Relative Effectiveness of Letrozole Compared With Tamoxifen for Patients With Lobular Carcinoma in the BIG 1-98 Trial
Identifieur interne : 000461 ( Pmc/Corpus ); précédent : 000460; suivant : 000462Relative Effectiveness of Letrozole Compared With Tamoxifen for Patients With Lobular Carcinoma in the BIG 1-98 Trial
Auteurs : Otto Metzger Filho ; Anita Giobbie-Hurder ; Elizabeth Mallon ; Barry Gusterson ; Giuseppe Viale ; Eric P. Winer ; Beat Thürlimann ; Richard D. Gelber ; Marco Colleoni ; Bent Ejlertsen ; Marc Debled ; Karen N. Price ; Meredith M. Regan ; Alan S. Coates ; Aron GoldhirschSource :
- Journal of Clinical Oncology [ 0732-183X ] ; 2015.
Abstract
To evaluate the relative effectiveness of letrozole compared with tamoxifen for patients with invasive ductal or lobular carcinoma.
Patients diagnosed with early-stage invasive ductal carcinoma (IDC) or classic invasive lobular carcinoma (ILC) who were randomly assigned onto the Breast International Group (BIG) 1-98 trial and who had centrally reviewed pathology data were included (N = 2,923). HER2-negative IDC and ILC were additionally classified as hormone receptor–positive with high (luminal B [LB] –like) or low (luminal A [LA] –like) proliferative activity by Ki-67 labeling index. Survival analyses were performed with weighted Cox models that used inverse probability of censoring weighted modeling.
The median follow-up time was 8.1 years. In multivariable models for disease-free survival (DFS), significant interactions between treatment and histology (ILC or IDC;
The magnitude of benefit of adjuvant letrozole is greater for patients diagnosed with lobular carcinoma versus ductal carcinoma.
Url:
DOI: 10.1200/JCO.2015.60.8133
PubMed: 26215945
PubMed Central: 4550691
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PMC:4550691Le document en format XML
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<author><name sortKey="Metzger Filho, Otto" sort="Metzger Filho, Otto" uniqKey="Metzger Filho O" first="Otto" last="Metzger Filho">Otto Metzger Filho</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
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<author><name sortKey="Giobbie Hurder, Anita" sort="Giobbie Hurder, Anita" uniqKey="Giobbie Hurder A" first="Anita" last="Giobbie-Hurder">Anita Giobbie-Hurder</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
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<author><name sortKey="Mallon, Elizabeth" sort="Mallon, Elizabeth" uniqKey="Mallon E" first="Elizabeth" last="Mallon">Elizabeth Mallon</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
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<author><name sortKey="Gusterson, Barry" sort="Gusterson, Barry" uniqKey="Gusterson B" first="Barry" last="Gusterson">Barry Gusterson</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
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<author><name sortKey="Viale, Giuseppe" sort="Viale, Giuseppe" uniqKey="Viale G" first="Giuseppe" last="Viale">Giuseppe Viale</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
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<author><name sortKey="Winer, Eric P" sort="Winer, Eric P" uniqKey="Winer E" first="Eric P." last="Winer">Eric P. Winer</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
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<author><name sortKey="Thurlimann, Beat" sort="Thurlimann, Beat" uniqKey="Thurlimann B" first="Beat" last="Thürlimann">Beat Thürlimann</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gelber, Richard D" sort="Gelber, Richard D" uniqKey="Gelber R" first="Richard D." last="Gelber">Richard D. Gelber</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
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<author><name sortKey="Colleoni, Marco" sort="Colleoni, Marco" uniqKey="Colleoni M" first="Marco" last="Colleoni">Marco Colleoni</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
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<author><name sortKey="Ejlertsen, Bent" sort="Ejlertsen, Bent" uniqKey="Ejlertsen B" first="Bent" last="Ejlertsen">Bent Ejlertsen</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Debled, Marc" sort="Debled, Marc" uniqKey="Debled M" first="Marc" last="Debled">Marc Debled</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Price, Karen N" sort="Price, Karen N" uniqKey="Price K" first="Karen N." last="Price">Karen N. Price</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
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<author><name sortKey="Regan, Meredith M" sort="Regan, Meredith M" uniqKey="Regan M" first="Meredith M." last="Regan">Meredith M. Regan</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Coates, Alan S" sort="Coates, Alan S" uniqKey="Coates A" first="Alan S." last="Coates">Alan S. Coates</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Goldhirsch, Aron" sort="Goldhirsch, Aron" uniqKey="Goldhirsch A" first="Aron" last="Goldhirsch">Aron Goldhirsch</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Relative Effectiveness of Letrozole Compared With Tamoxifen for Patients With Lobular Carcinoma in the BIG 1-98 Trial</title>
