Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Sci Rep. 2017 Feb 6;7:42045. doi: 10.1038/srep42045.
To investigate the clinicopathological characteristics and survival outcomes of microinvasive breast cancer, we conducted an observational study of female diagnosed with DCIS or DCIS with microinvasion (DCISM) from 1990 to 2012 using the Surveillance, Epidemiology, and End Results (SEER) database. There were 87695 DCIS and 8863 DCISM identified. In DCISM group, patients appeared to be younger and more black patients were identified in comparison with DCIS group. Furthermore, DCISM was associated with more aggressive tumor characteristics like higher rates of oestrogen receptor (ER) and progesterone receptor (PR) negativity, HER2 positivity, and lymph node metastasis. With a median follow-up of 91 months, patients with DCISM had worse cancer-specific survival (CSS) (hazard ratio [HR], 2.475; P < 0.001) and overall survival (OS) (HR, 1.263; P < 0.001). In the multivariable analysis, microinvasion was an independent prognostic factor for worse CSS (HR, 1.919; P < 0.001) and OS (HR, 1.184; P < 0.001). The 10-year cancer-specific mortality rate was 1.49% in DCIS and 4.08% in DCISM (HR, 2.771; P < 0.001). The 20-year cancer-specific mortality rate was 4.00% in DCIS and 9.65% in DCISM (HR, 2.482; P < 0.001). Deepening understanding of the nature of microinvasive breast cancer will be valuable for clinical treatment recommendations.
为了研究微浸润性乳腺癌的临床病理特征和生存结局,我们利用监测、流行病学和最终结果(SEER)数据库,对 1990 年至 2012 年间诊断为 DCIS 或 DCIS 伴微浸润(DCISM)的女性患者进行了一项观察性研究。共确定了 87695 例 DCIS 和 8863 例 DCISM。在 DCISM 组中,与 DCIS 组相比,患者年龄更小,黑人患者更多。此外,DCISM 与更高的肿瘤侵袭性特征相关,如雌激素受体(ER)和孕激素受体(PR)阴性、HER2 阳性和淋巴结转移的发生率更高。中位随访时间为 91 个月,DCISM 患者的癌症特异性生存率(CSS)(风险比 [HR],2.475;P<0.001)和总生存率(OS)(HR,1.263;P<0.001)更差。多变量分析显示,微浸润是 CSS(HR,1.919;P<0.001)和 OS(HR,1.184;P<0.001)更差的独立预后因素。DCIS 的 10 年癌症特异性死亡率为 1.49%,DCISM 为 4.08%(HR,2.771;P<0.001)。DCIS 的 20 年癌症特异性死亡率为 4.00%,DCISM 为 9.65%(HR,2.482;P<0.001)。深入了解微浸润性乳腺癌的性质对于临床治疗建议将具有重要价值。