Phung Thi Huyen, Pham Thanh Tung, Nguyen Huu Thang, Nguyen Dinh Thach, Nguyen Thanh Long, Hoang Thi Hoai
Department of Oncology, Hanoi Medical University, Hanoi, Vietnam.
Department of Medical Oncology 6, Vietnam National Cancer Hospital, Hanoi, Vietnam.
Breast Cancer Res Treat. 2025 Feb;209(3):667-674. doi: 10.1007/s10549-024-07529-x. Epub 2024 Oct 23.
To evaluate clinicopathological features in women with mucinous breast cancer (MBC), distinguishing between pure (PMC) and mixed (MMC) subtype.
A retrospective analysis of all 358 women with MBC treated at Vietnam National Cancer hospital from June 2015 to December 2020. PMC was defined by ≥ 90% mucinous components.
We identified 358 women with MBC (245 PMC and 113 MMC) representing 2.7% of all 13,254 BC patients. The proportions of stage I, II, III and IV were 34.9%, 50.8%, 10.4% and 3.9% respectively. The rate of HER2 overexpression was 12%, and only 1.4% of patients was treated with anti-HER2. 193 patients (53.9%) had chemotherapy, including 55 patients (15.4%) treated in the neoadjuvant setting. Only 3 patients (5.5%) achieved pCR. PMC patients were older (54.4 ± 13.3 vs 51.1 ± 13.1 years), had lower Ki67 expression, lower incidence of nodal metastasis (N +) (p values < 0.05). At a median follow-up of 58 months, the 5-year overall survival rate of non-metastatic patients was 86.6%. Multivariate analysis showed N + to be the most significant prognostic factor (HR = 3.3; 95%CI 1.5-7.1), followed by T-stage (HR = 2.9; 95%CI 1.4-6.3), HER2 + (HR = 2.5; 95%CI 1.2-5.3) and MMC subtype (HR = 1.9; 95%CI 1.0-3.9).
Poor prognostic factors of MBC include high T-stage, N-positivity, HER2 overexpression and MMC subtype. Given the low response rate to neoadjuvant CT, upfront surgery is appropriate for MBC patients.
评估黏液性乳腺癌（MBC）女性患者的临床病理特征，区分纯黏液性癌（PMC）和混合性黏液性癌（MMC）亚型。
对2015年6月至2020年12月在越南国家癌症医院接受治疗的358例MBC女性患者进行回顾性分析。PMC定义为黏液成分≥90%。
我们确定了358例MBC女性患者（245例PMC和113例MMC），占所有13254例乳腺癌患者的2.7%。I期、II期、III期和IV期的比例分别为34.9%、50.8%、10.4%和3.9%。HER2过表达率为12%，仅1.4%的患者接受了抗HER2治疗。193例患者（53.9%）接受了化疗，其中55例患者（15.4%）接受了新辅助治疗。只有3例患者（5.5%）达到了病理完全缓解（pCR）。PMC患者年龄较大（54.4±13.3岁 vs 51.1±13.1岁），Ki67表达较低，淋巴结转移（N+）发生率较低（p值<0.05）。中位随访58个月，非转移性患者的5年总生存率为86.6%。多因素分析显示N+是最显著的预后因素（HR=3.3；95%CI 1.5-7.1），其次是T分期（HR=2.9；95%CI 1.4-6.3）、HER2阳性（HR=2.5；95%CI 1.2-5.3）和MMC亚型（HR=1.9；95%CI 1.0-3.9）。
MBC的不良预后因素包括高T分期、N阳性、HER2过表达和MMC亚型。鉴于新辅助化疗的缓解率较低，对于MBC患者， upfront手术是合适的。
