Li Yongxin, Ye Yinyin, Tao Xinlong, Liang Xiao, Qiu Xingchang, Zhao Jiuda
Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai University & Affiliated Cancer Hospital of Qinghai University, Xining, China.
Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai University & Affiliated Cancer Hospital of Qinghai University, Xining, China.
Clin Breast Cancer. 2025 Aug;25(6):e846-e856.e6. doi: 10.1016/j.clbc.2025.03.019. Epub 2025 Apr 1.
Mixed invasive ductal and lobular breast carcinoma (IDLC) is a rare and understudied subtype of breast cancer with unique prognostic characteristics.
This study analyzed data from the SEER database and the METABRIC database. Survival outcomes of IDLC were compared with those of IDC and ILC using Kaplan-Meier survival curves and Cox regression analyses. Based on these findings, a prognostic model tailored for IDLC patients was developed using the SEER cohort, which was divided into a training set (70%) and an internal validation set (30%). The model incorporated clinical and molecular features and was externally validated using the METABRIC cohort. Its performance was assessed via C-index, AUC, calibration curves, and decision curve analysis (DCA).
A total of 26,138 early-stage IDLC patients were included, along with 391,888 IDC and 47,571 ILC patients. In unadjusted analyses, IDLC showed better overall survival (OS) and breast cancer-specific survival (BCSS) compared to both IDC and ILC. However, after multivariate adjustment, the differences in survival outcomes varied. IDLC demonstrated better OS than IDC and better BCSS than ILC. Additionally, a prognostic model for early-stage IDLC that incorporates clinical and molecular features was developed.
This study found that early-stage IDLC had superior BCSS and OS in unadjusted analyses. However, after multivariate adjustment, there was no difference in BCSS between IDLC and IDC, and no difference in OS between IDLC and ILC. A prognostic model was developed and validated, offering precise predictions of OS and BCSS.
浸润性导管和小叶混合型乳腺癌（IDLC）是一种罕见且研究不足的乳腺癌亚型，具有独特的预后特征。
本研究分析了监测、流行病学和最终结果（SEER）数据库以及分子分类和乳腺癌生存预测（METABRIC）数据库的数据。使用Kaplan-Meier生存曲线和Cox回归分析，将IDLC的生存结果与浸润性导管癌（IDC）和浸润性小叶癌（ILC）的生存结果进行比较。基于这些发现，利用SEER队列开发了一种针对IDLC患者的预后模型，该队列被分为训练集（70%）和内部验证集（30%）。该模型纳入了临床和分子特征，并使用METABRIC队列进行外部验证。通过C指数、曲线下面积（AUC）、校准曲线和决策曲线分析（DCA）评估其性能。
共纳入26138例早期IDLC患者，以及391888例IDC患者和47571例ILC患者。在未调整分析中，与IDC和ILC相比，IDLC显示出更好的总生存期（OS）和乳腺癌特异性生存期（BCSS）。然而，经过多变量调整后，生存结果的差异有所不同。IDLC的OS优于IDC，BCSS优于ILC。此外，还开发了一种纳入临床和分子特征的早期IDLC预后模型。
本研究发现，在未调整分析中，早期IDLC具有更好的BCSS和OS。然而，经过多变量调整后，IDLC和IDC之间的BCSS没有差异，IDLC和ILC之间的OS也没有差异。开发并验证了一种预后模型，可对OS和BCSS进行精确预测。
