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<p>Invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) are the two most common histological subtypes of breast cancer, yet their comparative survival outcomes and prognostic factors remain controversial. This population-based study aimed to compare clinicopathological characteristics, overall survival (OS), disease-specific survival (DSS), and prognostic determinants between IDC and ILC using the SEER database. Female patients diagnosed with primary breast cancer between 2010 and 2019 were identified from the SEER-17 Registries Research Plus database. Patients with IDC (ICD-O-3 8500/3) or ILC (ICD-O-3 8520/3) were included. Cases with multiple primaries, males, stage 0/Tis/T0 disease, unknown staging, or missing key demographic, tumor, or treatment data were excluded. Demographic, clinicopathological, molecular, treatment, and survival variables were analyzed. Survival outcomes were evaluated using Kaplan–Meier analysis and compared by log-rank test. Prognostic factors were assessed using univariate and multivariate Cox regression models. A total of 319,721 patients were included, of whom 286,651 (89.6%) had IDC and 33,070 (10.3%) had ILC. ILC patients were older and more frequently hormone receptor–positive, with lower HER2 positivity and a higher prevalence of the Luminal A subtype. Tumors were larger and stage III disease was more common in ILC, whereas visceral metastases were more frequent in IDC. Five-year OS did not differ significantly between ILC and IDC (87.2% vs. 86.2%, <i>p</i> = 0.481). However, five-year DSS was higher in ILC (92.8% vs. 91.3%, <i>p</i> &lt; 0.001). In multivariate analysis, histological subtype was not an independent predictor of DSS, while stage, grade, molecular subtype, receptor status, and treatment modalities remained significant prognostic factors. Although IDC and ILC demonstrate distinct clinicopathological and metastatic profiles, overall survival outcomes are largely comparable. Histological subtype alone does not independently determine prognosis, underscoring the importance of integrating molecular, pathological, and treatment-related factors in personalized breast cancer management.</p>

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An Update on Survival Outcomes and Prognostic Factors for Invasive Ductal Carcinoma and Invasive Lobular Carcinoma

  • 期刊论文

  • 发表日期：

    2026年5月12日

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  • Kubilay Özgür Öztütüncü,
  • Ahmet Necati Şanlı,
  • Özgür Gangal,
  • Cenk Özkan,
  • Ali Karabulut,
  • Mahmut Ozan Aydın

摘要

Invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) are the two most common histological subtypes of breast cancer, yet their comparative survival outcomes and prognostic factors remain controversial. This population-based study aimed to compare clinicopathological characteristics, overall survival (OS), disease-specific survival (DSS), and prognostic determinants between IDC and ILC using the SEER database. Female patients diagnosed with primary breast cancer between 2010 and 2019 were identified from the SEER-17 Registries Research Plus database. Patients with IDC (ICD-O-3 8500/3) or ILC (ICD-O-3 8520/3) were included. Cases with multiple primaries, males, stage 0/Tis/T0 disease, unknown staging, or missing key demographic, tumor, or treatment data were excluded. Demographic, clinicopathological, molecular, treatment, and survival variables were analyzed. Survival outcomes were evaluated using Kaplan–Meier analysis and compared by log-rank test. Prognostic factors were assessed using univariate and multivariate Cox regression models. A total of 319,721 patients were included, of whom 286,651 (89.6%) had IDC and 33,070 (10.3%) had ILC. ILC patients were older and more frequently hormone receptor–positive, with lower HER2 positivity and a higher prevalence of the Luminal A subtype. Tumors were larger and stage III disease was more common in ILC, whereas visceral metastases were more frequent in IDC. Five-year OS did not differ significantly between ILC and IDC (87.2% vs. 86.2%, p = 0.481). However, five-year DSS was higher in ILC (92.8% vs. 91.3%, p < 0.001). In multivariate analysis, histological subtype was not an independent predictor of DSS, while stage, grade, molecular subtype, receptor status, and treatment modalities remained significant prognostic factors. Although IDC and ILC demonstrate distinct clinicopathological and metastatic profiles, overall survival outcomes are largely comparable. Histological subtype alone does not independently determine prognosis, underscoring the importance of integrating molecular, pathological, and treatment-related factors in personalized breast cancer management.