Kiliç Berkay, Ilhan Burak
Department of Surgery, Division of General Surgery, Institute of Oncology, İstanbul University, İstanbul, Turkiye.
Department of Surgery, Division of General Surgery, Faculty of Medicine, İstanbul University, İstanbul, Turkiye.
Turk J Med Sci. 2024 May 23;54(6):1223-1229. doi: 10.55730/1300-0144.5903. eCollection 2024.
BACKGROUND/AIM: Mucinous breast carcinoma (MBC) is thought to be a favorable-differentiated form of invasive breast cancer and is rarely preferred for neoadjuvant chemotherapy (NAC). The study aimed to define the response of MBCs to NAC.
A review was made of the demographic, clinicopathologic characteristics, management and follow-up data of 70 patients diagnosed with MBC between May 2010 and December 2020 by examining the patients' historical files and oncology records.
The median age, tumor size, and follow-up period of patients were 52.9 (range: 32-87) years, 25.8 (range: 8-88) mm, and 61.5 (range: 18-143) months, respectively. Of the 70 patients, 45 had conservative surgery, 25 had a mastectomy, and 22 had axillary clearance due to a positive sentinel node biopsy or clinical axilla. Eight patients (11.4%) received NAC. Twenty-one patients (30.0%) received adjuvant chemotherapy, whereas almost all the patients received hormone therapy. The preoperative core biopsy diagnosis of four of eight patients receiving NAC was unspecified invasive breast carcinoma. NAC was used as treatment in patients who were younger, had tumors larger in diameter, had tumors with an initial higher T-stage, and especially those with clinically positive axilla, and tumors with a higher Ki-67 index. Despite these preference criteria, both the overall mastectomy and axillary clearance rates were significantly higher in these patients. Two local and five systemic recurrences were observed in the follow-up period. NAC had no significant contribution to survival.
It may be concluded that NAC is not sufficiently effective in either helping to diminish the need for mastectomy by downsizing the tumor, or in preventing axillary clearance in MBCs, and no significant benefit on survival could be observed. In addition, the results may emphasize the importance of identifying the MBC subtype, and the significant association between the degree of response to NAC and the subtype.
背景/目的:黏液性乳腺癌(MBC)被认为是浸润性乳腺癌中分化良好的一种形式,很少被选择进行新辅助化疗(NAC)。本研究旨在明确MBC对NAC的反应。
通过查阅2010年5月至2020年12月期间确诊为MBC的70例患者的病历档案和肿瘤学记录,对其人口统计学、临床病理特征、治疗及随访数据进行回顾性分析。
患者的中位年龄、肿瘤大小及随访时间分别为52.9(范围:32 - 87)岁、25.8(范围:8 - 88)mm和61.5(范围:18 - 143)个月。70例患者中,45例行保乳手术,25例行乳房切除术,22例因前哨淋巴结活检阳性或临床腋窝淋巴结转移而行腋窝清扫术。8例患者(11.4%)接受了NAC。21例患者(30.0%)接受了辅助化疗,而几乎所有患者都接受了激素治疗。接受NAC的8例患者中有4例术前粗针穿刺活检诊断为未特指的浸润性乳腺癌。NAC用于年龄较轻、肿瘤直径较大、初始T分期较高,尤其是临床腋窝淋巴结阳性以及Ki-67指数较高的患者。尽管有这些选择标准,但这些患者的总体乳房切除术和腋窝清扫率仍显著较高。随访期间观察到2例局部复发和5例全身复发。NAC对生存无显著贡献。
可以得出结论,NAC在通过缩小肿瘤体积减少乳房切除术需求或预防MBC腋窝清扫方面均未充分发挥作用,且未观察到对生存有显著益处。此外,研究结果可能强调了识别MBC亚型的重要性,以及对NAC反应程度与亚型之间的显著关联。