髓样乳腺癌与浸润性导管癌之间的特性和结局的差异：SEER18数据库人群研究

　　2016年3月17日，福建医科大学附属协和医院、复旦大学附属肿瘤医院在《肿瘤标靶》（Oncotarget）杂志在线发表了《髓样乳腺癌与浸润性导管癌之间特性和结局的差异：SEER18数据库人群研究》。

　　髓乳腺癌（MBC）是乳腺癌的一种独特组织学亚型。该研究旨在确定MBC与浸润性导管癌（IDC）之间的特征和结局的差异，并进一步确认MBC的预后因素。利用监测、流行病学和最终结果（SEER）数据库，研究人员确定了84764例符合条件的患者，其中309例MBC和84455例IDC。与IDC组相比，MBC组的确诊年龄较小、分级较高、分期较晚、肿瘤较大、三阴性乳腺癌（TNBC）比例较高。 Kaplan-Meier分析和单因素Cox比例风险回归模型显示，IDC患者的乳腺癌特异性生存（BCSS）显著优于MBC，但是总生存（OS）相似。然而在年龄、美国癌症联合委员会（AJCC）分期、分级和乳腺癌亚型1∶1配对后，MBC组织学不再是BCSS或OS的替代指标。此外，未婚、分级高、肿瘤大、淋巴结阳性、TNBC亚型、未接受放射疗法与不良BCSS和OS显著相关。总之，MBC表现出更侵袭性，但与IDC结局相似，这可能由预后因素决定，如乳腺癌亚型。这些结果不仅有助于更深入地了解MBC，还有助于个体化和针对性治疗，从而可能改善临床诊治及其结局。

Oncotarget. 2016 Mar 17. [Epub ahead of print]

Difference in characteristics and outcomes between medullary breast carcinoma and invasive ductal carcinoma: a population based study from SEER 18 database.

Wang XX, Jiang YZ, Liu XY, Li JJ, Song CG, Shao ZM.

Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.

Key Laboratory of Breast Cancer, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China.

Medullary breast carcinoma (MBC) is a unique histological subtype of breast cancer. Our study was designed to identify difference in characteristics and outcomes between MBC and invasive ductal carcinoma (IDC), and further confirm the prognostic factors of MBC. Utilizing Surveillance, Epidemiology, and End Results (SEER), we identified 84,764 eligible patients, including 309 MBC and 84,455 IDC. Compared with the IDC group, the MBC group was associated with younger age at diagnosis, higher grade, more advanced stage, larger tumor size, and higher proportion of triple-negative breast cancer (TNBC). Kaplan-Meier analysis and univariate Cox proportional hazard regression model showed that patients with IDC had significantly better breast cancer-specific survival (BCSS) compared to MBC, but they had similar overall survival (OS). However, MBC histology was no longer a surrogate for worse BCSS or OS after 1:1 matching by age, American Joint Committee on Cancer (AJCC) stage, grade and breast subtype. In addition, it was exposed that not married status, high grade, large tumor size, positive nodal status, the subtype of TNBC and no receipt of radiation therapy were significantly associated with poor BCSS and OS. In conclusion, MBC demonstrated more aggressive behavior but similar outcomes compared to IDC, which may be determined by prognostic factors such as breast subtype. These results not only confer deeper insight into MBC but contribute to individualized and tailored therapy, and thereby may improve clinical management and outcomes.

KEYWORDS: breast cancer-specific survival; invasive dutcal carcinoma; medullary breast carcinoma; overall survival

PMID: 27009810

DOI: 10.18632/oncotarget.8142