Joshi Utsav, Budhathoki Pravash, Gaire Suman, Yadav Sumeet K, Shah Anish, Adhikari Anurag, Choong Grace, Couzi Rima, Giridhar Karthik, Leon-Ferre Roberto, Boughey Judy C, Hieken Tina J, Mutter Robert, Ruddy Kathryn J, Haddad Tufia C, Goetz Matthew P, Couch Fergus J, Yadav Siddhartha
Rochester General Hospital.
BronxCare Health System.
Res Sq. 2023 Mar 20:rs.3.rs-2658909. doi: 10.21203/rs.3.rs-2658909/v1.
Triple-negative invasive lobular carcinoma (TN-ILC) of breast cancer is a rare disease and the clinical outcomes and prognostic factors are not well-defined. Women with stage I-III TN-ILC or triple-negative invasive ductal carcinoma (TN-IDC) of the breast undergoing mastectomy or breast-conserving surgery between 2010 and 2018 in the National Cancer Database were included. Kaplan-Meier curves and multivariate Cox proportional hazard regression were used to compare overall survival (OS) and evaluate prognostic factors. Multivariate logistic regression was performed to analyze the factors associated with pathological response to neoadjuvant chemotherapy. The median age at diagnosis for women with TN-ILC was 67 years compared to 58 years in TN-IDC (p<0.001). There was no significant difference in the OS between TN-ILC and TN-IDC in multivariate analysis (HR 0.96, p=0.44). Black race and higher TNM stage were associated with worse OS, whereas receipt of chemotherapy or radiation was associated with better OS in TN-ILC. Among women with TN-ILC receiving neoadjuvant chemotherapy, the 5-year OS was 77.3% in women with a complete pathological response (pCR) compared to 39.8% in women without any response. The odds of achieving pCR following neoadjuvant chemotherapy were significantly lower in women with TN-ILC compared to TN-IDC (OR 0.53, p<0.001). Women with TN-ILC are older at diagnosis but have similar OS compared to TN-IDC after adjusting for tumor and demographic characteristics. Administration of chemotherapy was associated with improved OS in TN-ILC, but women with TN-ILC were less likely to achieve complete response to neoadjuvant therapy compared to TN-IDC.
三阴性浸润性小叶癌（TN-ILC）是一种罕见的乳腺癌疾病，其临床结局和预后因素尚不明确。纳入了2010年至2018年期间在美国国家癌症数据库中接受乳房切除术或保乳手术的I-III期乳腺TN-ILC或三阴性浸润性导管癌（TN-IDC）女性患者。采用Kaplan-Meier曲线和多变量Cox比例风险回归分析来比较总生存期（OS）并评估预后因素。进行多变量逻辑回归分析以分析与新辅助化疗病理反应相关的因素。TN-ILC女性患者的诊断中位年龄为67岁，而TN-IDC为58岁（p<0.001）。多变量分析显示，TN-ILC和TN-IDC的OS无显著差异（风险比0.96，p=0.44）。黑人种族和更高的TNM分期与较差的OS相关，而接受化疗或放疗与TN-ILC更好的OS相关。在接受新辅助化疗的TN-ILC女性中，病理完全缓解（pCR）的女性5年OS为77.3%，而无任何反应的女性为39.8%。与TN-IDC相比，TN-ILC女性新辅助化疗后达到pCR的几率显著更低（比值比0.53，p<0.001）。TN-ILC女性诊断时年龄更大，但在调整肿瘤和人口统计学特征后，其OS与TN-IDC相似。化疗与TN-ILC的OS改善相关，但与TN-IDC相比，TN-ILC女性新辅助治疗达到完全缓解的可能性更小。
