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<p>While primary invasive lobular carcinoma (ILC) is well characterized, metastatic ILC remains understudied. Within the post-mortem tissue donation programs, UPTIDER (Belgium) and Hope for Others (USA), we first aimed to explore intra-patient heterogeneity of key prognostic and predictive markers (stromal tumor-infiltrating lymphocytes (sTIL), estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and KI67). Secondly, we compared detection of the metastases by pathology on autopsy samples versus pre-mortem imaging. In total, 306 metastases from 12 patients were collected at autopsy (median: 27 per patient). Both primary tumors (<i>n</i> = 15) and metastases (<i>n</i> = 232) had low sTIL levels, with a median of 2% (range: 0.67–6.67%) and 0.67% (range: 0–13.33%), respectively. Regression models showed lower ER- and PR-expression in metastases (respectively, <i>n</i> = 265 and <i>n</i> = 64) compared to primary tumors (both p &lt; 0.01). KI67 was significantly higher in metastases (<i>n</i> = 262, <i>p</i> = 0.02). HER2-low metastases were found in all but one patient although in varying proportion of metastases (range: 7.5–100%). Central radiology and pathology review had a median concordance of 78% at organ level (range: 33.33–100%) and 71% at patient level (range: 55.88-85.29%). Our findings suggest that a single metastatic biopsy has great limitations to guide treatment and that more adequate methods are needed to detect and monitor ILC metastases.</p>

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Clinical and histopathological characterization of metastatic lobular breast cancer: lessons learned from post-mortem tissue donation programs

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月20日

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  • Gitte Zels,
  • Karen Van Baelen,
  • Alexander CC Chang,
  • Anirudh Pabba,
  • Maxim De Schepper,
  • Marion Maetens,
  • François Richard,
  • Josephine Van Cauwenberge,
  • Tatjana Geukens,
  • Kristien Borremans,
  • Amena Mahdami,
  • Ha Linh Nguyen,
  • Sophia Leduc,
  • Patrick Neven,
  • Hans Wildiers,
  • Vincent Vandecaveye,
  • Raphaëla Dresen,
  • Wouter Van Den Bogaert,
  • Rohit Bhargava,
  • Tanner Bartholow,
  • Neil Carleton,
  • Ye Cao,
  • Jie Bin Liu,
  • Abdalla Wedn,
  • Hunter Waltermire,
  • Morgan Cody,
  • Lori Miller,
  • Margaret Q. Rosenzweig,
  • Julia Foldi,
  • Marija Balic,
  • Christoper Deible,
  • Christine Hodgdon,
  • Stephanie Walker,
  • Adrian V. Lee,
  • Steffi Oesterreich,
  • Giuseppe Floris,
  • Christine Desmedt

摘要

While primary invasive lobular carcinoma (ILC) is well characterized, metastatic ILC remains understudied. Within the post-mortem tissue donation programs, UPTIDER (Belgium) and Hope for Others (USA), we first aimed to explore intra-patient heterogeneity of key prognostic and predictive markers (stromal tumor-infiltrating lymphocytes (sTIL), estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and KI67). Secondly, we compared detection of the metastases by pathology on autopsy samples versus pre-mortem imaging. In total, 306 metastases from 12 patients were collected at autopsy (median: 27 per patient). Both primary tumors (n = 15) and metastases (n = 232) had low sTIL levels, with a median of 2% (range: 0.67–6.67%) and 0.67% (range: 0–13.33%), respectively. Regression models showed lower ER- and PR-expression in metastases (respectively, n = 265 and n = 64) compared to primary tumors (both p < 0.01). KI67 was significantly higher in metastases (n = 262, p = 0.02). HER2-low metastases were found in all but one patient although in varying proportion of metastases (range: 7.5–100%). Central radiology and pathology review had a median concordance of 78% at organ level (range: 33.33–100%) and 71% at patient level (range: 55.88-85.29%). Our findings suggest that a single metastatic biopsy has great limitations to guide treatment and that more adequate methods are needed to detect and monitor ILC metastases.