Westfal Maggie L, Chang David C, Kelleher Cassandra M
Department of Surgery, Massachusetts General Hospital, Boston, MA.
Department of Pediatric Surgery, MassGeneral Hospital for Children, Boston, MA.
J Pediatr Surg. 2019 Jan;54(1):140-144. doi: 10.1016/j.jpedsurg.2018.10.009. Epub 2018 Oct 5.
The purpose of this study was to evaluate trends in demographics and outcomes of pediatric breast cancer in a United States population-based cohort.
The Surveillance, Epidemiology, and End Results (SEER) database was utilized to identify all pediatric patients with malignant breast tumors between 1973 and 2014. Analysis was performed using Stata Statistical Software version 13.1. Associations between categorical variables were made using X test. Log-rank test was used for univariate survival analysis. Kaplan-Meier analysis investigated five-year survival rates across several variables. Adjusted analysis was performed using a Cox Proportional-Hazards regression.
134 patients with breast malignancies were identified. Carcinoma was the most prevalent histology (48.5%), followed by fibroepithelial tumors (FETs) (35.1%), and sarcoma (14.2%). FETs were twice as common in black compared to nonblack patients (56.3% vs. 29.0%, p < 0.01). Analyzing histology by stage revealed that 100% of FETs were early stage disease (p < 0.0001). 46.7% of the tumors tested were ER/PR negative, more than twice as many compared to the published adult estimate of 20.0%. Unadjusted survival analysis revealed worse survival for patients with adenocarcinoma/sarcomas, advanced stage, and high grade disease, without a survival difference between races.
Breast cancer remains a rare malignancy among pediatric patients. Although black patients were found to have more noncarcinomatous tumors with less advanced disease, this did not confer a survival advantage.
Retrospective cohort study.
Level III.
本研究旨在评估美国一个基于人群的队列中儿童乳腺癌的人口统计学趋势和预后情况。
利用监测、流行病学和最终结果（SEER）数据库，识别1973年至2014年间所有患有恶性乳腺肿瘤的儿科患者。使用Stata统计软件版本13.1进行分析。分类变量之间的关联采用X检验。对数秩检验用于单因素生存分析。Kaplan-Meier分析研究了多个变量的五年生存率。采用Cox比例风险回归进行校正分析。
共识别出134例乳腺恶性肿瘤患者。癌是最常见的组织学类型（48.5%），其次是纤维上皮性肿瘤（FETs）（35.1%）和肉瘤（14.2%）。与非黑人患者相比，FETs在黑人患者中更为常见（56.3%对29.0%，p<0.01）。按分期分析组织学发现，100%的FETs为早期疾病（p<0.0001）。46.7%的检测肿瘤为ER/PR阴性，是已发表的成人估计值20.0%的两倍多。未校正的生存分析显示，腺癌/肉瘤患者、晚期患者和高级别疾病患者的生存率较差，不同种族之间的生存率没有差异。
乳腺癌在儿科患者中仍然是一种罕见的恶性肿瘤。虽然发现黑人患者有更多非癌性肿瘤且疾病进展程度较低，但这并没有带来生存优势。
回顾性队列研究。
三级。
