Liao Hong-Ye, Zhang Wen-Wen, Sun Jia-Yuan, Li Feng-Yan, He Zhen-Yu, Wu San-Gang
Department of Breast Surgery, Xiamen Maternity and Child Care Hospital, Xiamen 361003, People's Republic of China.
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, People's Republic of China.
J Cancer. 2018 Jan 1;9(2):296-303. doi: 10.7150/jca.22280. eCollection 2018.
To determine the clinicopathological features and survival outcomes of triple-negative breast cancer (TNBC) according to different histological subtypes. Using the Surveillance, Epidemiology, and End Results database, we included TNBC cases in 2010-2013. The effect of histological subtype on breast cancer-specific survival (BCSS) and overall survival (OS) were analyzed using univariate and multivariate analyses. A total of 19,900 patients were identified. Infiltrating ductal carcinoma not otherwise specified accounted for 91.6% of patients, followed by metaplastic carcinoma (2.7%), medullary carcinoma (1.4%), mixed lobular-ductal carcinoma (1.4%), lobular carcinoma (1.3%), apocrine carcinoma (1.0%), and adenoid cystic carcinoma (0.6%). Medullary carcinoma was more frequently poorly/undifferentiated. Significantly more lobular carcinoma, mixed lobular-ductal carcinoma, and metaplastic carcinoma patients had larger tumors. Adenoid cystic carcinoma, metaplastic carcinoma, medullary carcinoma, and apocrine carcinoma were more frequently node-negative. Lobular carcinoma (16.0%) and mixed lobular-ductal carcinoma (10.4%) more frequently had distant stage at initial diagnosis. Histologic subtype was an independent prognostic factor of BCSS and OS. Compared with infiltrating ductal carcinoma, medullary carcinoma and apocrine carcinoma had better BCSS and OS, while mixed lobular-ductal carcinoma and metaplastic carcinoma had worse survival. Adenoid cystic carcinoma survival was not significantly different from that of infiltrating ductal carcinoma. TNBC histological subtypes have different clinicopathological characteristics and survival outcomes. Medullary carcinoma and apocrine adenocarcinoma have excellent prognosis; mixed lobular-ductal carcinoma and metaplastic carcinoma are the most aggressive subtypes.
根据不同组织学亚型确定三阴性乳腺癌（TNBC）的临床病理特征和生存结局。利用监测、流行病学和最终结果数据库，我们纳入了2010 - 2013年的TNBC病例。采用单因素和多因素分析方法分析组织学亚型对乳腺癌特异性生存（BCSS）和总生存（OS）的影响。共确定了19900例患者。未另行规定的浸润性导管癌占患者的91.6%，其次是化生性癌（2.7%）、髓样癌（1.4%）、混合性小叶 - 导管癌（1.4%）、小叶癌（1.3%）、大汗腺癌（1.0%）和腺样囊性癌（0.6%）。髓样癌更常见低分化/未分化。小叶癌、混合性小叶 - 导管癌和化生性癌患者的肿瘤明显更大。腺样囊性癌、化生性癌、髓样癌和大汗腺癌更常见淋巴结阴性。小叶癌（16.0%）和混合性小叶 - 导管癌（10.4%）在初诊时远处分期更常见。组织学亚型是BCSS和OS的独立预后因素。与浸润性导管癌相比，髓样癌和大汗腺癌的BCSS和OS更好，而混合性小叶 - 导管癌和化生性癌的生存更差。腺样囊性癌的生存与浸润性导管癌无显著差异。TNBC组织学亚型具有不同的临床病理特征和生存结局。髓样癌和大汗腺癌预后良好；混合性小叶 - 导管癌和化生性癌是最具侵袭性的亚型。
