9580)
- Stephen‐John Sammut (ORCID: https://orcid.org/0000-0003-4472-904X)
- Diane De Croze
- Rita A. Mukhtar (ORCID: https://orcid.org/0000-0001-8079-7846)
- Marick Laé (ORCID: https://orcid.org/0000-0002-7448-9537)
- Jeremy Thomas (ORCID: https://orcid.org/0000-0002-4652-610X)
- Peter S Hall (ORCID: https://orcid.org/0000-0001-6015-7841)
- Sara López‐Tarruella (ORCID: https://orcid.org/0000-0002-2606-9538)
- Kimberly Cole
- Gabe S. Sonke (ORCID: https://orcid.org/0000-0001-8088-9628)
- Priyanka Sharma (ORCID: https://orcid.org/0000-0001-8592-2239)
- Larry Hayward
- Christina Yau (ORCID: https://orcid.org/0000-0002-1937-0859)
- Kelsey Schwensen
- Elena Provenzano (ORCID: https://orcid.org/0000-0003-3345-3965)
- Laura J. Esserman (ORCID: https://orcid.org/0000-0001-9202-4568)
- Marı́a del Monte-Millán (ORCID: https://orcid.org/0000-0002-4499-5906)
- Vicente Valero (ORCID: https://orcid.org/0000-0001-5913-7480)
- Helena Earl (ORCID: https://orcid.org/0000-0003-1549-8094)
- Soumya Gottipati
- Carlos Caldas (ORCID: https://orcid.org/0000-0003-3547-1489)
- Thomas John (ORCID: https://orcid.org/0000-0003-3399-5342)
- Louise Hiller (ORCID: https://orcid.org/0000-0001-8538-9163)
- Miguel Martín (ORCID: https://orcid.org/0000-0001-9237-3231)
- Mi‐Ok Kim (ORCID: https://orcid.org/0000-0002-7712-3653)
- Fang Fan (ORCID: https://orcid.org/0000-0002-0836-2386)
- A Graham
Institutions
- Ontario Institute for Cancer Research (CA)
- Roswell Park Comprehensive Cancer Center (US)
- The University of Texas MD Anderson Cancer Center (US)
- University of California, San Francisco (US)
- University of Toronto (CA)
- University of Cambridge (GB)
- Western General Hospital (GB)
- Edinburgh Cancer Research (GB)
- The Netherlands Cancer Institute (NL)
- Hospital General Universitario Gregorio Marañón (ES)
- Yale University (US)
- University of Warwick (GB)
- Oncode Institute (NL)
- University of Kansas Medical Center (US)
- Mayo Clinic in Florida (US)
- Université de Rouen Normandie (FR)
- University of San Francisco (US)
- University of Pennsylvania (US)
- Institut Curie (FR)
- Philadelphia University (US)
Publication Details
- Journal
- npj Breast Cancer
- Published
- 2025-02-13
- DOI
- https://doi.org/10.1038/s41523-025-00720-3
- Citations
- 4
- Primary Topic
- Breast Cancer Treatment Studies
- Type
- article
- Field-Weighted Citation Impact
- 3.75
Funders
- National Cancer Institute