Lee Young-Won, Lee Sae-Byul, Chung Il Yong, Kim Jisun, Kim Hee Jeong, Ko Beom Seok, Son Byung Ho, Lee Jong Won, Yoo Tae-Kyung Robyn
Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea; Division of Breast Surgery, Department of Surgery, Ulsan University College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Division of Breast Surgery, Department of Surgery, Ulsan University College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Breast. 2025 May 9;82:104492. doi: 10.1016/j.breast.2025.104492.
This study aims to compare the efficacy of 5- versus 10-year endocrine therapy in pure mucinous breast carcinoma (PMBC), focusing on late recurrence and related factors for personalized treatment.
Patients with PMBC who underwent surgery from 1996 to 2014 at Asan Medical Center were included. Recurrence was categorized as early (<5 years) or late (≥5 years). The primary endpoint was disease-free survival in the 5- and 10- year endocrine groups. Subgroup analysis was performed focused on clinically high-risk patients (tumor ≥2 cm, nodal metastasis, or high histologic grade).
A total of 489 patients with PMBC were identified. During a follow-up time of 126 months, 35 (7.2 %) patients had an early recurrence, 25 (5.1 %) patients had a late recurrence, and 394 (87.7 %) patients had no recurrence. High histologic grade was the only factor significantly correlated to late recurrence (hazard ratio 6.92, 95 % confidence interval 1.53-31.3). Among the 5-year disease-free survivors (N = 416), 340 (81.7 %) and 76 (18.3 %) patients underwent 5-year and 10-year endocrine therapy, respectively. Endocrine therapy duration did not impact the 10-year disease-free survival rate (5-year [95.4 %] vs. 10-year [97.3 %] endocrine therapy, log-rank test p = 0.504). Subgroup analysis with clinically high-risk patients revealed no survival difference based on the endocrine therapy duration, too.
Extended endocrine therapy did not significantly reduce late recurrence in PMBC, even in high-risk groups, underscoring the importance of personalized strategies for sustained outcomes.
本研究旨在比较5年与10年内分泌治疗对纯黏液性乳腺癌（PMBC）的疗效，重点关注晚期复发及个性化治疗的相关因素。
纳入1996年至2014年在峨山医学中心接受手术的PMBC患者。复发分为早期（<5年）或晚期（≥5年）。主要终点是5年和10年内分泌治疗组的无病生存期。对临床高危患者（肿瘤≥2 cm、淋巴结转移或高组织学分级）进行亚组分析。
共确定489例PMBC患者。在126个月的随访期内，35例（7.2%）患者早期复发，25例（5.1%）患者晚期复发，394例（87.7%）患者无复发。高组织学分级是与晚期复发显著相关的唯一因素（风险比6.92，95%置信区间1.53 - 31.3）。在5年无病生存者（N = 416）中，分别有340例（81.7%）和76例（18.3%）患者接受了5年和10年的内分泌治疗。内分泌治疗持续时间不影响10年无病生存率（5年[95.4%]与10年[97.3%]内分泌治疗，对数秩检验p = 0.504）。对临床高危患者的亚组分析也显示，基于内分泌治疗持续时间的生存无差异。
延长内分泌治疗并未显著降低PMBC的晚期复发率，即使在高危组中也是如此，这突出了个性化策略对持续疗效的重要性。