<author><name sortKey="Metzger Filho, Otto" sort="Metzger Filho, Otto" uniqKey="Metzger Filho O" first="Otto" last="Metzger Filho">Otto Metzger Filho</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Giobbie Hurder, Anita" sort="Giobbie Hurder, Anita" uniqKey="Giobbie Hurder A" first="Anita" last="Giobbie-Hurder">Anita Giobbie-Hurder</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mallon, Elizabeth" sort="Mallon, Elizabeth" uniqKey="Mallon E" first="Elizabeth" last="Mallon">Elizabeth Mallon</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gusterson, Barry" sort="Gusterson, Barry" uniqKey="Gusterson B" first="Barry" last="Gusterson">Barry Gusterson</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Viale, Giuseppe" sort="Viale, Giuseppe" uniqKey="Viale G" first="Giuseppe" last="Viale">Giuseppe Viale</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Winer, Eric P" sort="Winer, Eric P" uniqKey="Winer E" first="Eric P." last="Winer">Eric P. Winer</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Thurlimann, Beat" sort="Thurlimann, Beat" uniqKey="Thurlimann B" first="Beat" last="Thürlimann">Beat Thürlimann</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gelber, Richard D" sort="Gelber, Richard D" uniqKey="Gelber R" first="Richard D." last="Gelber">Richard D. Gelber</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Colleoni, Marco" sort="Colleoni, Marco" uniqKey="Colleoni M" first="Marco" last="Colleoni">Marco Colleoni</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ejlertsen, Bent" sort="Ejlertsen, Bent" uniqKey="Ejlertsen B" first="Bent" last="Ejlertsen">Bent Ejlertsen</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Debled, Marc" sort="Debled, Marc" uniqKey="Debled M" first="Marc" last="Debled">Marc Debled</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Price, Karen N" sort="Price, Karen N" uniqKey="Price K" first="Karen N." last="Price">Karen N. Price</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Regan, Meredith M" sort="Regan, Meredith M" uniqKey="Regan M" first="Meredith M." last="Regan">Meredith M. Regan</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Coates, Alan S" sort="Coates, Alan S" uniqKey="Coates A" first="Alan S." last="Coates">Alan S. Coates</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Goldhirsch, Aron" sort="Goldhirsch, Aron" uniqKey="Goldhirsch A" first="Aron" last="Goldhirsch">Aron Goldhirsch</name>
<affiliation><nlm:aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Journal of Clinical Oncology</title>
<idno type="ISSN">0732-183X</idno>
<idno type="eISSN">1527-7755</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Purpose</title>
<p>To evaluate the relative effectiveness of letrozole compared with tamoxifen for patients with invasive ductal or lobular carcinoma.</p>
</sec>
<sec><title>Patients and Methods</title>
<p>Patients diagnosed with early-stage invasive ductal carcinoma (IDC) or classic invasive lobular carcinoma (ILC) who were randomly assigned onto the Breast International Group (BIG) 1-98 trial and who had centrally reviewed pathology data were included (N = 2,923). HER2-negative IDC and ILC were additionally classified as hormone receptor–positive with high (luminal B [LB] –like) or low (luminal A [LA] –like) proliferative activity by Ki-67 labeling index. Survival analyses were performed with weighted Cox models that used inverse probability of censoring weighted modeling.</p>
</sec>
<sec><title>Results</title>
<p>The median follow-up time was 8.1 years. In multivariable models for disease-free survival (DFS), significant interactions between treatment and histology (ILC or IDC; <italic>P</italic>
= .006) and treatment and subgroup (LB like or LA like; <italic>P</italic>
= .01) were observed. In the ILC subset, there was a 66% reduction in the hazard of a DFS event with letrozole for LB (hazard ratio [HR], 0.34; 95% CI, 0.21 to 0.55) and a 50% reduction for LA subtypes (HR, 0.50; 95% CI, 0.32 to 0.78). In the IDC subset, there was a significant 35% reduction in the hazard of a DFS event with letrozole for the LB subtype (HR, 0.65; 95% CI, 0.53 to 0.79), but no difference between treatments was noted for IDC and the LA subtype (HR, 0.95; 95% CI, 0.76 to 1.20).</p>
</sec>
<sec><title>Conclusion</title>
<p>The magnitude of benefit of adjuvant letrozole is greater for patients diagnosed with lobular carcinoma versus ductal carcinoma.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Clin Oncol</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Clin. Oncol</journal-id>
<journal-id journal-id-type="hwp">jco</journal-id>
<journal-id journal-id-type="pmc">jco</journal-id>
<journal-id journal-id-type="publisher-id">JCO</journal-id>
<journal-title-group><journal-title>Journal of Clinical Oncology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0732-183X</issn>
<issn pub-type="epub">1527-7755</issn>
<publisher><publisher-name>American Society of Clinical Oncology</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26215945</article-id>
<article-id pub-id-type="pmc">4550691</article-id>
<article-id pub-id-type="publisher-id">08133</article-id>
<article-id pub-id-type="doi">10.1200/JCO.2015.60.8133</article-id>
<article-categories><subj-group subj-group-type="hwp-journal-coll"><subject>Bc7</subject>
</subj-group>
<subj-group subj-group-type="heading"><subject>ORIGINAL REPORTS</subject>
<subj-group><subject>Breast Cancer</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Relative Effectiveness of Letrozole Compared With Tamoxifen for Patients With Lobular Carcinoma in the BIG 1-98 Trial</article-title>
