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Aims  The aim of this study was to compare breast cancer specific survival ( BCSS ) for invasive lobular carcinoma ( ILC ) and invasive ductal carcinoma ( IDC ) and, further, to evaluate critically the prognostic value of histopathological grading of  ILC  and examine E‐cadherin as a prognostic marker in  ILC .    Methods and results  The study comprised 116 lobular and 611 ductal breast carcinomas occurring between 1961 and 2008. All cases had been classified previously according to histopathological type and grade, stained for oestrogen receptor ( ER ), progesterone receptor ( PR ), antigen Ki67 (Ki67), epithelial growth factor receptor ( EGFR ), cytokeratin 5 ( CK 5) and human epidermal growth factor receptor 2 ( HER 2) and classified into molecular subtypes. For the present study, immunohistochemical staining for E‐cadherin was performed. The Kaplan–Meier method and Cox proportional hazards models were used in the analyses. Grade 2 tumours comprised 85.3% of the lobular tumours and 51.9% of the ductal tumours.  BCSS  in  ILC  grade 2 was comparable to that of  IDC  grade 3. E‐cadherin‐negative  ILC  had a poorer prognosis compared to E‐cadherin positive  ILC  and to  IDC  regardless of E‐cadherin status.    Conclusions  The implication of histopathological grading may differ in  ILC  compared to  IDC . E‐cadherin may be useful in prognostication in  ILC  and thereby influence the determination of treatment strategies for this group of women.

Invasive lobular breast cancer: the prognostic impact of histopathological grade, E ‐cadherin and molecular subtypes