Evidence map›Paper›PMID 32240457›Full record

ArticleBreast cancer research and treatment2020

Mitotic score and pleomorphic histology in invasive lobular carcinoma of the breast: impact on disease-free survival.

Rita A Mukhtar, Gregor Krings, Yunn-Yi Chen, Matina E Mamounas, Kelly Fahrner-Scott, Jasmine Wong, Michael Alvarado, Cheryl Ewing, Laura J Esserman, Hope Rugo

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Article in Breast cancer research and treatment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.2field-weighted citation impact, top 54% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Rita A MukhtarDepartment of Surgery, University of California, San Francisco, 1825 4th St, 3rd Floor, Box 1710, San Francisco, CA, 94143, USA. rita.mukhtar@ucsf.edu.
Gregor KringsDepartment of Pathology, University of California, San Francisco, San Francisco, CA, USA.
Yunn-Yi ChenDepartment of Pathology, University of California, San Francisco, San Francisco, CA, USA.
Matina E MamounasDepartment of Surgery, University of California, San Francisco, 1825 4th St, 3rd Floor, Box 1710, San Francisco, CA, 94143, USA.
Kelly Fahrner-ScottDepartment of Surgery, University of California, San Francisco, 1825 4th St, 3rd Floor, Box 1710, San Francisco, CA, 94143, USA.
Jasmine WongDepartment of Surgery, University of California, San Francisco, 1825 4th St, 3rd Floor, Box 1710, San Francisco, CA, 94143, USA.
Michael AlvaradoDepartment of Surgery, University of California, San Francisco, 1825 4th St, 3rd Floor, Box 1710, San Francisco, CA, 94143, USA.
Cheryl EwingDepartment of Surgery, University of California, San Francisco, 1825 4th St, 3rd Floor, Box 1710, San Francisco, CA, 94143, USA.
Laura J EssermanDepartment of Surgery, University of California, San Francisco, 1825 4th St, 3rd Floor, Box 1710, San Francisco, CA, 94143, USA.
Hope RugoHelen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA.
University of California, San Francisco · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePleomorphic invasive lobular carcinoma (ILC) has long been thought to have worse outcomes than classic ILC and is therefore often treated with chemotherapy. However, recent data question the utility of the pleomorphic designation, as the poor outcomes seen may be related to other associated high-risk features. Importantly, mitotic count may better define a subset of ILC with high risk of recurrence. We sought to determine the impact of pleomorphic histology versus mitotic count on disease-free survival (DFS) in pure ILC. Additionally, we evaluated whether pleomorphic histology was associated with receipt of chemotherapy when adjusting for other factors.

methodsWe analyzed a cohort of 475 patients with stage I-III pure ILC. We used Kaplan-Meier estimates, and Cox proportional hazards and logistic regression for multivariate analyses. Pleomorphic histology was confirmed by central pathology review.

resultsIn a multivariate model, pleomorphic histology was not associated with reduced DFS. Only mitotic score, receptor subtype, and pathologic stage were independently and significantly associated with DFS. Patients with pleomorphic ILC were significantly more likely to receive chemotherapy than patients with classic ILC (adjusted odds ratio 2.96, p = 0.026).

conclusionsThe pleomorphic designation in ILC does not have clinical utility and should not be used to determine therapy. Rather, mitotic count identified clear prognostic groups in this cohort of pure ILC.

Indexed as

AdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsCarcinoma, LobularCross-Sectional StudiesErb-b2 Receptor Tyrosine KinasesFemaleFollow-Up StudiesHumansMiddle AgedMitotic IndexNeoplasm InvasivenessPrognosisReceptors, EstrogenERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenReceptors, ProgesteroneBreast cancerMitotic countPleomorphic invasive lobular carcinoma

Identifiers

PMID32240457
OpenAlexW3014238248

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.