<alt-title alt-title-type="short">Effectiveness of Endocrine Therapies for Invasive Lobular Carcinoma</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Metzger Filho</surname>
<given-names>Otto</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
<xref ref-type="corresp" rid="cor1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Giobbie-Hurder</surname>
<given-names>Anita</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mallon</surname>
<given-names>Elizabeth</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gusterson</surname>
<given-names>Barry</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Viale</surname>
<given-names>Giuseppe</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Winer</surname>
<given-names>Eric P.</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Thürlimann</surname>
<given-names>Beat</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gelber</surname>
<given-names>Richard D.</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Colleoni</surname>
<given-names>Marco</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ejlertsen</surname>
<given-names>Bent</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Debled</surname>
<given-names>Marc</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Price</surname>
<given-names>Karen N.</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Regan</surname>
<given-names>Meredith M.</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Coates</surname>
<given-names>Alan S.</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Goldhirsch</surname>
<given-names>Aron</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<aff id="aff1">Otto Metzger Filho, Anita Giobbie-Hurder, and Eric P. Winer, Dana-Farber Cancer Institute; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research, Boston, MA; Elizabeth Mallon, Southern General Hospital; Barry Gusterson, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Giuseppe Viale, European Institute of Oncology and University of Milan; Marco Colleoni and Aron Goldhirsch, European Institute of Oncology, Milan, Italy; Beat Thürlimann, Kantonsspital, St. Gallen, and Swiss Group for Clinical Cancer Research, Bern, Switzerland; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergoniié, Bordeaux, France; and Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland, and University of Sydney, Sydney, Australia.</aff>
</contrib-group>
<author-notes><fn fn-type="equal"><p>Both O.M.F. and A.G.-H. contributed equally to this work.</p>
</fn>
<corresp id="cor1">Corresponding author: Otto Metzger Filho, MD, 450 Brookline Ave, Yawkey 1238, Boston, MA 02215; e-mail: <email>otto_metzger@dfci.harvard.edu</email>
.</corresp>
</author-notes>
<pub-date pub-type="ppub"><day>1</day>
<month>9</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>27</day>
<month>7</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>9</month>
<year>2016</year>
</pub-date>
<pmc-comment> PMC Release delay is 12 months and
0 days and was based on the . </pmc-comment>
<volume>33</volume>
<issue>25</issue>
<fpage>2772</fpage>
<lpage>2779</lpage>
<permissions><copyright-statement>© 2015 by American Society of Clinical Oncology</copyright-statement>
<copyright-year>2015</copyright-year>
<copyright-holder>American Society of Clinical Oncology</copyright-holder>
</permissions>
<self-uri xlink:title="pdf" xlink:type="simple" xlink:href="zlj02515002772.pdf"></self-uri>
<abstract><sec><title>Purpose</title>
<p>To evaluate the relative effectiveness of letrozole compared with tamoxifen for patients with invasive ductal or lobular carcinoma.</p>
</sec>
<sec><title>Patients and Methods</title>
<p>Patients diagnosed with early-stage invasive ductal carcinoma (IDC) or classic invasive lobular carcinoma (ILC) who were randomly assigned onto the Breast International Group (BIG) 1-98 trial and who had centrally reviewed pathology data were included (N = 2,923). HER2-negative IDC and ILC were additionally classified as hormone receptor–positive with high (luminal B [LB] –like) or low (luminal A [LA] –like) proliferative activity by Ki-67 labeling index. Survival analyses were performed with weighted Cox models that used inverse probability of censoring weighted modeling.</p>
</sec>
<sec><title>Results</title>
<p>The median follow-up time was 8.1 years. In multivariable models for disease-free survival (DFS), significant interactions between treatment and histology (ILC or IDC; <italic>P</italic>
= .006) and treatment and subgroup (LB like or LA like; <italic>P</italic>
= .01) were observed. In the ILC subset, there was a 66% reduction in the hazard of a DFS event with letrozole for LB (hazard ratio [HR], 0.34; 95% CI, 0.21 to 0.55) and a 50% reduction for LA subtypes (HR, 0.50; 95% CI, 0.32 to 0.78). In the IDC subset, there was a significant 35% reduction in the hazard of a DFS event with letrozole for the LB subtype (HR, 0.65; 95% CI, 0.53 to 0.79), but no difference between treatments was noted for IDC and the LA subtype (HR, 0.95; 95% CI, 0.76 to 1.20).</p>
</sec>
<sec><title>Conclusion</title>
<p>The magnitude of benefit of adjuvant letrozole is greater for patients diagnosed with lobular carcinoma versus ductal carcinoma.</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
</record>
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