Lobular breast cancer| Volume 91, ISSUE 1, P49-53, April 2009

Download started.


The impact of postmastectomy radiotherapy on local control in patients with invasive lobular breast cancer

Published:October 24, 2008DOI:



      The aim of this population-based study was to examine the impact of postmastectomy radiotherapy on the risk of local recurrence in patients with invasive lobular breast cancer (ILC).


      The population-based Eindhoven Cancer Registry was used to select all patients with ILC, who underwent mastectomy in five general hospitals in the southern part of the Netherlands between 1995 and 2002. Of the 499 patients 383 patients fulfilled the eligibility criteria. Of these patients, 170 (44.4%) had received postmastectomy radiotherapy. The median follow-up was 7.2 years. Fourteen patients (3.7%) were lost to follow-up.


      During follow-up 22 patients developed a local recurrence, of whom 4 had received postmastectomy radiotherapy. The 5-year actuarial risk of local recurrence was 2.1% for the patients with and 8.7% for the patients without postmastectomy radiotherapy. After adjustment for age at diagnosis, tumour stage and adjuvant systemic treatment, the patients who underwent postmastectomy radiotherapy were found to have a more than 3 times lower risk of local recurrence compared to the patients without (Hazard Ratio 0.30; 95% Confidence Interval: 0.10–0.89).


      Local control is excellent for patients with ILC who undergo postmastectomy radiotherapy and significantly better than for patients not receiving radiotherapy.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Radiotherapy and Oncology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. The world Health Organization histological typing of breast tumors-Second ed. The World Organization. Am J Clin Pathol 1982;78:806–816.

        • Fisher E.R.
        • Gregorio R.M.
        • Fisher B.
        • Redmond C.
        • Vellios F.
        • Sommers S.C.
        The pathology of invasive breast cancer. A syllabus derived from findings of the national surgical adjuvant breast project (protocol no4).
        Cancer. 1975; 36: 1-85
        • Wellings S.R.
        • Jensen H.M.
        • Marcum R.G.
        An atlas of subgross pathology of the human breast with special reference to possible precancerous lesions.
        J Natl Cancer Inst. 1975; 55: 231-273
        • Martinez V.
        • Azzopardi J.G.
        Invasive lobular carcinoma of the breast: incidence and variants.
        Histopathology. 1979; 3: 467-488
        • Sastre-Garau X.
        • Jouve M.
        • Asselain B.
        • et al.
        Infiltrating lobular carcinoma of the breast. Clinicopathologic analysis of 975 cases with reference to data on conservative therapy and metastatic patterns.
        Cancer. 1996; 77: 113-120
        • Yeatman T.J.
        • Cantor A.B.
        • Smith T.J.
        • et al.
        Tumor biology of infiltrating lobular carcinoma. Implications for management.
        Ann Surg. 1995; 222 (discussion 559-61): 549-559
        • Silverstein M.J.
        • Lewinsky B.S.
        • Waisman J.R.
        • et al.
        Infiltrating lobular carcinoma. Is it different from infiltrating duct carcinoma?.
        Cancer. 1994; 73: 1673-1677
        • Moore M.M.
        • Borossa G.
        • Imbrie J.Z.
        • Fechner R.E.
        • Harvey J.A.
        • Slingluff Jr., C.L.
        • et al.
        Association of infiltrating lobular carcinoma with positive surgical margins after breast-conservation therapy.
        Ann Surg. 2000; 231: 877-882
        • Peiro G.
        • Bornstein B.A.
        • Connolly J.L.
        • et al.
        The influence of infiltrating lobular carcinoma on the outcome of patients treated with breast-conserving surgery and radiation therapy.
        Breast Cancer Res Treat. 2000; 59: 49-54
        • Holland P.A.
        • Shah A.
        • Howell A.
        • Baildam A.D.
        • Bundred N.J.
        Lobular carcinoma of the breast can be managed by breast-conserving therapy.
        Br J Surg. 1995; 82: 1364-1366
        • Warneke J.
        • Berger R.
        • Johnson C.
        • Stea D.
        • Villar H.
        Lumpectomy and radiation treatment for invasive lobular carcinoma of the breast.
        Am J Surg. 1996; 172: 496-500
        • Chung M.A.
        • Cole B.
        • Wanebo H.J.
        • Bland K.I.
        • Chang H.R.
        Optimal surgical treatment of invasive lobular carcinoma of the breast.
        Ann Surg Oncol. 1997; 4: 545-550
        • Singletary S.E.
        • Patel-Parekh L.
        • Bland K.I.
        Treatment trends in early-stage invasive lobular carcinoma: a report from the national cancer data base.
        Ann Surg. 2005; 242: 281-289
        • van den Broek N.
        • van der Sangen M.J.
        • van de Poll-Franse L.V.
        • van Beek M.W.
        • Nieuwenhuijzen G.A.
        • Voogd A.C.
        Margin status and the risk of local recurrence after breast-conserving treatment of lobular breast cancer.
        Breast Cancer Res Treat. 2007; 105: 63-68
        • Voogd A.C.
        • Nielsen M.
        • Peterse J.L.
        • et al.
        Differences in risk factors for local and distant recurrence after breast-conserving therapy or mastectomy for stage I and II breast cancer: pooled results of two large European randomized trials.
        J Clin Oncol. 2001; 19: 1688-1697
        • Bontenbal M.
        • Nortier J.W.
        • Beex L.V.
        • Bakker P.
        • Hupperets P.S.
        • Nooij M.A.
        • et al.
        Adjuvant systemic therapy for patients with resectable breast cancer: guideline from the Dutch National Breast Cancer Platform and the Dutch Society for medical oncology.
        Ned Tijdschr Geneeskd. 2000; 144: 984-989
        • Goldhirsch A.
        • Glick J.H.
        • Gelber R.D.
        • Senn H.J.
        Meeting highlights: international consensus panel on the treatment of primary breast cancer.
        J Natl Cancer Inst. 1998; 90: 1601-1608
      2. Goldhirsch A, Glick JH, Gelber RD, Coates AS, Senn HJ. Meeting highlights: international consensus panel on the treatment of primary breast cancer. Seventh international conference on adjuvant therapy of primary breast cancer. J Clin Oncol 2001;19:3817–3827.

        • du Toit R.S.
        • Locker A.P.
        • Ellis I.O.
        • et al.
        An evaluation of differences in prognosis, recurrence patterns and receptor status between invasive lobular and other invasive carcinomas of the breast.
        Eur J Surg Oncol. 1991; 17: 251-257
        • Hussien M.
        • Lioe T.F.
        • Finnegan J.
        • Spence R.A.
        Surgical treatment for invasive lobular carcinoma of the breast.
        Breast. 2003; 12: 23-35
        • Overgaard M.
        • Nielsen H.M.
        • Overgaard J.
        Is the benefit of postmastectomy irradiation limited to patients with four or more positive nodes, as recommended in international consensus reports? A subgroup analysis of the DBCG 82 b&c randomized trials.
        Radiother Oncol. 2007; 82: 247-253
        • Hooning M.J.
        • Aleman B.M.
        • van Rosmalen A.J.
        • et al.
        Cause-specific mortality in long-term survivors of breast cancer: A 25-year follow-up study.
        Int J Radiat Oncol Biol Phys. 2006; 64: 1081-1091