Department of Surgery, Brandon Regional Hospital, HCA Healthcare/USF Morsani College of Medicine, Brandon, FL, USA.
Department of Surgery, Mayo Clinic Florida, Jacksonville, FL, USA.
Breast J. 2021 Sep;27(9):691-699. doi: 10.1111/tbj.14268. Epub 2021 Jun 25.
Invasive tubular carcinoma (ITC) and invasive mucinous carcinoma (IMC) of the breast are rare histologic subtypes of breast cancer associated with favorable prognoses. The aim of our study was to investigate the outcomes for these rare subtypes using the National Cancer Database. Female patients diagnosed with ITC or IMC between 2005 and 2014 were analyzed. The primary outcome was overall survival (OS), and we analyzed its association with adjuvant therapy. 2735 patients with ITC and 5602 patients with IMC were identified. ITC presented in younger patients (57 vs. 67 years), had smaller tumors (size <1 cm, 63.1% vs. 25.4%), earlier stage, and less node-positive disease (5% vs. 8.6%), compared with IMC. Older age, government insurance, lower income, treatment in a community cancer program, large tumor size, positive nodal status, and without endocrine therapy were associated with worse OS with either subtype on multivariate analysis. No OS benefit was found for node-positive ITC that received adjuvant chemotherapy compared with those who did not. (5-year OS of 96.0% vs. 91.3%, p = 0.17).OS was improved for IMC that received adjuvant chemotherapy (10-year OS: 82.5% vs. 60.1%, p = 0.008) and endocrine therapy (10-year OS: 86.6% vs. 81.2%, p < 0.001). We concluded that ITC has favorable clinicopathological characteristics and prognosis, even with node-positive disease. ITC and IMC may need to be evaluated independently when administering adjuvant treatment plans.
乳腺浸润性管状癌(ITC)和浸润性黏液癌(IMC)是乳腺癌罕见的组织学亚型,与良好的预后相关。本研究旨在使用国家癌症数据库研究这些罕见亚型的结局。分析了 2005 年至 2014 年间诊断为 ITC 或 IMC 的女性患者。主要结局是总生存(OS),并分析其与辅助治疗的关系。共确定了 2735 例 ITC 患者和 5602 例 IMC 患者。与 IMC 相比,ITC 患者更年轻(57 岁 vs. 67 岁),肿瘤更小(<1cm,63.1% vs. 25.4%),分期更早,淋巴结阳性病变更少(5% vs. 8.6%)。多变量分析显示,年龄较大、政府保险、收入较低、在社区癌症项目中治疗、肿瘤较大、淋巴结阳性状态和未接受内分泌治疗与两种亚型的 OS 较差相关。与未接受辅助化疗的患者相比,接受辅助化疗的淋巴结阳性 ITC 患者并未发现 OS 获益(5 年 OS:96.0% vs. 91.3%,p=0.17)。接受辅助化疗(10 年 OS:82.5% vs. 60.1%,p=0.008)和内分泌治疗(10 年 OS:86.6% vs. 81.2%,p<0.001)的 IMC 患者 OS 得到改善。我们得出结论,即使存在淋巴结阳性病变,ITC 也具有良好的临床病理特征和预后。在制定辅助治疗计划时,可能需要分别评估 ITC 和 IMC。